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Welsh boy, 9, died days after being sent home from A&E 'with suspected flu'
A nine-year-old boy was sent home with a suspected case of flu, only to tragically pass away days later from a ruptured appendix, an inquest heard. Dylan Cope, from Newport, died on December 14, 2022, just a week after his parents rushed him to A&E due to severe abdominal pain.
The inquest at Gwent Coroner's Court on Monday, May 20, revealed that Dylan was a "fit and healthy" boy before he fell ill in early December 2022 with stomach pain and vomiting.
Dylan's father Laurence described his son as "feisty and sensitive", who loved baking with his mum, wrestling with his brother, and bouncing on the trampoline. He was described as "loving" and a boy who "nothing delighted more than hearing Alexa say 'free hugs available in the lounge'" when he would eagerly run in to get one from one of his family.
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Dylan's father said his son had a "quirky sense of humour" and enjoyed computer coding and science at school. He enjoyed building Lego and was a "problem solver" who his father said would regularly find answers to things such as solving a Rubik's cube by looking it up or watching videos on YouTube. He said: "On the day we were meant to be proudly watching Dylan in his school Christmas play dressed as a little reindeer, instead we watched him dying," WalesOnline reported.
The inquest heard Dylan had been unwell on December 2 and vomited but by December 4 had returned to normal other than having a mild cough. He was not sent to school as as his parents were concerned about him passing on any illness or picking up something like Strep A. On December 6 he still had a cough and had lower abdominal pain, so he was given some Calpol and ate lunch as normal. Later than day he complained of "excruciating" abdominal pain and was brought to his GP who noted he had stiffness in his lower abdomen, known as guarding, and which is a sign of an inflamed appendix. His GP referred him to Grange Hospital's emergency department and he was brought there by his parents.
That night in AandE Dylan was triaged and assessed by a practitioner who said his symptoms were a "mystery." He had a nose swab taken and urine test done, and he tested positive for influenza. A male medic later visited the family and said it was "highly unlikely" Dylan had appendix issues as he had complained about the pain being worse on his left side, the opposite side to where the appendix is located.
He was discharged after 1am on December 7, 2022 with a cough and cold advice sheet and his father was informed he should give Dylan Calpol, allow him to rest and that he would start to notice improvements in the coming days. However, Dylan's symptoms did not improve and he complained of intermittent abdominal pain, was too unwell to attend school and was not eating.
On December 10, 2022 Dylan's family were concerned he was not improving and called the emergency number given to them when they left hospital. At 11.41am they got through at the 19th attempt and were told to call the NHS 111 number.
Dylan's father rang 111 and while he was waiting on hold they noticed Dylan was breathing more quickly. He was on the phone waiting for over two hours before getting through at 2.45pm. He said his son had cold hands and feet and was told by the call handler that a doctor would call them back.
However, Dylan then began complaining of pain in his legs and the parents decided to take him to AandE. Laurence drove him there while Dylan's mother Corrine followed on after arranging childcare for their two other children, and they arrived at the Grange Hospital at 4.10pm. There he was transferred to the University Hospital of Wales where he underwent an appendectomy. He died four days later on December 14. A medical cause of death was initially given as septic shock with multi-organ dysfunction caused by a perforated appendix.
Samantha Hayden, a paediatric nurse practitioner, told the inquest she carried out an assessment of Dylan in the Grange at around 10pm on December 6, 2022, which included taking a nose swab. She said she did not consult the GP referral made for Dylan before doing her assessment, adding that this would have been a "guide" but that the hospital was "exceptionally busy" that night and that the computers where this could have been reviewed were in rooms already occupied by patients, and that she felt it more important to have Dylan assessed.
She said she "doesn't recall" asking Dylan or his father how severe his abdominal pain was but noted he had expressed several times that the pain was worst on the left side. She said he had swollen lymph nodes and congestion in his throat and that his symptoms were a "mixed bag" which indicated a number of possible causes including flu, appenditicis and peritonitis, noting that tests for influenza had come back positive.
Asked by senior coroner Caroline Saunders why she did not include any mention of pain in Dylan's lower right abdomen in her statement, she said: "I'm not sure." Asked whether it would have altered her view about potential appendicitis if she had read the GP referral which mentioned guarding on the abdomen, a symptom of an inflamed appendix, she said it would not as she was already considering appendicitis as a possibility along with other potential causes. She confirmed she did not request a blood test due to the "number of differentials" in symptoms she was dealing with, adding that she had discussed with Dylan's father a number of possible reasons for why he was unwell.
Ms Hayden said a senior review was planned for another healthcare professional to carry out on Dylan. She later completed a discharge summary before this senior review took place. Ms Saunders put it to her that this indicated she had "already made up her mind" about what was wrong with Dylan, but Ms Hayden said these summaries were "pre-empted" and later reiterated that the fact a senior review was happening would not be something she would have to include. The inquest continues
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