Inquest into the Death of Child MD (Name Subject to a Suppression Order)

2y · Male·multiorgan failure in a boy with clinically suspected sepsis and Cockayne syndrome

A 2-year-old boy with Cockayne syndrome (a rare life-limiting genetic condition) died from multiorgan failure due to clinically suspected sepsis following hospitalisation for acute illness with vomiting, lethargy and poor oral intake. He was admitted to Perth Children's Hospital paediatric ICU after initial presentation to a regional hospital. The coroner found that emergency department management was appropriate, including antibiotic selection (single agent ceftriaxone per guideline) and decision not to escalate to consultant—neither impacted outcome. A medication error occurred where acetylcysteine was given intravenously instead of by nebulisation on two occasions, but this was determined to be safe. The child received quality, compassionate medical care from dedicated staff. The child had been in appropriate Department care since birth following pre-birth planning due to maternal risk factors. A minor system issue regarding acetylcysteine formulation packaging was subsequently corrected to prevent recurrence.