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11 chances to treat chess champion in months before asthma death, inquest told

There were 11 opportunities to treat a nine-year-old chess champion in the months before he died of chronic asthma, an inquest heard.

Michael Uriely was taken to the Royal Free Hospital in London twice in the days before his death after he suffered violent coughing and vomiting fits which left him struggling to breathe.

The national chess champion, from St John's Wood, north-west London, died on August 25 2015, five days after being discharged from the hospital for the second time.

In the months before his death he was also seen by NHS GPs, as well as having private doctor appointments.

Michael's mother Ayelet Uriely said in a statement that she was "devastated beyond words" about the loss of her son, who she described as "highly gifted".

Westminster Coroner's Court heard that there were chances to treat Michael in the months before his death.

While dealing with Mrs Uriely's statement to the inquest, Coroner Dr Shirley Radcliffe said: "There was 11 opportunities within seven months to appropriately test, diagnose and treat him."

The inquest heard Mrs Uriely "felt strongly" that her son was denied basic care. As early as February that year, Mrs Uriely asked a doctor about the chances of her son dying as she felt his condition was deteriorating.

Mrs Uriely said Michael's father Roy took their son out of the room and she asked the doctor about "the likelihood of death".

She said he responded to her by saying: "What are you talking about?"

She told the inquest he said that Michael was "not in this category".

Mrs Uriely told the inquest she made requests for Michael to be referred to an asthma clinic as well as Great Ormond Street Hospital, but these requests did not materialise before his death.

She said she was told on one occasion that Michael's condition "didn't require it".

Michael was admitted to the Royal Free Hospital on August 18 and discharged at 8pm the same day.

He was readmitted on August 19 and sent home again the following day.

On August 18, Mrs Uriely said she thought he was having the worst asthma attack she had ever seen him having.

But she said she was told: "You don't really need to be here. You should go home."

She told the inquest: "I said: 'I can't go without you doing some sort of test.'"

Mrs Uriely said they were told "something like we were wasting their time", and that Michael would grow out of asthma.

The child was brought back to the hospital in the early hours of August 19, and by this stage was having violent bouts of vomiting as well as a bloated chest.

The inquest heard he was told that he was "hysterical" and not having an asthma attack.

Mrs Uriely was told he was being discharged that afternoon but she said she told staff: "I am scared my son will die tonight".

She also said Michael himself said he was "afraid to die", adding that he was "not the kind of person to say something like that".

Mrs Uriely told her son: "Mummy's here."

She told the inquest: "I said: 'I'd never let anything bad happen to you.'"

She said she spoke to staff about the "worst case scenario" but was told she was on a "wild goose chase".

There was no improvement in Michael's condition on August 21, the inquest heard.

Mrs Uriely made an appointment with Dr Aisha Laskor, believing that her son had been prematurely and inappropriately discharged from hospital.

She felt the prospect of leaving him untreated for the weekend was "frightening" and felt that at this stage it was "imperative" that the referrals she had requested were sorted.

The inquest heard that Dr Laskor expressed shock that the hospital had failed to treat Michael - but the two women disagree about what was said during the appointment.

"Your recollection is completely different," the coroner said.

Dr Laskor said she was "concerned enough to consider calling for an ambulance", but decided not to send him to hospital.

She said her "gut instinct" was to send him back to hospital, but she said Mrs Uriely told her he was better since he was discharged - something Mrs Uriely says is untrue.

The doctor said she told the Urielys to stay in the waiting room for 20 to 30 minutes after the appointment so that if they needed to see her again they could do so.

Representing the Uriely family, Adam Korn put it to Dr Laskor: "It's not true, is it, that Mrs Uriely said Michael had got better?"

He suggested she was saying that to "justify" her decision to send him home.

Later in her evidence, a tearful Dr Laskor said: "I was still questioning my decision that evening."

Asked if Mrs Uriely appeared to be "desperate", the doctor said: "I would have to say that no, she did not appear desperate."

Michael died on August 25 after he collapsed in the early hours and never regained consciousness.

The inquest heard from expert Dr Mark Levy who has been a GP for 40 years and has published more than 140 papers on asthma. His statement said that Michael's asthma was "poorly controlled" in the last year of his life.

Dr Levy also said that children with severe asthma "should be seen by a respiratory specialist".

He added: "Severe asthma should be treated by a specialist, somebody with expertise."

The respiratory rate of 36 that Michael had during the August 21 appointment is considered to be "life threatening", Dr Levy said.

Meanwhile, Dr Michael Greenberg, from Wellington Outpatients Centre in Golders Green, was asked if he had declined Mrs Uriely's request to be referred to Great Ormond Street Hospital.

He said he does not recall that conversation, and added: "I would have happily made those referrals."

Asked if he could remember having a conversation with Mrs Uriely in February about the likelihood of death, Dr Greenberg said: "No I don't remember that conversation."

The inquest also heard from paediatrician Dr Neil Thompson who had seen Michael at the Royal Free Hospital on August 18.

He denied using the word "hysterical" to describe the child, and asked if he could recall Mrs Uriely "begging" not to be left to deal with Michael's cough alone, he said he could not.

The court heard Dr Thompson thought Michael's cough was likely to be "viral", and he said: "He had no wheeze. He had good air entry." He did add that he knew Michael was having "an exacerbation" in his asthma.

The inquest continues at 9.30am on Thursday.

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