A little boy died from an invasive Strep A infection after he was discharged from hospital despite having a red rash, an inquest has heard.
Five-year-old Jax Albert Jefferys was sent home where hours later he told his mother he couldn’t feel his legs.
As his family drove back to A&E, Jax began bleeding from his eyes and mouth and then stopped breathing, with his mother, Charlene McCormack, forced to give him CPR in the car in front of his three older siblings.On arrival at the Queen Alexandra Hospital in Portsmouth, Hampshire, doctors tried to resuscitate him but the five-year-old died less than two hours later at 10.15pm on December 1, 2022.
An inquest into his death at Winchester Coroner’s Court on Monday heard how Jax had been ill for days but it was dismissed as croup and then influenza.
Most Strep A infections are mild. When bacterial toxins cause a rash, it is called scarlet fever which is easily curable with antibiotics.
However invasive Group A Streptococcus is life-threatening and occurs when the bacteria enter normally sterile parts of the body, such as the bloodstream, deep tissues, or lungs, requiring urgent hospital treatment with intravenous antibiotics.
A nurse had highlighted a rash ‘over his back, his neck and his face’ but his mother said it ‘was never mentioned again’.Ms McCormack said: ‘I didn’t think I was being listened to. I was very concerned about Jax and how he was presenting.’
Jax had three older siblings and lived with his parents, his father an Army sergeant, in Waterlooville, Hampshire.
His father, Daniel Jefferys, was away in Estonia on November 27, 2022, and Ms McCormack and her four children stayed home that day and had a roast.
But in the early hours of the next day, she described how Jax woke up coughing.
He had been diagnosed with asthma and she gave him 30 puffs on his inhaler.
However when that didn’t stop the coughing fits, she dialled 999 at 1.05am.
Paramedics were called out, arriving at 1.22am and at 3am they called 111 for advice.
Ms McCormack was advised to give Jax paracetamol, keep his fluids up and follow-up with the GP but to call back if his symptoms further deteriorated.
The following day Jax asked to go to school, but at lunchtime, Ms McCormack was called to pick him up, saying he had a temperature of about 40C.
She had to go back to work, so a neighbour cared for him for the rest of the day.
On November 28, Jax was taken to see a nurse at Southbourne Surgery and coughed throughout the appointment.
Ms McCormack said: ‘By this time Jax was so weak I carried him into the surgery.
‘I told her he’d been up all night coughing, she raised the possibility of a chest infection or croup and prescribed steroids. I was still really worried about him.’
The next day, Jax went to the same neighbour’s house to be cared for.
His mother added: ‘His condition remained the same. He continued to cough and wasn’t really eating or drinking.’
By November 30 Jax still had a temperature and had become drowsy and at 6.08pm, Ms McCormack called 111 who suggested he attend A&E for review and Jax arrived at 6.50pm.
At 7.02pm Jax saw a doctor but his heart rate was high and his oxygen saturation was only 94 per cent, the court heard.
‘I kept questioning his O2 and heartrate, because at one point it was 166bpm, but the doctor said it was attributable to his fever and the way he was lying on the bed,’ Ms McCormack said.
A nurse first noticed Jax had a rash over his back, neck and face.
A red sandpaper-like rash is a classic sign of strep infection and happens when toxins provoke a widespread immune system response.
Ms McCormack said: ‘The nurse said it could possibly be heat rash because of his temperature but she would pass it onto the doctor.
‘To the best of my knowledge no member of staff checked the rash before discharge.’
At just after 10pm that evening, Ms McCormack was told Jax had tested positive for Influenza A and there was little that could be done except giving paracetamol.
The mother said she was told further blood tests would be taken and that they could go home.
Jax was put on the sofa and she later received a call from the hospital about his blood tests, which had revealed he was dehydrated. Ms McCormack was told to give him liquids.
The little boy remained on the sofa the following day with his condition unchanged until 8pm on December 1 when he told his mother he couldn’t feel his legs.
‘I knew I had to get him to the hospital straight away,’ Ms McCormack said.
‘When we got in the car he was responsive, but then he began bleeding from the eyes and mouth. It was horrible to see. Jax stopped breathing and became lifeless.
‘I started CPR. Jax’s siblings were in the car at the time and they witnessed this.’
Jax was carried into A&E at Queen Alexandra Hospital but died not long after arrival.
He was subsequently found to have Group A Strep.
Ms McCormack said: ‘When Jax died my heart was taken away. He was my only little boy. I always wanted a boy and I didn’t stop trying until I got one.
‘In a military family it really does take a village to raise a child and neighbours helped raise him, but he was still a mummy’s boy. He was a wonderful little boy.’
The inquest, being held in front of a jury, is expected to continue all week and will hear from the doctors and nurses who treated Jax.
Senior coroner for Hampshire, Portsmouth and Southampton, Christopher Wilkinson, warned those in court that the evidence ‘may be upsetting given the age that Jax was at the time of his death’.
