A heartbroken mum who tragically lost her infant daughter to liver failure, has blasted the medics who cared for her after they failed to spot jaundice in her newborn baby.
Jenner Akanwo was just 37 weeks pregnant when she gave birth to her third child Misha at the Royal Preston Hospital on November 8 in 2020.
The baby was slightly underweight at the time, and labour was induced after the number had become static - but she was later found to be ‘healthy and thriving’ by midwives and health visitors, reports Lancashire Live.
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Following the birth, the mum of three repeatedly told healthcare professionals, including her GP, that she thought Misha looked jaundiced, from around the age of eight weeks old. Despite frequently expressing her concern for her child, none of her worries were addressed including by an A&E doctor on February 26 when Misha was three months old.
Still adamant that her child was unwell, a persistent Jenner took her baby girl back to the hospital where a paediatric consultant 'immediately noticed' that Misha was significantly jaundiced.
Misha remained at the hospital for two days, before she was transferred to Leeds General Infirmary, a specialist liver centre, and was shockingly diagnosed with a life-threatening liver disease, biliary atresia, which begins in utero and means one of the bile ducts is blocked and scarred which then leads to liver failure.
Normally, to treat the condition surgeons would perform surgery within the first 100 days following the birth, but as this time had already passed, Misha was placed on the transplant list for a donor liver.
Tragically however, the young girl died on May 28 before a suitable match could be found for a live saving donor liver.
Speaking at an inquest at Preston Coroner's Court on Tuesday (March 29) the grieving mum expressed her frustration at having known her baby was unwell within weeks of her birth but felt she had been ignored by midwives, health visitors and doctors who didn’t listen to her concerns.
One of the health visitors that had been involved in Misha’s care, Louise McDonagh, told Area Coroner Richard Taylor that she hadn’t spotted any signs of jaundice in Misha nor had she made any record of Jenner highlighting any concerns.
"Had there been any signs of jaundice I would have followed standard procedure and referred her to paediatrics," she said. "If there had been any concerns raised at any point we would have referred her."
The claim was fiercely disputed by Jenner who openly accused the health visitor of lying.
"My baby is gone, you still have your life, you are disrespecting my child," Jenner said during the inquest. "She has gone, she is lost. Had it been spotted earlier she would have had a massive chance of life.”
The mum also went on to explain to the coroner that she feared the jaundice had not been spotted because Misha was mixed race, however this claim was also refuted by Joanne Goss, matron in midwifery at Lancashire Teaching Hospitals NHS Foundation Trust.
She said that 'in babies with a different skin tone' healthcare professionals would take care to examine the whites of a child's eyes and the colour of their poo which are also both affected by jaundice.
The inquest also heard that on February 26 last year when Jenner first took Misha to A&E, she was seen by a junior doctor who noted: "For me, I could not see jaundice.”
It was only later that day, while in the supermarket, that Jenner bumped into a nurse who immediately spotted Misha was jaundiced and clearly unwell. The mum and baby returned to the hospital immediately, where they were eventually seen by paediatric consultant Karnam Sugamar.
"[The jaundice] was picked up straightaway," Dr Sugumar told the inquest. "The baby was clearly jaundiced and had yellow eyes."
The coroner asked Dr Sugumar: "We know the junior doctor didn't see the jaundice and health visitors and midwives had also failed to see anything, so how is it missed?"
Dr Sugumar said: "Misha's bilirubin levels were 130. When the level, which should normally be about 10, is close to 100 it becomes visible to anyone. It should have been visible to the A&E doctor and it was visible to those better trained paediatric nurses and doctors.
"The golden rule in paediatrics is 'always listen to a parent's concerns'. Mums know their baby best."
Jenner, who lives on Yew Tree Avenue in Ribbleton agreed with Dr.Sugumar that as a mother she knew her baby the best.
She said: "A mum knows her child. I just don't get why [the junior doctor] thought he was so sure. He said 'her eyes look fine her eyes look healthy and she'd be itching all over if she was jaundiced'.
"It's just not good enough, the way he spoke to me was awful, I don't understand why he couldn't see it. I was ignored."
Dr Barath Jagadisan, a consultant in Children's & Adolescent Services at the Leeds Teaching Hospitals NHS Trust, also went on to tell the inquest a little more about Misha’s final moments.
"On May 28 she was undergoing a bag change on her feeding line, and this can cause blood sugar to drop so when we are doing the bag change we give a sugar solution at the same time, but suddenly Misha had a seizure," Dr Jagadisan said.
"Unfortunately we didn't get an offer of a donor liver and this is how we lost Misha.”
Dr Jagadisan also went on to call for all healthcare professionals to be trained to use the stool colour chart recommended by the Children's Liver Foundation to allow them to easily identify the pale stools that could signal a jaundice problem in babies.
"Biliary atresia is a disease which starts very early in life so jaundice starts very early," he said. "For a liver to go that bad, as it did with Misha, it has been there for a long time. Jaundice must have been present in the first month of life because of the size of the liver.
"If the colour chart was introduced throughout the NHS it would make a difference; every health visitor should be trained to use it."
Following Misha's death, the inquest was told that this simple chart has now been introduced across Lancashire and South Cumbria by HCRG Care Group - which supplies health visitors to NHS trusts.
Following the heartfelt testimony of all involved, the coroner ruled that there had been several missed opportunities to spot Misha's jaundice and that she had died as a result of the Royal Preston Hospital failing to recognise the illness until her second visit.
"It would appear more likely than not, as Dr Jagadisan has told us, that given biliary atresia starts very early the jaundice must have been present very early and it must have been present for some time but it wasn't spotted and it wasn't spotted by a number of people," Mr Taylor said as he recorded a narrative conclusion.
"Misha Akanwo died at Leeds General Infirmary on May 28 in 2021 as a result of liver failure signs for which were not recognised until a second visit to the Royal Preston Hospital on February 26 in 2021."
