A FIVE-YEAR-OLD boy who suffered a spasm at the conclusion of a simple medical test in a Sligo hospital died two days later, an inquest has heard.
Jessey Acheampong (5) of Glen Park, Foxhills, Letterkenny, Co Donegal, underwent an auditory brainstem evoked response (ABR) to investigate deafness, snoring and delayed speech at Sligo General Hospital on August 22nd, 2007.
The non–invasive procedure, under general anaesthetic and which lasted 50 minutes, was uneventful and the boy’s vital signs remained stable throughout.
At the end of the procedure, locum anaesthetist Dr Eugene Egan decided to insert a gastric tube to remove gas from the child’s stomach, (which was dilated due to the use of a face mask to put him to sleep), to minimise the chances of his vomiting.
He wanted to show a junior doctor how to deflate a stomach using such a tube.
The first attempt failed as the tube curled and Dr Egan attempted it again by shorting another tube and passing it behind the larynx before inserting the smaller gastric tube.
The anaesthetic “lightened” during the procedure and the boy developed severe spasm of his voice-box (laryngeal spasm) and blood was observed coming from his mouth. “The child bucked unexpectedly,” Dr Egan told the inquest at Dublin City Coroners’ Court yesterday.
The doctor had deepened the anaesthetic prior to passing the tubes to minimise the possibility of such a spasm, which is a recognised complication, the court heard. Dr Egan removed the tubes and attended to the boy, putting him on 100 per cent oxygen.
He called for the assistance of a surgeon after 15 minutes when the bleeding continued and the boy’s oxygen saturation levels continued to be difficult to maintain.
“I thought I must have torn the tissues in some way, and called colleagues,” said Dr Egan.
Surgeon Dr Javed Munir, who performed an examination under further aesthetic, was unable to locate any source of bleeding in the boy’s mouth, throat, food pipe or upper airway. A subsequent postmortem would show no trauma was found.
The boy was removed to the ICU and his condition improved somewhat that night.
Efforts were made to transfer him to one of the children’s hospitals, but by the time he reached Our Lady’s Children’s Hospital, Crumlin, on the afternoon of August 24th, he was near death and his pupils were fixed and dilated. He was pronounced dead that afternoon.
Anaesthetist Dr Ronan O’Hare had contacted Temple Street Children’s Hospital with regard to transfer on August 23rd, but there was no bed available.
Coroner Dr Brian Farrell said the spasm led to haemorrhage into the lungs, leading to death.
He recorded a narrative verdict and expressed his condolences to the boy’s father, Kofi Acheampong, who was in court, accompanied by two friends. His wife Elizabeth was too upset to attend.