East Yorkshire family pay tribute to five-year-old daughter who died of rare stomach condition

Esma Guzel had a rare stomach condition that caused her to go into cardiac arrest. Credit: Family Photo/MEN Media

The parents of a five-year-old girl from East Yorkshire, who died from an uncommon health condition, have said they will "never recover from their loss".

Esma Guzel died on her way to see an out-of-hours GP, hours after being sent home from another doctor with a stomach bug.Esma's family, from Cottingham, were told to seek further help if her condition deteriorated but she died shortly after her dad Erkan carried her into the GP surgery in the early hours of May 10, 2019, following a cardiac arrest.It was later discovered she had a condition not detected prior to her death known as Congenital Diaphragmatic Hernia (CDH). It led to part of her bowel becoming stuck in the hole in her diaphragm.On the final day of the inquest into her death in Hull, the family lawyer read out a powerful tribute from Esma’s parents Kerry and Erkan as the couple listened in tears.“Esma had a huge impact when she arrived into the world early and in a rush,” her parents said. “She continued that throughout her life, always eager to go to school, gymnastics and swimming lessons.“She was fearless and confident and she had the most infectious giggle ever. She had so much to offer this world and we will never recover from the loss. We are like a jigsaw that will never be complete. But we will live through her and will forever keep Esma in our hearts.”

Credit: MEN Media/Family Photo

CDH is a condition that affects approximately 1 in 2,500 births and usually can be detected in ultrasound scans.

Mum Kerry had three prenatal ultrasounds but, due to the type of CDH Esma had, it could not have been picked up at that early stage.If she was diagnosed, Esma would have been prepared for surgery and the outlook for late presenting CDH after surgery is excellent, the inquest heard.David Crabbe, a consultant paediatric surgeon, made clear the GP's assessment of May 9 could not have foreseen the CDH and it was not reasonable to suggest she should have referred Esma to hospital.On Wednesday, assistant coroner Dr Dominic Bell agreed and said, that while there were some flaws in the assessment, the actions of the doctor that day were that of a reasonable and competent GP.He accepted that had Esma been referred to hospital that day her condition would likely have been diagnosed and successfully treated.

But he felt Esma had been thoroughly examined and diagnosing a tummy bug was reasonable. He also said the GP provided a safety net by telling the family to call 111 if her condition worsens.

The coroner has ordered a review into the 111 algorithm that didn't send Esma to hospital. Credit: MEN Media/Family Photo

However, Dr Bell is holding a Rule 28 hearing next month which provides a ‘preventions of future deaths’ report, which sets out what action should be taken by a body or organisation to mitigate against similar deaths happening in the future.The hearing will focus on the NHS 111 service and the algorithms used to determine how a patient should be treated.

He said that, while Esma would probably have died even if an ambulance had been called, he questioned why they were sent to a surgery far away from paediatric services.Dr Bell said: “It is unacceptable that a parent should be transferring their dying child to a surgery and trying to access the building with the dying child in their arms.”He delivered a narrative conclusion, saying the only other option would be ‘natural causes’ which he felt was not adequate.

The hearing is due to be held in April.