The tragic death of six-year-old Shen'iyah Green serves as a stark reminder of the critical importance of accurate diagnosis and attentive medical care, especially for patients with pre-existing conditions. Shen'iyah, who suffered from sickle cell disease, was sent home from North Middlesex University Hospital after doctors attributed her symptoms—fever, vomiting, and shortness of breath—to a common stomach bug. Her mother, Shanieka, was assured that her daughter was “absolutely fine”.
However, Shen'iyah's condition rapidly deteriorated. She fell asleep during the car ride home and tragically never regained consciousness. This devastating turn of events highlights a critical failure in recognizing the potential complications arising from her sickle cell disease.
Despite Shanieka's desperate attempts to revive her daughter and the hour-long resuscitation efforts by paramedics, Shen'iyah was pronounced dead less than three hours after being discharged from the hospital. The speed with which her condition worsened underscores the need for immediate and thorough medical assessment in cases involving sickle cell disease.
Sickle cell disease, a lifelong genetic condition, is characterized by abnormally shaped red blood cells that resemble crescent moons. These misshapen cells can lead to various complications, including pain, anemia, and an increased susceptibility to infections. The disease is particularly prevalent in individuals of African descent, affecting an estimated 15,000 people in England.
Shanieka repeatedly flagged her daughter's sickle cell disease when she took Shen'iyah to the A&E on January 11, 2019. This crucial information was documented in her health records, yet the medical team failed to recognize the connection between Shen'iyah's symptoms and potential sickle cell complications.
The failure to recognize these complications proved fatal. Shen'iyah's cause of death was determined to be splenic sequestration, a rare but recognized complication of sickle cell disease where a large number of sickled red blood cells become trapped in the spleen. This condition can lead to a rapid drop in hemoglobin levels and potentially life-threatening complications.
An inquest into Shen'iyah's death concluded that neglect by the North Middlesex University Hospital NHS Trust had contributed to her untimely passing. The inquest revealed that medical staff failed to take a blood sample, document the cause of her abdominal pain, or admit her to the hospital for further observation and treatment. These omissions were deemed significant failures in her care.
The absence of a blood test, in particular, is a significant oversight. A blood test could have revealed crucial information about Shen'iyah's hemoglobin levels and the presence of sickled cells, providing valuable insight into the severity of her condition.
Shanieka, a nurse practitioner and mother of four from Enfield, expressed the profound sense of loss and anguish her family has endured since Shen'iyah's death. She emphasized that Shen'iyah's sickle cell disease required treatment under specialized protocols, which were unfortunately not followed.
“Shen’iyah had sickle cell disease, which meant she should be treated under specialist sickle cell protocols – but this did not happen, and she has paid the ultimate price,” Shanieka stated, highlighting the critical need for adherence to established medical guidelines when treating patients with specific conditions.
Shanieka emphasized the preventable nature of her daughter's death, stating, "This was wholly avoidable. She was only six years old and deserved so much better than being sent home to die." Her words underscore the importance of proactive and comprehensive medical care, especially for vulnerable patients.
Despite Shanieka's pleas for further investigation and testing, medics diagnosed Shen'iyah with gastroenteritis and discharged her at 5:25 pm. Shanieka's intuition as a mother and her professional knowledge as a nurse practitioner were disregarded, leading to devastating consequences.
“I know my daughter better than anyone, and I was not listened to,” Shanieka lamented, highlighting the crucial role of parental input and the importance of healthcare providers valuing the insights of family members who know the patient best.
Shanieka recalled, “I asked for blood tests to be carried out, I [asked for other tests], I repeatedly raised my concerns that something was badly wrong, but I was told she was fine to go home.” This paints a picture of a mother desperately trying to advocate for her child, only to be dismissed by medical professionals.
The devastating reality is that Shen'iyah fell asleep on the car journey home and never woke up again. She was rushed back to the hospital, but it was too late. She was pronounced dead by 8:00 pm.
Shanieka painfully remembers the same triage nurse and doctor who had seen Shen'iyah earlier in the day were present when she was rushed back to the hospital. "This made me very angry – why didn’t they listen to me earlier when I begged them to?” she questioned, expressing the unbearable frustration and grief of knowing that her concerns were ignored.
A Serious Incident Report by North Middlesex Hospital NHS Trust acknowledged that Shen'iyah’s observations “were not completely within normal limits and more information was needed” before discharging her. The report also admitted that her cause of death was a “rare diagnosis for a six-year-old child with sickle cell disease and therefore may not have been considered – but may have been picked up if the child was in hospital”.
Shanieka continues to be haunted by the fact that she was not listened to by medics. She hopes that Shen'iyah's tragic story will serve as a catalyst for change, ensuring that other families are spared the unbearable pain and suffering she has experienced. She wants families to be listened to and their fears and concerns for their child taken seriously.
“Families need to be listened to and their fears and concerns for their child taken seriously,” Shanieka urged, emphasizing the importance of open communication and collaborative decision-making between healthcare providers and families.
Shanieka believes that children must receive the care that is right for them, particularly in cases where they have specific medical conditions which warrant specialist attention. "There can be no excuses for Shen’iyah’s death – but we only hope that lessons are learned from it so this can never, ever happen to another child,” she stated, emphasizing the need for systemic changes to prevent similar tragedies in the future.
A spokesperson for the Royal Free London NHS Foundation Trust, which now runs North Middlesex University Hospital, offered their deepest condolences to Shen’iyah Green’s family and expressed their profound sorrow for her death. They stated that following Sheni’yah’s death in 2019, a full investigation was carried out, and a number of improvements have since been introduced to the care provided to children with sickle cell disease.
These improvements include ensuring all patients receive a full blood count test and a complete set of observations before being discharged home. While these changes are a step in the right direction, it is crucial that they are consistently implemented and that healthcare providers remain vigilant in recognizing and addressing the potential complications of sickle cell disease. The NHS website offers further information about sickle cell disease and its management.