Inquest hears parents' concerns over care of Trixie Morvoren, 1, who died at Royal Cornwall Hospital

Mixed · 2An inquest in Truro has heard that Trixie Morvoren, known as Trixie Mo, died on 29 April last year after she could not be resuscitated at the Royal Cornwall Hospital. 1 2 Mixed · 2She had turned pale and was drifting in and out of consciousness at home in Newquay, a few months short of her second birthday, before being taken to hospital. 1 2 Mixed · 2Trixie Mo was born with Down syndrome and a congenital heart defect that needed surgery in Bristol by the time she was six months old. The inquest heard there were complications but she recovered after four days in intensive care. 1 2

Mixed · 2Her mother, Ashleigh Cooke, said she had an en caul or 'veiled' birth, in which a baby is born enclosed in an unruptured amniotic sac. Such births occur in roughly one in 80,000 and are known as 'mermaid births', which inspired her middle name, Morvoren, Cornish for mermaid. 1 2 Left · 1At the paediatric assessment unit, staff struggled to insert a cannula for blood samples and intravenous treatment, and several attempts were made. 1 Left · 1Her parents, Ashleigh and James Cooke, believe ultrasound-guided cannulation should have been used from the start, given her history of difficult cannulation and cardiac problems. The Mirror reports they also felt senior consultants rather than registrars should have cared for her. 1

Mixed · 2Ashleigh Cooke told the inquest that 'everyone seemed very chilled' and that there 'never seemed to be any sense of urgency'. She asked why more effort was not made to give supplementary oxygen, and said a specialist cardiologist should have been involved once 'crackle-like' sounds were heard in her chest. 1 2 Right · 1James Cooke said he felt excluded and 'very much in the dark', and believed staff spoke to Ashleigh, who was almost eight months pregnant, more as a colleague than as the mother of a seriously ill child. Only the Express reports this. 2 Mixed · 2Consultant paediatrician Rachel Nicholls said registrars rather than consultants are the cannulation experts because they do it routinely, which is why she asked them. She said ultrasound-guided cannulation is a skill not every nurse or registrar has, and that the Royal Cornwall Hospitals Trust is working to improve this. 1 2

Mixed · 2Dr Nicholls said the crackles could have indicated an infection, and that difficulty cannulating Trixie Mo made it harder to find the cause of her illness and treat it. She said the child was warm and did not seem to be continually deteriorating, and that she was shocked by the collapse. 1 2 Mixed · 2Consultant paediatrician Veronica Nijloveanu, who took over later that day, called the death an 'extremely rare scenario'. She said resuscitation processes were followed thoroughly and added: 'We don't understand what happened.' Consultant paediatrician Katy Huxstep said communication with patients and parents about treatment and procedures needs to improve. 1 2 Mixed · 2The inquest is expected to conclude on Wednesday 7 October, so no finding on the cause of death has been reported. 2 1