An inquest has concluded that systematic failures in care at Royal Bolton Hospital contributed to the death of a premature baby twin. Kingsley Olasupo died at 10 days old from bacterial meningitis and sepsis in April 2019, but the coroner said he would have survived if antibiotics had been given earlier.
Kingsley and his sister Princess were born at 35 weeks. While Princess fed well, Kingsley had a low birth weight and low temperature—both infection risks. A senior neonatal practitioner wrongly recorded no meconium at birth and did not escalate his care to a doctor. His heart and respiratory rates were also not recorded.
Under guidelines, his poor feeding and low temperature should have triggered an infection test, but this did not happen until 12 April. A midwife said she contacted a paediatrician about his low temperature but was told to put a sleep suit on him. “I felt if you have a concern … it should be acknowledged and acted upon,” she said.
Coroner Peter Sigee stated: “There were individual and systemic failures … these amounted to a gross failure to provide basic medical care to Kingsley and they were causative of his death.” He noted the Newborn Early Warning System was not in use on the ward at the time.
Bolton NHS Trust apologised and said it had “made significant changes” to its practices. New guidance states babies should receive antibiotics within an hour of a detected infection risk. Kingsley’s father Tunde Olasupo said: “We want Kingsley to be remembered as the baby who put new and better policies in place.”
