The family of a five-year-old boy who accused hospital staff of laughing nearby as their son was removed from life support have criticised an investigation into his death after a “catalogue of errors” in his care.
Muhammad Ayaan Haroon, who was known as Ayaan, died on 13 March 2023 at Sheffield Children’s Hospital, eight days after he was admitted with breathing problems.
Following complaints from his family, a draft report by Niche Health and Social Care Consulting found that his family were given “poor bereavement care” and shown “substantially inadequate” cultural sensitivity by an NHS trust.
While it found that some of his care did not meet the expected standard and made 15 recommendations, it also concluded that while changes may have marginally increased his chances of survival, they were ultimately unlikely to have changed the outcome.
Speaking to The Independent, his father Haroon Rashid, 42, said: “We see this as a cover-up. How can you criticise every element of his care and the many aspects of concern and say the outcome would not have changed?”
These changes included an earlier escalation to intensive care, the earlier insertion of a chest drain and earlier intubation to treat Ayaan, who had a history of respiratory problems and a rare genetic condition called Hace1.
The family is now calling for a second investigation, adding: “The main thing for us as a family is despite it saying his care was mismanaged, it still says the outcome would not have changed. We as a family can’t accept that.”
Among their complaints against NHS Sheffield Children’s Hospital is that Ayaan was taken to the morgue in a soiled nappy, and that staff there had not liaised with funeral directors before releasing his body, compounding their distress.
The family have previously complained they could hear staff laughing nearby during Ayaan’s final moments, and the report said that as the unit was busy there was no side room available “to support a private dignified death which, while unavoidable, added to the family’s distress”.
The investigation found “no evidence of systemic or individual harassment or victimisation” but said staff did not find out if there were specific cultural wishes of the family when performing Ayaan’s last rites and in the management of Ayaan’s body.
They added that the fact that this was not covered in the NHS trust’s policy “may be seen as indirectly discriminatory”.
Prior to his death, Ayaan was admitted to Sheffield Children’s Hospital on five occasions with respiratory illnesses and on each occasion there was an escalation of his symptoms and the treatment he needed.
On 5 March 2023, he became unwell at home and was admitted with a lower respiratory tract infection. When his condition deteriorated he was transferred to the paediatric intensive care unit (PICU), where he died on 13 March from overwhelming disseminated adenovirus bronchopneumonia.
Out of 736 complaint points submitted by Ayaan’s family, investigators upheld 307 points (42 per cent), partly upheld 171 (23 per cent), did not uphold 174 (24 per cent) and could not substantiate 61 (8 per cent) points. They said 23 points (3 per cent) did not require an outcome judgement.
Investigators said there were aspects of Ayaan’s care that did not meet expected standards, including the fact that he should have been started on high-flow oxygen therapy sooner and a four-hour delay in admitting him to PICU because of bed and staff capacity issues.
The report said the medical clinical handover on the inpatient ward Ayaan was initially admitted to “was chaotic and ineffective” and “had the potential for the sickest children not to be adequately handed over at the change of shift”.
The report found there was “poor communication” around the likelihood of Ayaan’s survival and a failure to provide timely bereavement support, with the first successful contact made 15 days after his death. The family also received a call regarding an upcoming physiotherapist appointment for Ayaan, with the report stressing that the distress caused to his family by this contact could not be “underestimated”.
Mr Rashid said: “He was the light of this family, our only son. He lit up the house, screaming and talking, you could hear him all over the house. He was the light of this family, since he’s been gone there is constant silence in this house. The heart of this family has been ripped and torn to shreds.”
The report made 15 recommendations, including; alternative strategies for ventilatory support on the ward where an intensive care bed is not available; guidelines on handling the “immediate post-death period”; considering whether a member of staff who shares the same ethnic background should act as a link worker for the bereavement process; and organising unconscious bias training for all clinical staff.
Dr Jeff Perring, executive medical director at Sheffield Children’s NHS Foundation Trust, said: “We express our deepest condolences to Ayaan’s family for their loss.
“We commissioned an independent investigation into the care and treatment of Ayaan. The draft report, with recommendations, has now been shared with Ayaan’s family for their feedback.
“During the investigation, we have addressed a number of concerns from Ayaan’s family and we are committed to working with the family to address the learning within the draft report.
“We are working alongside NHS South Yorkshire to make sure Ayaan’s family have the support they need, as they review the draft report before it is finalised and published.”
A spokesperson for NHS South Yorkshire said: “We would again like to offer our sincere condolences to Ayaan’s family for the loss and distress they have experienced.
“We’re continuing to work very closely and support Ayaan’s family and have met with Ayaan’s father to share with him the draft report into Ayaan’s care.
“As this report is still in draft we’re currently at the stage where everyone, most importantly Ayaan’s family, have the opportunity to fully read and provide feedback and comment before the final report is released.”
