Girl, 13, in pain in Kettering General Hospital ‘asked mother if she would die’ before passing away from sepsis, inquest told

Chloe Longster was taken to the emergency department of Kettering General Hospital in Northamptonshire on November 28 2022 after she awoke with pain in her ribs and cold-like symptoms.

She was admitted to the paediatric ward, Skylark, that evening and was later transferred to intensive care where she was intubated, and died the following morning. At an inquest which began at Northampton Coroner’s Court on Monday, Chloe’s mother told assistant coroner Sophie Lomas that pain relief for her daughter was “delayed”.

Her parents were “devastated” by her death which they believe was “completely preventable”.

Chloe’s mother, Louise Longster, told the inquest that her daughter was “wincing and squirming” from pain while in hospital.

She said: “Chloe asked if she could be put to sleep because it was unbearable. I remember thinking how pale and clammy she looked. It’s harrowing to see your own child in so much pain.

“She was clock-watching constantly – she knew when her paracetamol and ibuprofen were due and it was always delayed. It was like we were chasing her pain rather than getting on top of it.

“Chloe asked me on Skylark if she was going to die. It’s haunting that the 13-year-old was the one that was right. It’s devastating.”

Mrs Longster said she heard Chloe’s chest “crackling” as she lay in the hospital bed, which she flagged to a nurse.

She said she felt that she was being a “nuisance” and “dramatic” because she was trying to get more help for Chloe. It was not until Chloe was put in a side room and diagnosed with influenza A that it was “taken seriously or acknowledged how much pain she was in”, Mrs Longstertold the court.

Chloe’s blood pressure was recorded for the first time on the system nearly eight hours after she arrived at the hospital. A&E consultant Dr Marwan Gamaleldin saw Chloe three or four times before she was transferred to the paediatric ward and believed she had a chest infection at the time.

He said: “It was already flagged that pain was the main thing. She did not come across as struggling to breathe. The pain was described as severe so the next logical step was to jump to morphine. She had four doses of pain relief with three different medications. I appreciate that maybe it was not enough, but it was four doses of pain relief.”

Dr Gamaleldin said that in the two-hour period that he observed Chloe, he “did not think” that she had sepsis. He told the court that there are four markers to diagnose the condition.

Two of these are high white blood cell count and fever, which the patient needs to have one of to be diagnosed with sepsis, and two other criteria which are heart rate and respiratory rate.

He said that Chloe had neither of the mandatory signs – high white blood cell count nor a fever.

Dr Gamaleldin said: “There are other things I should have started if I was thinking of sepsis, rather than antibiotics. I did not think Chloe had sepsis at this point.”

He said that Chloe’s chest X-ray showed “consolidation” on her lower left lung, where there is solid material rather than air, which suggested an infection.

Mrs Longster said the scan looked “terrifying” and Chloe’s lungs were not symmetrical.

Nurse Tricia Martinez triaged Chloe when she arrived at the hospital and had only recently joined the paediatric ward.

She told the court that Chloe looked in “agony” when she arrived in A&E so she “escalated” the issue and asked for the X-ray, but did not tick one of the boxes on a sepsis screening document.

She said: “The fault on my part was that I was not able to complete the sepsis form or go back to it after escalating. During the time that I saw her, something within said that there is something wrong with this child. We can only suggest or say she has possibly this or that, but the diagnosis will be given by the doctor.”

The inquest continues.