A two-year-old girl tragically died from natural causes after suffering an “acute event” in a taxi with her mother, an inquest has heard.
Lilly-Mae Woodall had “very complicated medical needs” and was admitted to University Hospital Lewisham on February 24, 2020, with a high temperature.
The infant was a well-known patient to the paediatric unit, as she required a gastric tube for all feeding and medicine, had slow development and required home oxygen to maintain breathing.
Giving evidence of her condition when she had been admitted to the emergency unit, consultant paediatrician Dr Sarmad Kalamchi explained that Lilly-Mae had a background of “severe neurological disability” from birth which included an unsafe swallow.
Describing her as a “beautiful girl”, he told Inner South London Coroners Court: “It means the muscles are weak and not well coordinated. She doesn’t have the ability to protect her airway when food contents come up, so she’s always at risk of asphyxia.”
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Two weeks prior to being admitted to hospital, she had been diagnosed with a chest infection and had been prescribed antibiotics.
Dr Kalamchi said that her temperature and heart rate was monitored every 50 minutes to an hour but it was not believed to be necessary to order an X-ray or blood tests.
Mr Thomas Jones, the lawyer representing Lilly-Mae’s mother Donna Arnold, had questioned why she had been discharged that evening when her heart rate was above normal and she still maintained a high temperature.
However, Dr Kalamchi said that her breathing was regular, she hadn’t needed any increase in her oxygen requirement and she wasn’t vomiting as much as usual, therefore it was deemed reasonable that she be discharged.
The inquest also investigated the provisions in place within Greenwich for a community nurse facility, which could have instigated a check on the family the following day.
He told the court: “I accept we could have done more to engage with the community, or phoned Lilly-Mae or Mum to see how she was doing the next day.”
On February 25, Lilly-Mae’s condition had seemingly improved and her temperature had reduced.
However, all of this was to change the following day after Ms Arnold realised that her daughter was once again becoming ill, and decided to take her to hospital for review.
After hailing a taxi, she realised that Lilly-Mae had become “unresponsive” and when passing an ambulance station, she stopped and alerted the attention of the paramedics who begun immediate CPR.
In his summary, Assistant Coroner Julian Morris said: “Everything had seemed calm when the taxi driver picked them up. Only when passing the ambulance station there was a cry from the back asking him to stop. The events were an unexpected shock.”
Paramedics had described Lilly-Mae as “lifeless” and begun immediate chest compressions whilst administering doses of adrenaline.
PEM consultant Dr Benjamin Cahill told the inquest that Lilly-Mae had entered cardiac arrest, and after arriving at hospital, his team spent 58 minutes attempting to resuscitate her.
He noted that she had endured “severe brain damage” and that continued CPR would be “futile”, therefore after consulting with his team, she was pronounced dead at 7:34pm.
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A post-mortem examination found that Lilly-Mae had large amounts of gastric contents in her airway and her cause of death was listed as aspiration pneumonia.
In his closing statement, Coroner Morris said: “I conclude on balance that there was an acute event in the taxi that led Lily-Mae to stop breathing.
“The coincidence of being outside an ambulance station did not alter the outcome.”
He also noted: “In respect of her condition on the 25th, I do not believe that a lack of community review contributed to her demise”, and said that her discharge from hospital on the 24th did not contribute to her “sad outcome”.
He offered his condolences to the family, telling them: “I’m not sure I can begin to understand the loss of a child at the age of 2.”