A PREMATURE baby died days after a catheter was misplaced in his stomach by a junior doctor at a hospital, an inquest heard.

James Barnes, who was born prematurely, was transferred to the Royal Sussex County Hospital in Brighton, where he died a few hours later.

Doctors there said the umbilical venous catheter – UVC – was not in the right place.

The inquest at Brighton Coroner’s Court yesterday heard James was born in Darent Valley Hospital in Kent on April 22 last year and moved to Medway Hospital the next day where the UVC tube was inserted before being identified as a problem after an X-ray and removed.

The inquest heard the tube was known to be misplaced for six hours before being removed and James’s condition started to deteriorate, with signs of E coli sepsis, a type of blood infection, becoming apparent.

He was moved to the Royal Sussex County Hospital on April 27 for a surgical opinion to be formed, where he died some seven hours later.

Dr Prashanth Bhat, a consultant neonatologist at the Royal Sussex County Hospital, said: “The UVC is meant to be placed close to the heart. We try and avoid inserting UVCs too low. The registrars may not be supervised [when inserting the UVC].”

Dr Bhat told the inquest the UVC was misplaced and had been in the left abdomen before he saw James.

A chest drain was inserted and he was put on a breathing machine at Darent Valley Hospital, with a decision being made to move him to Medway Hospital for further treatment.

The inquest heard Dr Ghada Ramadan, a consultant paediatrician at Medway, believed the catheter could have moved after being inserted.

Pathologist Dr Andreas Marnerides said: “We would not be able to say whether this baby was born with the infection or not. It [the UVC] was found misplaced. It led me to believe that it was as a result of the UVC being inserted.”

A review meeting between staff at Medway was only held in July after James’s death and medical notes about his case were added to an online logging system used by hospital staff.

Coroner Veronica Hamilton-Deeley said “protocol and procedures were not being carried out properly” due to the meeting being held three months after his death.

Ms Hamilton-Deeley recorded the cause of death as E coli sepsis as a result of the insertion and continued use of the misplaced UVC.

She concluded that James, son of Genanne and Michael Barnes, died as a result of medical misadventure after a failure by medical staff to follow the hospital trust’s own guidelines.

Speaking after the inquest, Mr Barnes said: “It’s such a relief to finally have answers after so long. From what we heard from the coroner it is the outcome we expected.”

Lesley Dwyer, Chief Executive of Medway NHS Foundation Trust, said: “We extend our sincerest condolences to James’ family on their tragic loss.

"The insertion of catheter lines in premature babies is a challenging and complex area for all doctors involved in their care and we are deeply sorry that on this occasion we got it wrong, despite all the guidelines in place at the time.

"Since James’ death we have focussed on improving awareness and communication of the risks involved and carried out additional education and training of the specialist staff in the Unit to ensure any risk to babies is minimised and that this does not happen again.”