Girl, 17, who died from sepsis during school trip would have survived if she had antibiotics

Girl, 17, who died from sepsis during school trip would have survived if she had antibiotics

A schoolgirl who died during a school trip to New York would have survived if she had received antibiotics in the days before her death, an inquest has heard.

Ana Uglow, 17, from Redland, Bristol, collapsed in her hotel room and was pronounced dead at Mount Sinai West hospital, New York, on December 19, 2019.

Ana, a senior prefect at Bristol Grammar School who had aspirations to attend Oxford University, was on a school trip to Washington, Philadelphia, and New York at the time, Avon Coroner's Court has heard.

A report by the chief medical examiner of the city of New York concluded that Ana died from bronchopneumonia and sepsis, complicating influenza upper respiratory infection.

And experts have now told the inquest, which is due to last for five days, that Ana would have survived if she had been given antibiotics in the days before her death.

The teenager's parents, David and Natalia Uglow, claimed Ana told her teachers that she thought she had a chest infection and asked to see a doctor two days before her death but this was 'refused'.

But the two teachers, Rory Hambly and Ellice Clare insisted Ana only complained of having a blocked nose and feeling tired, adding that she did not directly ask to see a doctor.

On Thursday, two experts told the inquest that the schoolgirl would have survived if she had been given antibiotics in the days prior to her death.

Consultant general paediatrician Dr. Nelly Ninis said Ana's pneumonia would have been cured if she had received 'high-dose, broad-spectrum oral antibiotics' and taken them as directed on December 17.

She added: 'If she had received oral antibiotics, I think that would have prevented the secondary infection.'

On December 17, Ana had raised the issue of seeing a doctor with her teachers during a train journey and they took her to a pharmacy that evening, where she bought nasal decongestant and cough syrup.

The following day, Ana asked her teachers if she could stay in her hotel room rather than going on a walking tour, but ended up going along after speaking to them.

The teenager went shopping with a friend that same afternoon before going to the Empire State Building that evening, where she was seen coughing and retching over a bin.

Dr. Ninis continued: 'If two doses of antibiotics could have been taken and kept down by the evening of December 18, I think it would have slowed down what happened.'

She told the inquest that if Ana had attended a hospital 'at any point' that day, she would have been assessed and started on high-dose intravenous antibiotics.

'I believe she would have survived,' Dr. Ninis said.

Meanwhile, Professor Andrew Lever said that Ana would have survived if she had been given antibiotics on either December 17 or 18.

The inquest heard that it is likely Ana had flu when she went on the trip on December 14, with her symptoms worsening and becoming pneumonia between December 16 and 18.

The schoolgirl is believed to have developed a secondary bacterial infection, group A streptococcus, around that time and sepsis between December 18 and 19.

Ana told her teachers that she felt tired during the trip and asked to stay in her hotel room on both December 16 and 18, rather than taking part in planned activities.

In the days before her death, Ana's body was able to 'compensate' for the infection and her symptoms would have fluctuated, the experts also claimed.

On December 19, Ana woke Mr. Hambly at about 6.15am to tell him she felt unwell, her heart was racing, she had difficulty sleeping, had a sore back, and was feeling anxious.

During the inquest, Prof Lever was asked if he believed Ana would have survived if a paramedic had been called and given her appropriate treatment at that stage before she suffered a cardiac arrest at 8.15am.

The expert on infectious diseases said: 'On the balance of probabilities, the things that influence me to say that she could have survived is that her collapse was a very sudden event.

'In terms of that morning, the fact that she was physically well and walking around and able to go and knock on the teacher's door suggests that things had not reached a critical point.'

He added that young people such as Ana were 'very resilient and they do bounce back.

Mr. Hambly fetched Mrs. Clare, who previously described how she did 'breathing exercises' with Ana to calm her down before she ate a banana and took painkillers.

The teachers, who had both received first aid training and were experienced at taking students on school trips, then walked Ana back to her hotel room so she could get some sleep.

Dr. Ninis was asked whether it would have made a difference if Ana had been taken to hospital at that point, and she replied that Ana's chance of survival at 6am 'was not zero, it was above zero'.

But she added that Ana would have needed to go to the hospital, where she would have been admitted to intensive care, at least six hours before her collapse at 8.15 am.

'At the point, Ana went into cardiac arrest, I think her chance of survival was zero,' Dr. Ninis said.

'What I believe is that six hours earlier, it was above 50 percent that her life could have been saved.'

But Prof Lever said he believed some of her physical changes may have been reversed 'if prompt medical attention had been provided when she went to her teacher'.

At 7.30am, two students who were sharing Ana's hotel room woke up to discover she had suffered a nose bleed, was pale and her breath was gasping.

She was struggling to form words and told her friends: 'I think I'm going mad' and 'I can't feel anything, as well as asking Mr. Hambly, who was brought to the room, 'Why is this happening to me?'.

Mr. Hambly previously told the inquest that Ana was 'lucid, responsive and articulate' when he went to the room, but suddenly collapsed at 8.15am.

Prof Lever said there was a 'delay' to Mr. Hambly giving Ana CPR before paramedics arrived, as the teacher 'picked her up and put her over his shoulder and carried her to the bathroom' before placing her on the floor.

'If someone collapses, then people who have first aid experience would immediately reach for a pulse then they should start CPR straight away,' Prof Lever said.

But Dr. Ninis said she did not believe 'there was any delay' in Mr. Hambly administering CPR.

Paramedics arrived at the hotel at 8.26am and Ana was taken to hospital, where she was pronounced dead at 10am.

The inquest continues.
Girl, 17, who died from sepsis during school trip would have survived if she had antibiotics
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