An apparently healthy Manchester boy died aged just two from a rare and deadly heart infection which spread so rapidly it killed him in just 24 hours.
Little Tamael Cabe Robertson, who had been complaining of sickness and pain, was in bed when he became severely ill – just days after seeing his family GP.
He was taken to Royal Manchester Children’s Hospital by his parents Cassie Robertson and Neil Richmond but his condition deteriorated and he passed away just nine hours later as doctors battled to save him.
A post-mortem examination showed the ‘happy, cheerful’ lad died on July 1 last year from septicaemia and multi-organ failure as a result of infective endocarditis – a condition so rare and rapid that doctors have found it difficult to investigate.
After an inquest, the boy’s mother, from Urmston, said: “It’s a relief in a way to have a final answer and to know for definite what took him but it doesn’t make it any easier. It’s so rare. Why did it have to happen to our little boy?
”On Saturday he was a seemingly well, very happy, laughing little boy, enjoying the fresh air, sunshine and his new boots.
”On Sunday he was suddenly a fatally ill little boy and then gone from us. At just two years old, he was denied the wonder and experiences of the life laid out before him and his parents were denied ever seeing him grow into the wonderful young man we knew he would be. Life is so very, very cruel sometimes.”
Earlier the Manchester hearing was told Tamael was a normal baby who had learned to count and read and loved nothing more than playing with his trucks.
He was illness-free until he joined playgroup in December 2012 when he began to pick up viruses and infections – but nothing more than a normal child of his age.
Miss Robertson, 43, added: “He was up to ten with his numbers and doing well with his letters. He was such a bright, cheerful and happy child.
“On June 10 last year he became feverish. We thought it was a virus and gave him fluids. After a week he became cold and the doctor found he had an infection in his throat but as far as we were aware tests and records were normal.
“He was prescribed medication which helped and he began to eat again. On June 17 he began shrieking as if in pain and he became cold and clammy. We took him to see the GP but by the time we saw the doctor his condition had improved.”
A rash was then found on Tamael’s chest and he was prescribed antibiotics.
She added: “By the end of the week on tablets he had improved and I wasn’t worried at that stage as he had responded. He was still a bit under the weather so we decided not to send him to playgroup.
“He had been coughing though so we took shifts to stay up and make sure he wasn’t coughing in case he vomited.”
By Saturday June 29 Tamael was back to his normal self so his parents took him on a shopping trip.
“About 5.30pm he asked to go to bed,” Miss Robertson said. “It was early for him but he had a busy day. He woke up at 2am and asked for some milk and drank most of it. At 6am he woke up again and was loud and crying and wanted to get up.
“Neil took him down and he went on the computer and after about 10 or 15 minutes he went back to bed.
“About 10 minutes later he was crying due to stomach pain. The pain seemed to be coming in waves.
”He also vomited some yellow fluid. I took him to the walk-in centre and the observations seemed alright. We took him home and got him some pain relief.
”He still had some pain and vomiting but by 12 midnight he wasn’t himself. While in the car to the hospital he just wanted to drift off.
“We kept waking him up and he kept saying ‘sorry’. We got to hospital and it was clear something was wrong. His condition deteriorated and he passed away.”
Doctors battled to save Tamael when he was admitted to the emergency department where his symptoms suggested septic shock. He was given intravenous medication but didn’t respond so was transferred to life support.
Dr Robert Yates, who tended to the tot in his final moments, said: “An echocardiogram suggested a poor heart and despite large doses of medication he suffered a cardiac arrest and died at 9.30am with his parents. The clinical assessment was he had overwhelming sepsis.”
Dr Stefania Bitetti, a consultant histopathologist at Royal Manchester Children’s Hospital who conducted the post-mortem aid the infective endocarditis had severely inflamed Tamael’s heart.
“There are few theories as to how it comes about,” she added. “It is very rare and extremely rare in children. There are mechanisms by which bacteria can enter the blood.
”It’s often a case associated with congenital heart defects. If he was born with an abnormal heart it is also more predisposed but that was not the case here.
“There could be some underlying immune problem but it’s not possible to determine that after death. It spreads so rapidly that it’s very hard to investigate this condition.
”It’s an infection of the heart so the symptoms aren’t as clear as a chest infection, for instance.”
Recording a vedrict of death by natural cause coroner Sara Lewis told Tamael’s parents: “I offer my sincere condolences for your loss. It was clearly a very shocking and distressing event that happened very quickly.
“It’s so difficult to understand what happened because it is so extremely rare.”
Image courtesy of David Martin, with thanks
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