A newborn baby who died in a Glasgow hospital after developing an infection was “stable” the day before she passed away, an inquiry has heard.
Sophia Smith was just 11 days old when she died at the Royal Hospital for Children (RHC) at Queen Elizabeth University Hospital (QEUH) campus in Glasgow on April 11 2017.
The newborn became ill with an infection similar to MRSA, which developed into sepsis.
In 2020, Sophia’s case was handed over to the Crown Office and Procurator Fiscal Service (COPFS) which, earlier this year, announced a Fatal Accident Inquiry (FAI) into her death.
Sophia was born at the Royal Alexandra Hospital in Paisley, Renfrewshire, on March 31 2017.
The FAI is being heard at Glasgow Sheriff Court (Andrew Milligan/PA)
The inquiry heard that following her birth Sophia had difficulty breathing and a possible heart issue, so she was transferred to the neonatal intensive care unit (NICU) at the RHC.
There she was placed in an incubator with one-on-one nursing care and a “raft of machinery” next to her cot.
She was also given antibiotics via lines into her body, initially in her abdomen and then in her left foot.
The child “rallied” over the following days, with parents Theresa and Matthew Smith being led to believe she would be home in “a matter of weeks”.
However on April 10 Sophia’s health suddenly deteriorated and despite efforts to save her Sophia she died at 5.48pm on April 11.
On Tuesday the inquiry heard evidence from Lorna McSeveney, a senior charge nurse who had been on duty at NICU on April 10 and 11.
The inquiry heard she carried out a routine “package of measures” at the start of her shift at 7.30am on April 10 to check on Sophia’s condition, and that these did not give her “cause for concern”.
“She was a sick baby, but she was stable,” she told the inquiry.
She took the inquiry through Sophia’s medical charts for April 10 and into April 11.
These showed, she said, that the initial signs Sophia was “not quite right” came at about 3pm.
This included changes in a number of vital signs, including her temperature, heart rate and oxygen levels, which were being constantly monitored.
Small amounts of blood were also found in her airway.
These signs continued to worsen over the ensuing hours, and she was found to be suffering from a pulmonary haemorrhage (bleeding on the lung).
When asked whether these could have been signs Sophia had sepsis, Ms McSeveney said not necessarily, since they could have been caused by other things.
She added that it was “very difficult” even for experienced staff to detect sepsis in newborn children, and that the signs of the condition could be “very subtle”.
She was also asked if there was anything she would have done anything differently in the knowledge Sophia had an infection.
She replied: “I have gone over it in my head I don’t know how many times.
“I don’t think there was.”
She said Sophia was being constantly monitored, and that from a nursing perspective she had done everything she could.
The inquiry heard there was a practice of taking a weekly swab of each patient on NICU to test for infections.
Sophia was swabbed on her arrival on the ward on April 1, but was not then given another test until April 10.
Ms McSeveney said it was “unusual” for her not to have been tested during this period, and that there would normally have to be a medical reason for not doing so.
The retired nurse was asked about handwashing protocols in NICU.
Sophia’s parents gave evidence on Monday that it had been “frustrating” to see handwashing protocols were not being followed at all times by all visitors and staff.
Ms McSeveney said handwashing was required when entering and leaving the room, and when moving between patients, either at the sink or using the gel at each cot.
She also said all staff had a “duty” to challenge visitors or other staff who were not following hygiene protocols.
“We would stop them. I would say: ‘Excuse me, would you mind washing your hands’”, she explained.
She added that having to do so was a rare occurrence.
The retired nurse was also asked about the use of “bank” nursing staff on the ward – which Advocate Depute Chris Fyffe KC likened to using supply teachers in schools.
In their evidence on Monday, Mr and Mrs Smith had described what they understood to be a bank nurse, wearing a different uniform from the other nurses, working on Sophia.
They had said the nurse looked like “a rabbit in headlights”, and that they had looked “out of her depth” when working on Sophia’s arterial line.
Ms McSeveney said she did not know who the nurse was, or why they were in a different uniform.
She added: “You would not employ anyone from the bank who had no neonatal experience.”
On Monday, Sophia’s mother Theresa Smith told the inquiry she just wanted to know what happened to her baby.
“I want to know why she is not here, playing with her brothers and sisters,” she said.
She added: “She’s dead. I live every day of my life knowing she’s dead, knowing that absolutely putrid hospital caused an infection in my child and killed her,” she said.
“And when it killed her it killed me too. I want to know what happened.”
The inquiry continues.