Medical staff left ‘devastated’ after sudden death of ‘joyous’ Swanmore toddler Zach Keay born with Down Syndrome

As reported, Zach Keay, of Swanmore, passed away aged two at Southampton General Hospital on December 8, 2021, from acute bronchial pneumonia after becoming ill in a case that has baffled medical professionals.

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On the second day of the inquest at Hampshire Coroner’s Court, Emma Newell, the nurse in charge of the high dependency unit at the hospital, revealed she had concerns over Zach as medical professionals struggled to find out what was wrong with the infant, who had been admitted after being ‘lethargic’ and having a puffy face.

A consultant had brought Zach up to the high dependency unit around 11pm, which Ms Newell said ‘rarely happens’. She said: ‘I could tell he was unwell. His heart rate had increased through the night, he was puffy in the face, had mottled and cold skin. In my opinion he looked unwell.’

One condition was ruled out before attention turned to the possibility of Addision’s disease - a problem with the immune system - and sepsis which Zach was given antibiotics for as a precaution. A post mortem did not reveal sepsis. Ms Newell admitted she had concerns over Zach’s heart. ‘I was worried his heart was going so quickly for so long,’ she said. ‘His heart rate was high from when he arrived.’

The healthcare professional said his heart rate and blood pressure had been ‘fluctuating’ but the nurse said she was ‘reassured’ by the senior consultant on duty over treatment. But as they struggled to get to the bottom of Zach’s issues, she admitted: ‘It came to the point when we had given what we could give and so potentially his care needed to be escalated.’

The nurse described how Zach was ‘alert and awake’ before matters suddenly took a serious turn when a test showed a heart ventricle was ‘thick’ despite him not having any ‘known cardiac issues’. After taking in a gulp of air Zach suddenly stopped breathing resulting in chest compressions as medical staff were called before rallying to save him. But he was sadly pronounced dead at 6.08am.

The nurse said she ‘wished’ she had told Zach’s dad, who had taken him to hospital, to stay before the infant’s unexpected deterioration. ‘Obviously I have deep regret and feel awful they weren’t there,’ she said.

Doctor Andrew Baldock, who led the University Hospital Southampton NHS Foundation Trust review of the incident, said an action plan has been drafted following Zach’s death to prevent future deaths.

Dr Michael Rowe, a paediatrician at Southampton General Hospital who was on call from home the night Zach died, had said he was in dialogue with a doctor treating the infant at the hospital before Zach was given antibiotics. ‘My conclusion was he was stable,’ he told the inquest.

The hearing previously heard Zach’s family had suffered ‘profound grief’ and ‘damage’ following the ‘joyous’ infant’s death.

The inquest was adjourned to a future date.