Child due to have heart transplant died of natural causes, coroner rules

A 16-month-old child, who was awaiting a heart transplant, died from natural causes, a coroner has determined.Nina Heffernan from Dundalk, Co Louth, died in Crumlin children’s hospital on August 26th, 2022.Her inquest on Monday heard that she was due to travel to the cardiothoracic unit at the Freeman Hospital in Newcastle, England, for a heart transplant. Almost €50,000 had been raised through a public appeal by her parents, Johnny and Laura, for the operation. However, she was unable to travel because of continuing infections after an operation in May 2022. READ MORENina Heffernan was born on April 26th, 2021, and immediately diagnosed with a congenital heart condition. She had a permanent pacemaker fitted four days later. She was constantly in hospital and had to be fed through a tube. She suffered from severe reflux. She underwent fundoplication surgery on May 5th, 2022 – an operation that wraps the top of the stomach around the bottom of the oesophagus to improve digestion. She was admitted to intensive care afterwards. Her mother said there were many “unanswered questions” in relation to her daughter’s care. The parents’ barrister, Doireann O’Mahony, said the child had been “a ray of sunshine” in her parents’ lives. [ Girl attacked by sheepdog while playing near home settles High Court action for €60,000Opens in new window ]She argued that coroner Dr Clare Keane should consider a verdict of medical misadventure if she determined the child’s death was the result of the “unintended consequence of a medical procedure”. Consultant cardiologist Dr Mark Walsh said the child had a congenital health problem from birth. She experienced a “failure to thrive” and was in the 0.4 percentile for weight despite multiple interventions. The care given to her included “extraordinary measures” and reflected that if “you can’t gain weight, you can’t survive”. Her medical results were sent to the Freeman Hospital in Newcastle-upon-Tyne, and she was formally listed for a heart transplant in June 2022. However, she continued to suffer from chronic colonisation (persistent bacterial infections), which led to recurring sepsis. He said the Pseudomonas infection that Nina Heffernan developed was extremely difficult to treat despite intravenous antibiotics.[ Medical devices firm still chasing HSE for part of multimillion-euro sum following court rulingOpens in new window ]As a transplant would involve immunosuppressant drugs, the Freeman Hospital could not admit such a patient with a prior infection. He accepted that the prospect of a heart transplantation was an “emotional rollercoaster on an already stressed family”. A transplant became the only option for Nina Heffernan, but it could not happen because of the infection, he told the inquest. Delivering her verdict, Keane expressed sympathy with Nina Heffernan’s parents on their loss. She said she hoped the inquest had answered some of the questions that the parents had. She ruled that the cause of death was recurring sepsis and bacterial colonisation on the background of a severe failure to thrive. This was due to a complex congenital heart disease, a heart block and a genetic heart mutation causing cardiomyopathy. She agreed with the evidence of the doctors that Nina Heffernan had suffered a severe “failure to thrive” due to reflux disease and that although the initial operation was a success, the infections made a transplant impossible. Therefore, her death was due to natural causes.