Baby's Death From Meningitis Could Have Been Prevented, Inquest Hears

A five-month-old baby girl likely would have survived meningitis if she had received antibiotics sooner and medical staff had considered diagnoses beyond COVID-19, an expert witness stated at an inquest. Baby Esta High died on November 2, 2023, at Leeds General Infirmary, with the inquest jury hearing of "missed opportunities" in her care.

Professor Simon Nadel, a consultant in pediatric intensive care, testified that the chances missed at the hospital "more than minimally, negligibly or trivially" contributed to Esta's death. Her parents contend that clinicians overlooked crucial signs of a bacterial infection, focusing instead on her COVID-19 diagnosis.

Esta was taken to the emergency department on October 31, 2023, by her parents, Lynsey Carr and Leon High, presenting with a high temperature and vomiting. The inquest heard that Esta tested positive for COVID-19 and, despite her parents' concerns, hospital staff initially intended to send her home. However, she was kept in the hospital due to the parents' worries.

Professor Nadel agreed with questions posed by the family's representative, Rachel Young, that a missed opportunity occurred on October 31 to comply with national guidelines for blood tests and cultures, which materially contributed to the outcome. He also affirmed that further missed opportunities to save Esta's life occurred between the night of November 1 and the morning of November 2.

During these periods, observations of Esta should have prompted a medical review by a senior doctor, leading to a revised diagnosis and earlier administration of antibiotics, Professor Nadel stated. He further agreed that a doctor's decision around 8 a.m. on November 2 to continue attributing Esta's symptoms to COVID-19, rather than pursuing an antibiotic-based treatment, also "more than minimally, negligibly or trivially" contributed to her death.

By midday on November 2, when Esta began showing seizure activity, antibiotic intervention would likely have been too late, the professor testified. Under questioning from Megan Crowther, representing Leeds Teaching Hospitals NHS Trust, Professor Nadel acknowledged that his opinion on the precise timing for a different outcome had evolved, emphasizing the difficulty in establishing exact timelines and that his opinions were based on the balance of probabilities.

He also noted that the presence of COVID-19 complicated decision-making for the medical team. "I have said all along that the earlier antibiotics were started the more likely that the outcome would have been different," Professor Nadel stated.

Professor Nadel concluded that his professional opinion was that the cause of Esta's death was pneumococcal meningitis, though he deferred the formal determination to the jury. Last week, Esta's mother, Ms. Carr, had described her daughter as a "happy, healthy, smiling girl" before she became ill. She recounted how her and Mr. High's concerns about Esta's deteriorating condition were repeatedly dismissed by hospital staff until it was too late.

Ms. Carr stated that the family felt staff were more focused on isolating Esta due to the COVID-19 risk than on listening to their concerns. She added that the family's worries, documented in a video shown to the jury, were "dismissed on multiple occasions." Ms. Carr told the jury, "Unfortunately, as our daughter had been left untreated for 55 hours, it was too late to save our darling girl."

Esta's parents described their daughter as "bright, beautiful and perfect from the first moment" and said, "When she arrived, she completed us." The inquest is ongoing.