Published: 06:00, 22 August 2019
A two-year-old girl who died after choking on a cocktail sausage arrived at hospital with breathing tubes in the wrong place, an inquest has heard.
Mia Atkins died at Darent Valley Hospital on Sunday, July 1, 2018, after her airways were blocked when she choked on the snack.
An inquest into the youngster’s death was held at Maidstone’s Archbishop’s Palace where it was revealed that when she arrived at the Dartford hospital the endotracheal tube, which is meant to be placed in the windpipe, was in her oesophagus.
Mia had returned from a day out at Swanley Park on Saturday, June 30, when her mother, Beth Ranger, began to cook dinner for the youngster, as well as her sister Lauren, and Lauren’s children, at around 7.30pm.
The children were given some cocktail sausages to eat while they waited for their dinner.
Minutes later Ms Ranger heard her sister scream “she’s choking” and she rushed into the living room.
In a statement read out in court she said: “I came in and she was turning blue. She was bleeding from her nose and mouth.”
The court heard how Mia’s mum struggled to get through to the emergency services, only managing to reach a call handler a few minutes later on the third attempt.
By this time Mia had become unconscious and was in cardiac arrest.
Ms Ranger performed CPR while an ambulance was dispatched to the property in Cutty Sark Court, Low Lane, Greenhithe.
Paramedics worked on the tot before making the decision to put in an endotracheal tube, which should be placed through the mouth into the windpipe, to try and get oxygen into Mia’s body, before taking her to Darent Valley Hospital.
On arrival, Ms Ranger was taken to a family waiting area with her sister while Mia’s dad, who lived in London, was picked up by Metropolitan Police officers and brought to the hospital.
After a scan, Ms Ranger was given the devastating news her daughter was classed as brain dead and there was no sign of brain activity.
The family was able to say their goodbyes before turning off her life support machine. Mia died seven minutes after it was turned off, at 4.08am.
During the hearing, solicitor James Weston, who was representing the family, claimed Mia’s chances of survival were reduced because the endotracheal tube was incorrectly put in the oesophagus, rather than the trachea, meaning the two-year-old was without proper oxygen support until she arrived at the hospital, and therefore was in cardiac arrest for around 30 minutes.
The paramedic, from the South East Coast Ambulance Service, who was the first on the scene in June last year and placed the tube was questioned at the inquest. He said he was sure it was in the right place due to signs such as mist on the tube and chest movement.
He suggested the tube could have been knocked out while the little girl was being moved.
This idea was supported by paediatric specialist Dr Ian Maconchie who was called to the inquest as an expert.
But Dr Francoise Lossifidis, the consultant anaesthetist working on Mia the night she was brought in, claimed the pipe was too far down the oesophagus to have simply fallen out of the trachea and down the foodpipe.
She said the two-year-old was extremely cyanosed - meaning her skin was turning blue - a sign she did not have enough oxygen in her body.
Dr Lossifidis also said she removed a 2cm piece of sausage from Mia’s throat.
Paramedics said they had seen a small piece of sausage in the youngster’s throat - roughly 1cm - but didn’t remove it as he could see her vocal chords clearly and it wasn’t blocking the airways.
Dr Lossifidis agreed the sausage wasn’t blocking the airways but should have been removed to reduce further risk.
A post-mortem result gave Mia’s cause of death as upper airway obstruction.
The inquest was adjourned after two days and will continue in October.