Toddler ‘would have lived longer’ if antibiotics for common bug were given faster after mum describes ‘sheer agony’
A “BEAUTIFUL” toddler who died from sepsis would have lived longer if she’d been given antibiotics sooner, an inquest has heard.
Ava Hodgkinson was just two years old when she contracted deadly condition sepsis, which was caused by Group A Streptococcus.
Her dad, Adam Hodgkinson had taken her to see a GP at Beacon Primary Care at lunchtime on December 13th, 2022.
The GP, aware of the increased prevalence of Group A Streptococcus – a type of bacteria that can cause skin, soft tissue and respiratory tract infections – and asked a specialist nurse practitioner to issue a prescription of amoxicillin at 1pm.
However, this wasn’t done until 2.04pm.
As the pharmacy didn’t have the requested dose in stock, the GP surgery was contacted for an alternative.
But a new prescription wasn’t issued until the next morning, which meant Ava took her first dose of the antibiotics at 9.30am on December 14th.
Just hours later, her mum Jade rushed Ava to Ormskirk and District General Hospital where she collapsed and tragically died from “overwhelming sepsis” that was “likely” caused by Strep A.
A jury inquest into the toddler’s death heard from Dr Sharryn Gardner, who worked at Ormskirk and District General Hospital.
When asked if Ava would not have died or would have lived longer had she started the antibiotics “as originally planned”, Dr Gardner replied: “It is more likely she would have lived for longer.”
At the time, there was a nationwide shortage of amoxicillin due to increased demand caused by a spike in the number of Strep A cases.
Dr Rosalind Bonsor, GP partner at Beacon Primary Care, said the need to start Ava on antibiotics “wasn’t felt to be urgent” despite Strep A being particularly prevalent at the time.
“Many, many people were presenting worried about Strep A,” Dr Bonsor said.
“The walk-in centre had had an extremely busy weekend and people were concerned because it was in the news.
“People were worried on the background of the national news and they were bringing children in due to their concern. They were presenting in large numbers because of their worries about any kind of upper respiratory tract issues.
HIGH ALERT: Symptoms of invasive Strep A
Group A Streptococcus (GAS) – is also known as Streptococcus pyogenes – and is a bacteria that can cause mild illnesses like sore throats and skin infections, including tonsillitis cellulitis, impetigo and scarlet fever.
In rare cases, the bacteria can trigger the life-threatening illness, invasive group A Strep disease.
Guidance from the NHS states that there are four key signs of invasive disease:
- fever (a high temperature above 38°C (100.4°F)
- severe muscle aches
- localised muscle tenderness
- redness at the site of a wound
Invasive disease happens when the bacteria break through the body’s immune defences.
It can happen if you’re already ill or have a weakened immune system.
Two of the most severe examples of invasive disease are necrotising fasciitis and toxic shock syndrome.
You’re at increased risk of Group Strep A invasive disease if you:
- are in close contact with someone who has the disease
- are over the age of 65
- are diabetic, have heart disease or cancer
- have recently had chickenpox
- have HIV
- use some steroids or intravenous drugs, according to the NHS.
Group Strep A bacteria can also cause scarlet fever, which can be serious if it’s not treated with antibiotics.
“They had heard that this dangerous thing was about nationally. I don’t think the increased numbers reflected the increased prevalence – it reflected the increased concern.”
The GP added: “It wasn’t felt to be urgent with Ava. I can see why it ended up being urgent the following morning. There was no sense of urgency.”
Ava and her siblings all had Strep A
The toddler, from Banks near Southport, was ill at the same time as her older brother and sister towards the end of 2022.
While Ava’s siblings Isaac and Emilia recovered, she developed sepsis and tragically died on December 14th, 2022.
Following her death, Ava’s mum Jade described her as “the most beautiful, caring, funny, kind, most beautiful soul”, LancsLive reports.
Who gets sepsis and what causes it?
Sepsis can affect anyone. The condition occurs when the body’s immune system has an overeaction to an infection.
As a result, the body attacks itself.
Some people are more likely to get an infection that could lead to sepsis, however.
This includes babies under the age of one, people over 75 years old, people with diabetes or a weak immune system (either due to treatment, a condition or genetically), people who have recently had surgery or given birth.
Any infection can lead to sepsis. But those more likely to are those of:
- Lungs, such as pneumonia.
- Kidney, bladder and other parts of the urinary system
- Digestive system
- Bloodstream
- Catheter sites
- Wounds or burns
In a tribute after Ava’s death, Jade also said: “Words can’t describe the hell we are in. Living hell. Our Baby Angels Ava, you have been taken from our world too soon and so suddenly, you have left a trail of sheer agony and ripped our family apart.
“No one could see the events that have unfolded for us this week and we are tormented at every opportunity at something no parent should ever witness and I don’t know how I am ever going to get over that.
“You are the most beautiful, caring, funny, kind, most beautiful soul and it physically and mentally hurts to the core as to why this had to happen. You completed our family. You, Isaac and Emilia, built in best friends and as parents we are so blessed, lucky, proud at all three of you and how special and magical your bond was together.”
What are the symptoms of sepsis?
SEPSIS is a life-threatening reaction to an infection that happens when your immune system overreacts and starts to damage your body's own tissues and organs.
Symptoms of sepsis in an adult include:
- Acting confused, slurred speech or not making sense
- Blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
- A rash that does not fade when you roll a glass over it, the same as meningitis
- Difficulty breathing, breathlessness or breathing very fast
Symptoms in a child include:
- Blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
- A rash that does not fade when you roll a glass over it, the same as meningitis
- Difficulty breathing (you may notice grunting noises or their stomach sucking under their ribcage), breathlessness or breathing very fast
- A weak, high-pitched cry that’s not like their normal cry
- Not responding like they normally do, or not interested in feeding or normal activities
- Being sleepier than normal or having difficulty waking
They may not have all these symptoms.
If you think you or someone else has symptoms of sepsis, call 999 or go to A&E.
Source: NHS
Medications being out of stock “is a very common occurrence”, the inquest heard.
Since Ava’s death, several changes have been introduced at Beacon Primary Care, and staff across the surgery are now regularly informed about any medications that aren’t available.
The inquest, which is due to last four days, is still ongoing.