DHB's inconsistent care led to baby's death
A badly dehydrated Hutt Valley baby died in hospital after medical staff failed to respond to her deteriorating condition.
In a decision released today, The Health and Disability Commissioner said the Hutt Valley District Health Board was directly responsible for the failures in the 11-month-old baby's care, which include failings of several staff.
The baby was admitted to Hutt Hospital with vomiting and poor weight gain in 2010. She was later diagnosed with rotavirus, and continued to lose weight, vomit and developed diarrhoea in hospital.
On her 13th day in hospital, the baby was found unresponsive, having suffered severe renal failure and dehydration, and later died.
Despite her loss of fluids, the degree of dehydration was not properly monitored and many people involved in her care were not told she had rotavirus. Some of the notes by medical staff were inconsistent and the doctor managing the baby's care appeared unaware she had been diagnosed with rotavirus.
Commissioner Anthony Hill said a lack of communication between the team caring for the child meant several opportunities to improve its feeding regime were missed. However, the DHB was ultimately at fault for a failure in the overall service provided to the baby.
He recommended improvement in communication between medical staff, including better oversight of junior staff and auditing of handover notes.
The DHB said it had since implemented many of the recommendations.
The Dominion Post