Hospital criticised over teen's asthma death

A teenage girl who died after her first asthma attack could have survived if she had not been "inappropriately discharged" from a north London hospital, a coroner has said.

Billie Wicks, 16, was taken by her parents to the Royal Free Hospital in Hampstead in September last year, but senior coroner for Inner North London, Mary Hassell, said she wasn't checked regularly so was not diagnosed or treated.

In a report, Ms Hassell raised concerns about a "theme" of a "lack of observations" following the death of Daniel Klosi from sepsis at the same hospital.

The Royal Free London Trust apologised and said it had "taken steps to increase staffing levels".

If Billie had received regular observations when she was taken to the children's emergency department, doctors would have recognised the severity of Billie's illness, Ms Hassell said in her prevention of future deaths report.

"Billie was inappropriately discharged at approximately 3.30am without adequate repeat observations or senior clinical review, and so her asthma was not diagnosed or treated," she wrote.

"If it had been, she probably would have survived."

Billie died on 15 September.

The coroner added that although having a first asthma attack aged 16 without any family history was "unusual", "Billie should have had observations every hour".

"If she had had these observations, the emergency registrar who discharged her would have recognised that she was not as well as he thought, and would have sought senior medical review," Ms Hassell said.

"That senior medical review would have changed the course of her management and saved her life."

Ms Hassell also mentioned the case of Daniel Klosi - who died from sepsis at the Royal Free in 2023.

Daniel was taken to the hospital four times in the week running up to his death, and a previous report into the circumstances surrounding his death also raised concerns about observations.

Ms Hassell said she also wrote to the hospital following that incident, and added: "Although the circumstances were different, there is a theme."

"At inquest, I heard repeatedly that on the night Billie attended, the Royal Free emergency department was understaffed, and that it remains understaffed of doctors, nurses, and even a healthcare assistant who could take basic observations."

Ms Hassell also raised concerns about the Royal Free's references to carrying out "safety-netting", when Billie's parents were told to return if they had any concerns.

"In reality, her parents' initial concern was well placed and they had responded to it appropriately by bringing Billie to hospital," she said.

"When Billie began to deteriorate again, her parents' natural instinct had been blunted by their first visit to the hospital."

A spokesperson for the Royal Free London said: "We would like to share our heartfelt condolences with Billie's family and to say how sorry we are that she died while under our care.

"Following an investigation into the care provided to Billie, we have taken steps to increase staffing levels in the children's emergency department during nights and weekends and improve the process for alerting senior clinicians when an abnormal test result is received.

"We will carefully review the coroner's findings and respond to all the matters she has raised."

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