A one-year-old girl who had a rare 'mermaid birth' and suffered from a heart condition died at Royal Cornwall Hospital after becoming unwell, an inquest has heard. Trixie Morvoren, known as Trixie Mo to her loved ones, was taken to the hospital after turning pale and drifting in and out of consciousness at home in Newquay.
She went to the paediatric assessment unit where staff struggled to insert a cannula so blood samples and intravenous treatment could be administered. She died on April 29 last year after she could not be resuscitated.
Parents' concerns over cannulation
Parents Ashleigh and James Cooke believe ultrasound guided cannulating should have taken place from the outset when staff knew Trixie Mo's history of cannulation difficulty and cardiac issues. They told the inquest in Truro how they feel senior consultants should have taken care of Trixie Mo rather than her being seen by registrars.
Rachel Nicholls, the consultant paediatrician who looked after Trixie Mo, told the hearing how registrars rather than consultants are the cannulation experts as they do it routinely, which is why she asked them to do it. She also said using ultrasound guided cannulation is a skill not every nurse or registrar has but is something the Royal Cornwall Hospitals Trust, which runs Treliske at Truro, is working to change and improve.
Rare 'mermaid birth' and heart condition
Ashleigh said Trixie Mo had an en caul birth or veiled birth, which happens when a baby is born completely enclosed inside an unruptured amniotic sac. En caul births occur in one in roughly 80,000 births. They are known as 'mermaid births' hence the middle name Ashleigh and James gave Trixie - Morvoren - which means mermaid in Cornish.
Born with Down syndrome, Trixie Mo was diagnosed with a congenital heart defect that required surgery in Bristol by the time she was six months old. The inquest heard how there were complications to the procedure but after four days in intensive care Trixie Mo pulled through and her physical development came on leaps and bounds after that.
Mother describes lack of urgency
Ashleigh, who had been almost eight months pregnant with her third child at the time of Trixie Mo's death, told the inquest how Trixie had thrown herself into every aspect of life, how Crazy Frog was her favourite song, how much she loved theatre and puppet shows and riding around her village on her ride-on car.
"Trixie Mo brought a big smile on people's faces," Ashleigh said. "Fish and chips was her favourite food and she would steal yours from your plate if you let her. She was developing a cheeky smile and had an infectious laugh."
Ashleigh told the inquest that "everyone seemed very chilled" when they took their baby to hospital. "I was baffled that no-one seemed that concerned," she said. "Why wasn't more effort made to give her supplementary oxygen? Everyone seemed so casual. There never seemed to be any sense of urgency."
Medical staff respond
The inquest heard several attempts were made to insert a cannula and take blood, and small 'crackle-like' sounds were found in her chest - which Dr Nicholls said could have been from an infection. Dr Nicholls also said difficulty cannulating Trixie Mo made it difficult to find the cause of her illness and tackle it.
Fellow consultant paediatrician Veronica Nijloveanu, who took over from Dr Nicholls later that day, said Trixie Mo's death had been an "extremely rare scenario". She told the hearing that Trixie Mo had had a successful complex cardiac surgery in Bristol the year before and all resuscitation processes on the day were followed thoroughly. She added: "We don't understand what happened."
Katy Huxstep, a consultant paediatrician at RCH, said looking forward, communication with patients and parents about treatment and procedures need to be improved. The inquest is expected to conclude on Wednesday.
