Child In Pain Visited Sheffield Hospital Three Times In 48 Hours Before Death From Heart Failure

A 10-year-old girl complaining of stomach pain died after hospital staff failed to investigate her increased heart rate, an official report has found.

Simra Ali had visited Sheffield Children’s Hospital three times in 48 hours in the days before her death, complaining of abdominal pain, vomiting and tiredness. Her symptoms were initially diagnosed as a water infection.

However, three days after her original visit, she collapsed at home. Simra, of Tinsley, was taken to Sheffield Children’s Hospital after suffering a heart attack. She was pronounced dead around 30 minutes later.

Following the death of the Brinsworth School pupil, her parents Akbar Ali and Nighat Farzana, instructed specialist medical negligence lawyers at Irwin Mitchell to investigate Simra’s care at the hands of Sheffield Children’s NHS Foundation Trust, which runs the hospital.

Simra’s parents have now joined their legal team at Irwin Mitchell in calling for the Hospital Trust to learn lessons.

It comes after a Serious Untoward Incident report found Simra’s “significantly elevated heart rate” was attributed to a faulty pulse monitoring machine or Simra’s agitated state and staff missed opportunities to investigate her high heart rate.

An inquest has also concluded that there were serious omissions and missed opportunities for Simra to be reviewed by a senior doctor and for further investigations to be performed which the coroner, Christopher Dorries, stated amounted to a significant failure. The coroner concluded that had Simra been properly recognised appropriate interventions would have saved her life.  

Expert Opinion

This is an incredibly tragic case and, more than a year after Simra’s death, Akbar, Nighat and the rest of the family remain understandably devastated by the loss of a much-loved daughter, sister and niece.

“Simra’s family had a number of concerns about the way she was treated in the days before her death, and sadly, the findings of the NHS Trust’s own internal investigation and the inquest validates these concerns. On behalf of the family we welcomed the NHS Trust’s apology, made to the family after the inquest, for the failings in the care which they provided to Simra.

“Whilst nothing can make up for Simra’s death we are pleased that the NHS Trust has identified opportunities to improve care, including through staff training and introducing guidelines around diagnosing and treating high heart rates. We now call on the Trust to ensure it implements these measures at all times so other families don’t have to suffer the heartache that Akbar, Farzana and the rest of the family have endured following Simra’s death." Tania Harrison - Partner

Simra was first taken to Sheffield’s Children’s Hospital on 12 March, 2017, after her family called the 111 NHS Direct helpline saying she had been unwell for a week. Following examination by a junior doctor her increased heart rate was classed as a secondary issue attributed to dehydration. Simra was diagnosed as having a water infection and sent home with antibiotics.  

The Serious Untoward Incident report said that because Simra was displaying warning signs her case should have been escalated to consider whether she needed to be seen by a senior doctor and undergo investigations. However, this did not happen.

Simra was taken back to the hospital the following afternoon. A heart rate of up to 250 beats per minute was recorded. However, following further examination this was put down to a technical error and Simra was sent home.

She attended the hospital again just after 11pm that night was admitted overnight for observation and discharged on the afternoon of 14 March. 

Simra was brought to A&E at around 4.55pm on 16 March by paramedics after collapsing at home. However, she could not be resuscitated and was pronounced dead around 20 minutes later.

Speaking after the hearing on behalf of the family, Simra’s mother, Nighat Farzana, paid tribute to Simra and said: “Simra was a lively, energetic, beautiful caring girl who always put others first.

“Simra loved her family and we had never been parted. To lose her in such tragic and sudden circumstances is heart-breaking.

“I will never forget that pain and suffering Simra had to endure in the week leading up to her tragic death. I felt that my concerns about Simra’s health concerns were not taken seriously during her hospital visits.
 
“We put our trust in the opinion of the medical professionals at Sheffield Children’s Hospital. We feel that the hospital should have taken our concerns and Simra’s visually poor health more seriously and should have tried to establish the cause of her on-going health rather than dismissing it as an infection. 

“Because of this I will not see my daughter develop into a young lady living her dream of becoming a pharmacist like her sister, not will I have the opportunity to tell her how much I loved her, as she was always telling me.

“All our family can hope for now is that the hospital ensures it acts on the findings of the Serious Untoward Incident investigation and the inquest. I would never want anyone else to experience the pain our family has experienced since Simra’s death.”

The narrative conclusion provided by Mr Dorries was:

Simra Ali (aged just 10) died on 16 March 2017 at Sheffield Children’s Hospital having collapsed at her home a short time before. The cause of death was dilated cardiomyopathy.

Simra had presented at the hospital on 12 March and twice on 13 March 2017 and was incorrectly thought to be suffering from an infection. Opportunities were lost to identify the true cause and seriousness of Simra’s condition as follows:

• 12 March – missed opportunity for a senior review;
• 13 March – failure to carry out an ECG which would have more likely than not identified the underlying cardiac problem;
• 14 March – further missed opportunity for a senior review before discharge which may have identified the path to diagnosis.

Together these omissions add up to a significant failure to identify a seriously ill patient. On the balance of probabilities, had Simra’s condition been properly recognised then appropriate interventions would have saved her life.

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