A young boy from Limerick suffered fatal brain damage after choking on a cocktail sausage at home three years ago, an inquest has heard, reports The Mirror.
4-yr-old Robert Power-O’Meara, known as Robbie, from Churchfield, O’Malley Park in Limerick, died on August 20, 2022, at Children’s Health Ireland in Temple Street.
He had been transferred to the Dublin hospital for specialised treatment after first being brought by ambulance to University Hospital Limerick, reports The Mirror.
Robbie’s mother, Melissa Power, told the Dublin District Coroner’s Court on Thursday that the incident took place on August 16, 2022, while she and Robbie were in the kitchen. Her older son, Bradley, was upstairs on the computer.
Ms Power explained that Robbie approached her, pointing to his throat after she had given him sausages and chips while she was standing at the cooker, reports The Mirror.
Knowing he had been eating a sausage, she attempted to make him vomit by putting her fingers down his throat to try to bring up the food.
The court heard that Robbie had previously choked on food and they had managed to remove blockages in the same way, reports The Mirror.
“By placing my fingers down his throat, we would remove the food,” Ms Power said. “On this occasion, the sausage was not coming up,” reports The Mirror.
She said she picked up Robbie and ran next door to neighbour John Quinn, who also tried to clear his airway with his fingers.
When she saw blood coming from Robbie’s throat, Ms Power rushed back home to call an ambulance. Another neighbour, Derek Quaide, also tried to help, reports The Mirror.
She told the inquest the ambulance arrived within minutes and took Robbie to UHL’s emergency department. He was later transferred to Temple Street hospital in Dublin.
In response to questions from Coroner Cróna Gallagher, Ms Power said Robbie had been in good health that day and showed no signs of illness.
She confirmed that he had been eating a cocktail sausage. “He loved them,” she said, reports The Mirror.
Ms Power said that no food came out of his mouth at home.
Regarding past choking episodes, she said they had always been resolved either by removing or pushing the food down manually, and they had never needed to call for emergency help before.
She added that Robbie had never had issues eating sausages prior to that incident, reports The Mirror.
However, she noted that since the age of two, Robbie had a habit of putting large amounts of food in his mouth at once, and they often had to hide certain foods like wine gums from him.
Medical records presented during the hearing indicated that Robbie had been referred to an ear, nose, and throat specialist at UHL earlier in the year due to concerns about his tonsils and the possibility of sleep apnoea.
Coroner Gallagher also pointed out that a second urgent referral had been made after a GP visit to Dr Gerard O’Brien on July 12, 2022, reports The Mirror.
Ms Power said her son never got to attend the specialist appointment, and they had torn up the letter confirming it, which arrived two weeks after his death.
The court heard that Robbie had no pulse when he arrived at UHL at 7:57pm. Doctors managed to restore circulation after 45 minutes before transferring him to CHI at Temple Street.
Consultant paediatric pathologist Dr John O’Neill told the inquest that a postmortem revealed Robbie had enlarged tonsils, though there was no sign they were blocking his airway, reports The Mirror.
He concluded the cause of death was hypoxic-ischemic encephalopathy—brain injury due to lack of oxygen—and brain herniation, which compressed the brain stem.
Dr O’Neill said encephalitis, or inflammation of the brain stem, was a contributing factor, reports The Mirror.
While such inflammation can interfere with swallowing, he said it could not be definitively confirmed in Robbie’s case.
When asked by the coroner, Dr O’Neill said the enlarged tonsils could also have played a role, but again, it was not something they could determine for certain, reports The Mirror.
Coroner Gallagher said she was surprised a piece of sausage was found in Robbie’s throat during the autopsy.
However, Dr O’Neill suggested it was unlikely the piece had remained there all along and could have come up from his stomach.
The coroner also remarked that sausages seem to be a problematic food for young children, referencing similar choking incidents, reports The Mirror.
Dr O’Neill responded that any dense, solid food could pose a choking risk, regardless of age.
He added that typically, a four-year-old should be able to eat sausages without issue, unlike younger children who are more vulnerable, reports The Mirror.
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