By Louise Roseingrave
A baby boy born with a chromosome defect died during a prolonged attempt to ventilate him prior to surgery. Baby Culann MacNeill of Knocknacarra in Co Galway was eight days old when he was transferred from University Hospital Galway for treatment in Dublin.
He had been born with DiGeorge syndrome, a disorder resulting in poor development of several body systems. The condition was suspected by medical staff but not diagnosed until proven at autopsy.
Born on January 7 2016, baby Culann suffered from seizures due to a lack of calcium. He was treated for this but a heart murmur was detected and his heart function began to deteriorate. He was critically ill when he was transferred to Our Lady’s Children’s Hospital in Dublin on January 15. Surgery was planned for the following day to correct an aortic abnormality. Prior to surgery medics decided to carry out a coronary angiography to assess the baby’s cardiovascular system.
The angiography procedure was deemed high-risk and there were five consultants present as baby Culann was given his anaesthetic. However, immediately after he was sedated, the consultant anaesthetist encountered difficulties inserting a tube into the infant’s airway because there was no ‘obvious opening’ in sight.
The first three attempts to insert the tube failed and while the fourth attempt was successful, the baby had been without oxygen for a period of five to 10 minutes because doctors were unable to direct air into his lungs. The infant suffered a cardiac arrest. Doctors battled for 30 minutes to save baby Culann's life. His parents were called into the room and he died in his mother’s arms shortly after 8pm.
The cause of death was hypoxic brain injury secondary to cardio vascular collapse at induction of anaesthetic due to failure of ventilation, with delayed intubation in the context of DiGeorge syndrome, according to Pathologist Dr Michael McDermott.
Dr McDermott said the child’s larynx was unusually far forward in his neck and this made if difficult for doctors to insert a tube into his airway to allow him to breathe.
Dr Orla Franklin said children born with DiGeorge can live long, happy and healthy lives but on the other end of the spectrum, some can encounter severe medical difficulties.
Coroner Dr Myra Cullinane returned a narrative verdict setting out the circumstances of the case.