An incorrectly placed breathing tube could have contributed to the death of a 13-year-old boy who became Britain’s first known child with Covid-19, a doctor inquest into his death has told.
Ismail Mohamed Abdulwahab, from Brixton in South London, died of acute respiratory distress syndrome caused by coronavirus pneumonia in the early hours of 30 March 2020, three days after testing positive for the virus.
He was admitted to King’s College Hospital in London after developing fever, cough, shortness of breath, vomiting and diarrhea, and suffered a heart attack before dying.
Hours before his death, an endotracheal tube – which is used to help patients breathe – was found to be in the wrong position and it was decided to leave it in and monitor him.
The inquest at the London Inner South Coroner’s Court is examining whether the endotracheal tube should have been reinserted.
Dr. Tushar Vince, Consultant Pediatric Intensive Care at the hospital, treated Ismail after he had already been intubated.
Giving evidence through video link, Vince said that the death of the teenager could have been due to the wrong position of the windpipe.
When asked by the coroner whether it would be appropriate to put tube position on the death certificate as one of the causes, Vince said: “I think it would be appropriate to consider that, yes.”
She said the fact that the tube was not in the right place “on a fundamental level” contributed to cardiac arrest.
The court heard that the consultant had seen X-rays of Ismail’s chest. When asked what this said about the position of the tube, he said: “It’s too high.”
She said: “I fully admit I just didn’t look. I was so focused on the lungs that I didn’t see how high up the tube was and I’m sorry I didn’t see it.”
Anuj Khatri, another paediatrician, told Vince at around 9.30am that the tube was too high, and after a conversation about the risks of moving or not moving it, Vince decided not to re-insert it, the court said. heard.
During the deposition, Khatri told the court that he did not agree with his colleague’s decision. He said he believed the situation was “urgent” because the tube could be dislodged, which was “potentially life-threatening and paralyzing” for patients using muscle relaxants.
Vince told the court that a dislodged tube should not “easily” lead to cardiac arrest in previously fit and healthy children.
The court heard how Ismail was one of the first children with coronavirus that Vince treated. She said: “We all thought we were going to die from being exposed to Covid. We all thought the worst could happen and we could take it home to our families and we could kill them.
Vince said: “It was terrifying to be there.”
A statement read out in court by Ismail’s eldest sister described the teenager as a “kind and genuine soul”. She said that a few hours before her death she had received a phone call requesting that a family member come to see Ismail.
“Once we arrived, we were met with the terrible, shocking and sad news of his passing,” said his sister. “We are overwhelmed with grief at his passing.”
The inquiry is on.