Broome baby died of pneumonia, ‘could have lived’ if treated adequately

A five-week-old baby who died of pneumonia despite being taken to Broome Hospital on three occasions in four days could have lived if she had been admitted sooner and adequately treated, an inquest has been told.

Masaly Mosby was taken to the emergency department with her mother and aunt on Sunday, October 2, 2011, because of concerns over fever and vomiting.

She was assessed by a nurse and a general practitioner, who diagnosed her with a head cold.

The baby was prescribed Panadol and discharged.

Baby Masaly was taken to the hospital by her aunt two days later after developing a cough, abnormal breathing, nasal flaring and a “funny cry”.

On this occasion, the baby was not seen by a medical practitioner and was taken from the emergency department after waiting for 20 minutes without speaking to nursing staff.

The baby was taken in for the third time on October 5 because of cough and fevers and waited nearly two hours.

She was discharged against advice after having been seen by nursing staff and a sixth year medical student.

She was triaged as category three, which meant she should have been seen within 30 minutes by a doctor. The court was told the baby was brought into hospital the next day in full cardiorespiratory arrest and died that morning.

An autopsy on October 10 found the baby had died of acute necrotising pneumonia.

During the inquest in Broome, the court was told baby Masaly’s heart rate was abnormally high when she first presented at the hospital, with reading of 185.

A normal heart rate is considered to be about 160 for her age.

Paediatrician Dr Paul Porter, who reviewed the case, said the high heart rate could have been a sign of infection.

He said a urine sample should have been taken to rule out a urinary tract infection and an observation period of at least 12 hours followed to rule out a respiratory tract infection.

Dr Porter said the baby’s deteriorating condition from the second visit indicated she had a respiratory disease, based on her “funny breathing” and nasal flaring.

He also said on the occasion she was discharged from the hospital without a formal assessment, there should have been a follow-up.

He said though the observations “did not scream” Masaly was a “very unwell child,” her history and prolonged illness made them significant.

He said that if baby Masaly had been admitted, he would have expected her to survive.

Dr Murtaza Khanbhai, who assessed baby Masaly on her first visit, said the baby did not present with any “abnormal” symptoms at the time he examined her.

Dr Khanbhai said he advised the mother to give the baby Panadol if she got feverish and if the baby was still unwell, to come back to the hospital.

The inquest continues.