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Inquest of Baby Joshua Opens in Cumbria

The inquest of a baby boy who died from an infection which was undetected by staff at Furness General Hospital begins this week.

The family of Joshua Titcombe, who died on 5th November 2008 when he was nine days old, hope that the inquest can finally answer questions about his care and treatment.

The inquest is listed for 2nd and 3rd June (with 6th to 7th June as reserve dates) and will take place at Barrow Town Hall with Ian Smith as HM Coroner.

The University Hospitals of Morecambe Bay NHS Foundation Trust which runs Furness General Hospital has already admitted that the standard of care given to Joshua was unacceptable and accepted liability for his death. Since Joshua’s death the Hospital’s Maternity Services have been the subject of several investigations, but for his family, questions still remain. The loss of some of Joshua’s key medical records by the Hospital means that some of those questions may never be answered conclusively.

Joshua was born on 27th October 2008 and was the second child of James and Hoa Titcombe from Dalton in Furness. Hoa’s pregnancy had been uneventful and the whole family was looking forward to a new baby in time for Christmas.

Baby Joshua with sister Emily

On Saturday 25th October, Hoa’s waters broke so the couple went to the maternity unit of Furness General Hospital. Hoa had been feeling unwell and James says he raised concerns about the possibility of an infection but they were reassured and sent home with instructions to return the next morning. The next day there were still no signs of labour. James and Hoa were sent home again and told to return the following morning (Monday).

Early on the morning of Monday 27th October, Hoa’s contractions began. They went back to Furness General Hospital and at 7.38am, Joshua was born.

James said, “When Joshua was born he seemed at first to struggle with his breathing. He was blue and limp and didn’t cry, but once he had had some oxygen, his condition improved, he let out a cry and went pink. We were ecstatic. Our son appeared to be a perfect healthy boy.”

Hoa was doing less well and within half an hour she was feverish with an infection for which she was given antibiotics. The infection was subsequently identified as pneumococcus. James was extremely concerned about baby Joshua and asked if Joshua should also be treated with antibiotics, but was told it was unnecessary.

He said, “I was very surprised to be told that he didn’t need antibiotics. This seemed wrong but I had no choice but to trust what I was told. The midwives were totally dismissive that anything could be wrong with Joshua.”

However, throughout the day and into the night, there were concerns about Joshua’s temperature being low and he was placed into a warming cot at least twice. Then, in the early hours of the morning, Hoa called the nurses because she was worried about Joshua’s breathing. He was taken away for 30 minutes. When he was returned the midwives again reassured Hoa that there was nothing to worry about.

Joshua’s battle for life began in earnest on Tuesday 28th October when he was found 25 hours after his birth, blue and in a state of collapse.

Joshua was put on to a ventilator and his family told that he probably had a heart defect and was being treated with heart medication and antibiotics.

The decision was made to transfer him to the specialist paediatric centre at Manchester St Mary’s. At Manchester it was established that he had collapsed due to an overwhelming pneumococcus infection in his lungs and sepsis. Joshua had the same infection as Hoa.

Joshua remained in a very serious condition and was receiving maximum life support. The family was advised that his best chance of survival now was extra corporeal membranous oxygenation (ECMO), a technique that provides temporary heart and lung support.

Joshua was transferred by helicopter to Newcastle Freeman for ECMO.

On arrival at Newcastle, James and Hoa were told that Joshua had an 80-90% chance of survival and he responded well to the ECMO treatment. However on 3rd November, staff began weaning him off the ECMO and at the latter stages of this process, Joshua began to bleed from his left lung.

Over the next 2 days, Joshua’s condition deteriorated and on 5th November, the family were told that Joshua’s bleeding was too severe and it was time to turn off his life support. His lungs had been irrecoverably damaged by the infection.

James said, “We had no choice but to agree to let Joshua go but I begged the doctor to make sure he went without pain. For the next 15 minutes I sat embracing Hoa. We knew our beautiful boy was passing away. A short while later his death was confirmed. Joshua had bled to death.”

Despite the investigations and reviews, there are four key areas which continue to concern Joshua’s family.  Those issues are: Hoa’s illness prior to labour and how it was documented; Joshua’s condition at birth; Joshua’s lowest temperatures and the care of Joshua prior to his collapse. 

James concluded, “For three years we have been trying to find out the truth about Joshua’s death. Hoa and I are determined that the Trust will be held up to scrutiny and we are extremely grateful to our legal team at Burnetts for helping us to get here today.”

The inquest will hear evidence from eleven midwives, four paediatricians and the Trust’s Chief Executive Tony Halsall. Representatives from the General Medical Council and the Nursing and Midwifery Council are also attending.

Miranda Hill, solicitor from Burnetts in Carlisle and Paula Sparks, barrister from Doughty Street Chambers, London are representing James and Hoa. Miranda said, “This is a very sad case. The inquest into Joshua’s death is the first chance that the family have had to hear evidence first-hand from the individuals involved in Joshua’s care in order to understand more about the circumstances that led to Joshua’s death. I hope that the inquest is able to resolve the family’s outstanding queries about Joshua’s treatment.”


31st May 2011

For further media information contact Angela Huck on 07525 128762 or email ash@burnetts.co.uk


Published: Tuesday 31st May 2011
Categorised: Medical Negligence

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