Review into baby Zara’s Mulheran’s treatment recommends changes to Ryan’s Rule call process

A review into the tragic death of toddler Zara Mulheran at the Queensland Children’s Hospital has led to several changes being recommended, including to Ryan’s Rule protocols.

A review into Zara Mulheran’s death has recommended changes to Ryan’s Rule. Picture: Supplied

Changes to the Ryan’s Rule medical call process have been proposed following a review into the death of a Caboolture toddler.

Earlier this year, 20-month-old Zara tragically died at Queensland Children’s Hospital after suffering two cardiac arrests in the wake of contracting hand, foot and mouth disease.

The Courier Mail previously revealed Zara’s shocking deterioration over the space of a month, leading her mother Carly Mulheran to invoke Ryan’s Rule after watching her daughter turn blue in front of medical staff.

Now a clinical review into Zara’s death has resulted in five recommendations by Children’s Health Queensland, including a proposal to require Ryan’s Rule call takers to ask a new question to help screen for immediate or urgent patient deteriorations.

Zara Mulheran died after contracting Hand,Foot and Mouth disease Picture supplied by Carly Mulheran

Zara Mulheran

Currently, the rule involves a five-step call process to 13Heallth.

“This will save thousands, and I know that without even having it implemented yet, because I spent 22 minutes on the phone to Ryan’s Rule for Zara,” Ms Mulheran said.

“So having this addition to Ryan’s Rule could allow a (medical emergency team) call to happen in five minutes, where, in Zara’s case, it was almost an hour and a half.”

Other recommendations in the review include having medical imaging reports more visible in patient care systems, as well as updating expectations on contacting parents and carers if clinical concerns are escalating.

Carly Mulheran outside the Queensland Children's Hospital, South Brisbane. Picture: Liam Kidston

“It obviously doesn’t take away the pain and doesn’t bring her back, but to know that my four other kids can go to the hospital now and have better care because of their sister is huge – and not just my kids, it’s all these kids,” Ms Mulheran said.

Ms Mulheran said she would continue to fight for change.

“It’s not just pediatrics, it’s not just one hospital, and that’s what I’m going to continue to push for is that this isn’t just for kids,” she said.

“We need to change where it’s not a guideline, it’s a ‘you must do this’.”

A Queensland Health spokesperson said following the review, the Department of Health will consider all recommendations that have a statewide impact, including those relating to Ryan’s Rule.

“We acknowledge the ongoing impact that Zara’s death has left on her family, friends and the community and extend our deepest condolences,” the spokesperson said.

“Just as we worked closely with Baby Weston’s family to strengthen Ryan’s Rule, we will work with Zara’s family, specialist clinicians, and those with lived experience, on any recommended adjustment to the rule.”

The parents of baby Weston invoked Ryan’s Rule in October 2022 at Caboolture Hospital after being sent home twice with their son who was later revealed to have been suffering from staphylococcus scalded skin syndrome.