Consultant tells why heart op was delayed for tragic Jake Murphy
The paediatric cardiac consultant caring for an 11-year-old said he now wishes he had gone ahead with an operation he decided to delay eight months before the boy died.
Dr Andrew Sands told Londonderry Coroner's Court he decided not to carry out surgery to widen a valve in Jake Murphy's heart in 2012 because of the risks posed by the procedure.
Eight months later on July 7, 2013, Jake collapsed while playing near his home and was pronounced dead at Altnagelvin Hospital.
Despite the efforts of members of the public administering CPR, ambulance staff and medics at Altnagelvin, the youngster could not be saved.
Jake, the only son of Peter and Leona Murphy from Ardnamoyle Park in Derry, was diagnosed with the progressive heart condition aortic valve stenosis when he was a baby.
His parents told Coroner Joe McCrisken that he was an avid football fan who supported Liverpool, but he was frustrated by his condition because it meant he couldn't play the game.
Mr Murphy said that although he and his wife knew not to let Jake take part in strenuous activity, they were never told his illness was fatal.
He said: "If we had been told Jake could have dropped dead in the street, we would never had let him outside at all.
"But we were told that, outside of strenuous activity like playing football or boxing, Jake could be like any other child."
A play park that opened last year near where he collapsed has been named in his memory.
An earlier inquest, opened in March 2014, was postponed to allow further evidence to be collected about Jake's condition. It was reconvened in Derry yesterday.
Mr McCrisken was told by Dr Michael Rigsby, a consultant paediatric cardiologist at the Royal Brompton Hospital in England, that after he had reviewed all of Jake's medical notes he would have performed a surgical operation to widen his heart valve in 2012. He said that given the fact Jake had previously collapsed while he was walking home with a friend, had complained of chest pains while eating, and that previous tests for mercury levels in his blood showed a high reading, he would have operated. Dr Rigsby explained to the court that although he would have carried out the surgery, Dr Sands was not wrong in delaying the procedure because there was "no absolute perfect treatment" for the condition, and that taking the wrong decision would make a situation worse - it all depended on the individual child concerned.
He explained that sudden death was "rare", and that in his 33-year career he had only come across three cases where a child had died.
Dr Rigsby said that Dr Sands' approach to Jake's medical care was "conservative, but reasonable".
He added that Dr Sands' overall commitment to Jake was "very, very good".
Dr Sands told the inquest that Jake's death had had a deep effect on him, and he offered his sympathy to the boy's parents.
He explained the reasons why he and his team decided to delay operating were because although it was a low risk procedure, it was not a "no risk procedure".
He said that cardiac services in Northern Ireland were being reviewed at the time, which he feared would add to the risks.
He also said that they had been waiting on the results of an MRI scan that was to be carried out, but that "in hindsight I would have preferred to go ahead and not wait".
Mr McCrisken said in his findings that after listening to the evidence he believed the "decision not to operate wasn't unreasonable, but a matter for clinical judgment".
The cause of Jake's death was found to be aortic valve stenosis with left ventricular hypertrophy.