One of our medical negligence solicitors acted for Aaron Sikorski who at 14 months of age, swallowed a button battery. It was alleged that despite his mother consistently telling the GP and A&E doctors of her fear that he had, an x-ray was not performed. Aaron ended up requiring transfer to Crumlin for emergency surgery; Aaron was left with significant scarring, some difficulties eating and psychological trauma.
On Wednesday, 17th of January 2024, the High Court will rule on the settlement of a medical negligence case involving Aaron Sikorski, a boy who at fourteen months of age, swallowed a button battery. An alleged negligent delay in arranging investigation and removal of the battery by both the GP and those at Galway University Hospital, meant multiple opportunities to avoid the development of a trachea-oesophageal fistula were missed. The case was brought against both the GP, Dr Maire McGarry and the Health Service Executive.
On 25th July 2018, Marlena left her son Aaron on the floor, so that she could pour a cup of coffee. It was approximately 10:15am. She then heard Aaron choking and saw that he was over by the drawer. She thought this drawer had been cleared but she knew that it was ordinarily where the batteries were kept. She immediately suspected that he had choked on a battery. She shoved her fingers down his throat to try and clearly obstruction, and he threw up. Marlena telephoned the GP practice and told the secretary that she suspected Aaron had swallowed battery. The secretary told her to come in straight away. Marlena took it from the tenor of the secretary’s voice, that they would be seen immediately on arrival. When they arrived at approximately 10:30am, Marlena was frustrated to be left waiting in the waiting room while the GP saw another patient. She remembers looking at the clock and it was 11:00am, immediately before she was called into the GP’s room. Marlena alleges that she told the GP that she found Aaron by the drawer choking, and she believed he may have swallowed a button battery that she recalled had been in that drawer. The GP listened to the chest and asked Marlena if anybody in the family had been sick recently. Marlena told the GP that her daughter had had a high temperature, the weekend before. The GP concluded that Aaron could be dehydrated and advised fluids and Paracetamol.
Aaron continued to exhibit choking/breathing difficulties overnight and Marlena took an audio recording on her phone which she has retained. She brought Aaron to the GP clinic, first thing the following morning, 26th July. She showed the audio recording to Dr McGarry. The GP did not consider the need for referral or an x-ray and noted that he had had a high temperature overnight and had vomited again. His mother reported a difficulty in swallowing and mentioned her fear that he had swallowed a battery but again, no significance was attached to this. The GP advised that it could be croup.
On 27th July 2018 Marlena took Aaron to the Accident & Emergency Department in Galway University Hospital. The nursing records clearly document that there was a possibility of Aaron having ingested a battery, per Marlena. It was noted that he had difficulty breathing and that he was not eating. He was seen by a Registrar who noted that he also had irritability, that he had developed a temperature and coughing, and that he had bilateral air entry with no wheeze and no crepitations.
It is alleged that there was a failure to take a proper history and a failure to arrange a chest x-ray. The nursing records imply that the nursing staff discussed Aaron having a chest x-ray with the Registrar, but that suggestion was not acted upon. Aaron was subsequently seen by the pediatric team where again, an inadequate history was taken, there was poor communication with the nursing team and the possibility of a swallowed foreign body was overlooked. No chest x-ray was performed.
It is alleged that if an adequate history and chest x-ray had been taken at that stage the presence of a button battery would have been identified and it could have been removed. It would not have leaked, and the Plaintiff would have been spared the harm he came to.
Marlena brought Aaron back to the GP on 2nd August 2018 when it was noted that he had been assessed in hospital and still had stridor at night. An examination was carried out which revealed no abnormality. He was thought to have mild croup and was given more prednisolone, an inhaler and advice.
On 3rd August the Plaintiff returned to the GP and was referred back to the hospital. Following review in hospital he was found to have a polyphonic wheeze. A chest x-ray and gastrografin swallow showed a foreign body. The doctor who spoke with Marlena told her it was believed to be a coin and she said, much as she had all along that it was a button battery.
Aaron was referred to the ENT team and taken for emergency surgery and it was indeed confirmed to have been a button battery. The foreign body was removed, but Aaron was found to have oedema around the oesophagus. A subsequent gastrografin swallow showed a trachea-oesophageal fistula (TOF). Aaron required transfer to a specialist tertiary referral for significant and complex surgery in Crumlin on 4th August. The Paediatric Surgeon came to speak Marlena that night in Crumlin. She was visibly upset; she told Marlena that she did not know yet what they could do to help Aaron and they would seek guidance from Great Ormond Street Hospital in London. The Surgeon placed a call and Marlena was shocked at the number of medics that entered the room. To Marlena, they all appeared upset and concerned when they were told how serious Aaron’s situation was.
Aaron required additional surgeries to treat the TOF, and he has now been left with extensive surgical scarring. psychological trauma and residual dysmotility. His dysphagia (difficulty swallowing) has now resolved.
The Health Service Executive has in the course of the proceedings admitted breach of duty (liability) but puts Aaron on proof of causation; Dr Maire McGarry denies liability.
A settlement offer of €220,000 to include the cost of future treatments and therapies has been accepted.
Our Solicitor on behalf of Aaron’s family:
This is every parent’s worst nightmare. Marlena told multiple doctors over three days, that she feared her one-year-old boy had swallowed a battery. A simple x-ray would have confirmed that but the opportunities to arrange one were missed. All the while, the battery was leaking and corroding Aaron’s throat. Simply put, had Marlena been listened to, Aaron would not have suffered these horrific injuries.
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