Medics 'don't understand' why 'joyous' Swanmore toddler died suddenly, inquest hears

Zach Keay 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, with a senior consultant saying: ‘I don’t understand it.’

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Hampshire Coroner’s Court heard how Zach’s death had resulted in a ‘profound impact’ on his devastated family, of Swanmore. His dad Vince said in a statement: ‘His absence is felt every day. He was the centre of our lives and was so loving to everyone in the family and being with him was joyous. Our dreams for the future have been shattered by this loss.’

The dad said the loss of Zach had also led to ‘profound grief’ and ‘damage’ to Zack’s siblings and both parents who now ‘feel guilty’ and ‘blame ourselves’. Amid questions over the medical care given to Zach, the dad called for an ‘improvement in communications and transparency’ between medical professionals.

The hearing heard how Zach, who also had Hirschsprung’s disease which affects the functioning of the intestine, attended Winchester Hospital’s emergency department on December 5, 2021, where it was thought he may have been suffering from an allergy, resulting in being given antihistamines.

Two days later his GP was contacted due to him being sick and having a puffy face. Dr Shazatoi Subari, who had seen Zach a few weeks before, told the inquest he was different to before with him ‘lethargic’ but he had ‘no respiratory distress’ and was ‘very calm’. ‘I wasn’t sure what was wrong with Zach,’ she said, before stating: ‘There was no source of infection I could think of.’

But with concerns over his condition, the GP said Zach should go to hospital. ‘When I heard he had passed away the next day I was really shocked by the news,’ she added.

Questioned over whether Zach was affected by sepsis, Dr Subari said his condition was ‘not typical of a child with sepsis’ but added: ‘I told his mum I was not sure and he might have an infection.’

Asked by coroner Rosamund Rhodes-Kemp if she was surprised to find out Zach died from acute bronchial pneumonia, the GP said: ‘I was because he did not have more symptoms and his chest was clear.’

Paediatric pathologist Dr Samantha Holden said the cause of death was as a result of an ‘acute chest infection’ - namely acute bronchial pneumonia - but said there were ‘no specific findings’ of sepsis.

Dr Helen Crossley, a consultant at Hampshire NHS Trust who prescribed antihistamines to Zach when she assessed him said there was ‘no evidence of infections’.

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

But the coroner raised questions over the communications between Dr Rowe and the doctor at hospital when it emerged Zach was ‘making strange noises’ and there was an increase in his pulse and blood pressure dropping. ‘You think you should have gone in?’ Ms Rhodes-Kemp asked, to which Dr Rowe replied: ‘I wish I had gone in with hindsight.’

The coroner added: ‘There’s nothing like looking at a child.’

But Dr Rowe insisted he was ‘assured’ the doctor at hospital was ‘comfortable with the situation’.

Dr Rowe said Zach’s heart rate had come down and his blood gasses had improved. He said: ‘It’s difficult to know why he died three hours later. He seemed no worse and had improved slightly.’

He added: ‘I don’t understand it. There are complexities in this case we will never have answers to.’

As reported in January 2022, the devastated Keays raised thousands of pounds for the Portsmouth Down Syndrome Association. PDSA is a charity that supports young people with Down syndrome and their families, providing specialist services and helping with development and education.

Vince told The News then: ‘He was very empathetic - I think it made him understand emotions better. He’d see that you were sad and would give you a smile and cuddle. For him, Down syndrome was his superpower. It made him such a lovely little person to be around.’

Mum Caroline added: ‘It is an exceptional charity that helps support people in this community, enabling them to grow, develop and lead fulfilling lives.’

She explained that the charity offers children of preschool age speech and language and numeracy sessions, and had Zach gone to school, the association would have continued to support him in his education. ‘With these groups, they support children to give them the best start’, Caroline said. ‘PDSA helped Zach grow and develop.’

Rachael Ross MBE, PDSA chair, said previously: ‘We’re all devastated by the loss of beautiful Zach. It was just such a shock. We’re putting donations towards a sensory room that will help other children with Down syndrome.’

Zach also had Hirschsprung's disease, which meant he needed a stoma and a major operation when he was only a year and a half old - but this did not stop him from ‘getting on with life’, his mum said.

Caroline added: ‘None of those operations set him back, and once his stoma was reversed he gained confidence.’

Zach used the sign language Makaton to speak to people and was well known for his ‘cheeky’ smile.

(Proceeding)