Published: 12:00, 17 May 2018
| Updated: 12:15, 17 May 2018
A grieving father has spoken of his relief after hearing how hospital staff failed to follow guidelines after incorrectly inserting a catheter into his premature son.
Tiny James Barnes died a week after he was born in April last year.
Now parents Jenanne and Michael Barnes, of Gravesend, have been told by a coroner their son's death was the result of medical misadventure at Medway Maritime Hospital.
The inquest at Brighton Coroner's Court heard James was born at Darent Valley Hospital, Dartford, on April 22.
Despite being eight weeks premature he was generally healthy but had some breathing problems which required medical attention and he was moved to Medway the next day, where an umbilical venous catheter — UVC — tube was inserted.
However an X-ray carried out 42 hours later established it had been incorrectly placed in his stomach. Six hours later it was removed but by that point James's condition had seriously deteriorated.
Signs of E. coli sepsis, a type of blood infection, became apparent and he was rushed to the Royal Sussex County Hospital 50 miles away in Brighton.
By this point James was too ill to be operated on and he died some seven hours later.
Pathologist Dr Andreas Marnerides said it was his belief the incorrect placing of the UVC lead to James's death.
The inquest also heard a review meeting between staff at Medway was only held in July.
This delay, Coroner Veronica Hamilton-Deeley said, showed "protocol and procedures were not being carried out properly".
Ms Hamilton-Deeley recorded the cause of death as E coli sepsis as a result of the insertion and continued use of the misplaced UVC.
She concluded James died as a result of medical misadventure after a failure by medical staff to follow the hospital trust's own guidelines.
Speaking after the inquest, Mr Barnes said: "It's such a relief to finally have answers after so long. From what we heard from the coroner it is the outcome we expected."
"It's such a relief to finally have answers after so long" - Michael Barnes
Lesley Dwyer, Chief Executive of Medway NHS Foundation Trust, said: "We extend our sincerest condolences to James's family on their tragic loss.
"The insertion of catheter lines in premature babies is a challenging and complex area for all doctors involved in their care and we are deeply sorry that on this occasion we got it wrong, despite all the guidelines in place at the time.
"Since James' death we have focussed on improving awareness and communication of the risks involved and carried out additional education and training of the specialist staff in the Unit to ensure any risk to babies is minimised and that this does not happen again."
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