Lessons to be learned after five-year-old Walsall boy with complex needs died as a result of severe dehydration
An inquest into the death of a five-year-old Walsall boy found he died as a result of severe dehydration due to an undiagnosed condition with links to autism.
Joshua Lee Allcock, who had complex needs, died in hospital on January 3, 2023 after suffering a bleed on the brain. The three-day hearing was told that it was clear that the child was dehydrated when he was admitted to Walsall Manor Hospital on December 28, 2022 in a poorly condition before being transferred to Birmingham Children's Hospital the next day.
The cause of death was given as brain bleed, dehydration and abnormally low sodium levels.
Recording a narrative conclusion Senior Black Country Coroner Zafar Siddique said: "Joshua had developed dehydration during the course of his placement with his foster carers due to ARFID [Avoidant Restrictive Food Intake].
“It is likely that on the balance of probabilities when he saw the GP on December 28 there would have been dehydration. The CRT [Capillary Refill Time] test of under two seconds gave false reassurance.”
"The deceased Joshua Lee Allock died from severe dehydration due to limited diet due to autism and ARFID."
"This has been a very difficult inquest," he added.
“It is important that lessons are learned. I do not make findings of gross negligence in medical care or systemic failure.”
The three-day hearing held in Oldbury was told a CRT or rapid nail test for dehydration gave the doctor a "false reassurance" and that it was likely that if Joshua had been diagnosed earlier, he would have survived.
A decision was taken by Walsall Council's social services to take Joshua into care over Christmas following concerns over his family's ability to look after him. He was placed with a foster family who only received the updated information about his dietary needs after he had been admitted to hospital.
The inquest heard that the lack of an earlier diagnosis of ARFID along with limited dietary advice made it difficult for his concerned new carers to know what fluids to give him. He was non-verbal and tolerating a limited diet of milk and crisps due to undiagnosed ARFID.
Mr Siddique said while he had concerns about about the lack of information sharing between agencies dealing with the Old Hall Special School pupil, he said he did not find there was gross negligence in the medical care given or systemic failures.
However, he said he would also be preparing a 'prevention of future deaths' report and writing to the Department of Health and Walsall Healthcare Trust relating to the case.
Joshua's mother Gemma Allcock described her son, who had "curly hair and beautiful blue eyes", as "loved".
"All I have left are my memories and videos of him," she added.
Joshua's family had raised concerns over his deteriorating condition once he had been taken into care, their difficulties contacting social workers aware of his needs over the Christmas break, and that he appeared "grey", "skinny" with "sunken eyes" at family visits in the weeks leading up to hospital admission.
ARFID is a condition characterised by the person avoiding certain foods or types of food, having restricted intake in terms of overall amount eaten, or both.