Belfast Telegraph

Parents of child who died in hospital didn’t know daughter was gravely ill

By Anna Maguire

The parents of a nine-year-old girl who died in hospital 16 years ago have spoken of her final anguished moments.

Alan and Jennifer Roberts told an inquiry of their concerns that they were not told by medical staff about the seriousness of their daughter’s condition — which they believed to be nothing more than a tummy bug.

Claire Roberts’ death is one of five being examined by an independent public probe into hyponatraemia-related deaths of children in Northern Ireland hospitals.

Hyponatraemia is a condition where there is not enough salt in the body which causes the brain to swell.

Claire, who they described as active and always chatting, died two days after she was admitted to the Royal Victoria Hospital for observation on October 21, 1996.

The Castlereagh schoolgirl had been suffering from vomiting and lethargy.

Claire’s parents told the inquiry that while they were told by a nurse that she had a comfortable night on October 21, they later discovered she had suffered continuous vomiting.

Alan and Jennifer Roberts said they were also not aware that Claire’s neurological performance was being recorded, that she was being observed hourly or what medication she was receiving.

The day after Claire was admitted to hospital, Jennifer Roberts witnessed her daughter — who had a history of

epileptic fits as a baby — suffer a “violent” seizure.

She said medical staff did not examine Claire when she informed them of the incident. Mrs Roberts said: “She (a nurse) told me to write it down on the sheet.”

Breaking down, she described as “very distressing” comments by the inquiry’s senior counsel that some nurses had formed the opinion that Claire was the sickest child on the ward at that time.

The couple recalled being informed that their daughter may have been experiencing internal fitting, which he was seeking a second opinion about.

However, Mr Roberts said they were not aware of any serious neurological condition.

“There was nothing to raise concerns for us at that time that she (Claire) had anything other than what we knew, which was a tummy bug.”

The couple left their sleeping daughter shortly after 9pm on October 22.

Around seven hours later a doctor called them to say Claire was being transferred to intensive care and to come down to the hospital immediately.

When they arrived they were shocked to be informed that there was a build-up of fluid around Claire’s brain and a CT scan confirmed she was brain dead.

Yesterday, Mr Roberts said the couple would never have left their daughter if they were aware of concerns about her condition.

He added: “There was no discussion with a doctor. There was no, ‘we need to discuss Claire's state or condition’. That just did not happen.”

On her last weekend she helped buy some flowers for a harvest festival. On Monday she was unwell. Two days later Claire passed away

By Anna Maguire

Alan and Jennifer Roberts, whose nine-year-old daughter Claire (top right) died in the Royal Belfast Hospital for Sick Children in 1996. Below right: The scene inside Banbridge Courthouse where the inquiry is being held Jonathan Porter/Presseye

Claire Roberts’ mother broke down a number of times as she relayed the final days and hours of her only daughter’s life.

At one point, recalling a telephone conversation with a cousin in Scotland hours before Claire died, the inquiry paused for 10 minutes to allow Jennifer Roberts to compose herself.

She was describing a brief call with her cousin in the nurses’ office of the hospital ward where Claire was being treated for what her parents thought was a simple “tummy bug”.

Before leaving for the evening, Jennifer had popped in to tell the nurses that Claire was sleeping and settled.

When the phonecall came through, Mrs Roberts told her cousin that Claire would be fine and had just been experiencing an “unsettling” few days.

Less than 10 hours later, Jennifer and her husband Alan faced the devastating news that nothing more could be done for their daughter.

A CT scan had confirmed that she was brain dead.

As far as the Roberts were aware, the stomach virus had spread to Claire’s brain, causing a fluid build-up.

Recalling the conversation they had with Claire’s doctors in the early hours of October 23, 1996, Mr Roberts said: “I think she (Claire’s doctor) maybe used the terms enterovirus and explained to us that viruses can

originate in the stomach and other parts of the body and they can move into other areas of the body, ie the brain. And it was the virus that had caused Claire’s brain to swell.”

Claire’s parents did not question that version of events until they watched a UTV documentary years later, which looked at the deaths of other children in Northern Ireland.

Her death is now one of five being examined by an independent public inquiry into hyponatraemia-related deaths of children in Northern Ireland hospitals.

Hyponatraemia occurs when there is a low amount of sodium in the bloodstream. Mr Roberts said he did not recall Claire’s doctors mentioning in the early hours of October 23 that low levels of sodium may have led to her condition.

The Castlereagh schoolgirl died that evening, when her life support was turned off following a second set of brain scans.

Just 72 hours earlier the bubbly nine-year-old had been enjoying a typical weekend with her family.

Her parents recalled their only daughter spending time with her cousins and grandparents, shopping for flowers for the harvest festival which she was due to celebrate at school on Monday. Mrs Roberts told the inquiry yesterday: “Claire was always very happy and active.”

Claire, who loved singing, did take part in the harvest celebrations that Monday, the only time her colour recovered on a day her teachers noted her as pale and lethargic.

When Claire returned home that afternoon, she vomited a number of times, prompting her parents to call her GP.

The schoolgirl, who had learning difficulties, was admitted to the Royal Belfast Hospital for Sick Children on the evening of Monday, October 21, for observation.

The following morning her parents expected to find her “bouncing about the bed”.

But they found no improvement. She was lethargic and, for a girl who was “always chatting”, there was little communication.

Claire’s parents spent the morning with her before leaving their daughter with her grandparents while they went into the city to buy her “a treat”.

Mrs Roberts broke down as she recalled how her daughter had grabbed her grandfather’s hand during a consultation with a doctor in their absence.

Just over 24 hours later, having received the devastating news that their child was brain-damaged, Jennifer and Alan Roberts were faced with a terrible decision.

That evening, they turned off Claire’s life support machine, shortly before 7pm, and she passed away.

The issues central to the public inquiry

Nine-year-old Claire Roberts died two days after she was admitted to the Royal Belfast Hospital for Sick Children on the evening of October 21, 1996.

Her death, 16 years ago, is one of five being examined by an independent public inquiry into hyponatraemia-related deaths of children in Northern Ireland hospitals.

The inquiry is examining the deaths of three children — Adam Strain, Claire Roberts and Raychel Ferguson — as well as the events following the death of Lucy Crawford and issues arising from the treatment of Conor Mitchell.

The issue of fluid management, and the issue of hyponatraemia, is central to the cases of each of the children.

Hyponatraemia, which occurs when there is a low amount of sodium in the bloodstream, is the common thread connecting the five deaths.

In the case of four of the children, the inquest verdict stated that hyponatraemia was a factor which contributed to their deaths.

Among a series of issues the inquiry is examining in relation to Claire Roberts’ death are whether there was a failure to respond adequately to an early indication that Claire’s blood sodium level was low, and whether Claire’s fluid management was appropriate, in view of her symptoms.

Claire, who had a learning difficulty, has been described by her parents as a “loving and active child”, who was “a dream come true” for her family.

She was admitted to Royal Belfast Hospital for Sick Children on October 21, 1996, after suffering vomiting and lethargy that day. On admission, she was prescribed intravenous fluids in the form of Solution No 18, which she continued to receive during her time in the hospital.

The solution is used for patients where there are concerns about depleted water and sodium levels.

Claire died shortly before 7pm on October 23, two days later.

During an emotional day of evidence yesterday, Claire Roberts’ father Alan said he could not recall Claire’s doctors mentioning in the early hours of October 23 that low levels of sodium may have led to her being diagnosed as brain dead.

The Castlereagh schoolgirl died that evening when her life support was turned off.

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