Brock lost both parents young. Now he’s grieving a daughter who could have been saved

A two-year-old who died in a regional NSW hospital should have received treatment immediately after recording a heart rate in the “red zone” for potential sepsis, but she did not because emergency staff were inundated with critically ill patients including another child needing resuscitation, an inquest into her death has heard.

Pippa White died at Orange Base Hospital on June 13, 2022, less than a day after visiting the emergency department at Cowra Hospital with vomiting, diarrhoea and lethargy. She had been recovering from COVID-19 two weeks earlier.

She recorded a heart rate of 171 beats per minute when triaged about 2pm on the day before her death.

A heart rate that high would be considered in the “red zone” for potential sepsis and ought to have automatically triggered a rapid response from doctors, the inquest heard on Monday.

Nikota Potter-Bancroft, the nurse who triaged Pippa at the Cowra emergency department, told the inquest she did not believe the toddler met the criteria for sepsis, despite accepting the high heart rate would normally result in a rapid response.

“She didn’t look like a toxic child to me,” Potter-Bancroft told the inquest.

The nurse assessed Pippa as a category 3 patient, but said she did not think the toddler would have been treated within the recommended 30-minute timeframe because the department’s two nurses and one doctor were preparing to treat an eight-year-old who was being resuscitated in an ambulance on the way to the hospital.

Potter-Bancroft told the inquest she had been working since 7am and had not had a break.

All four beds were full, including one with a patient who had required a medical cardioversion (an alternative to defibrillation) to restore normal heart rhythm, and an agitated parent who had earlier been removed by police.

“It was a hectic day,” Potter-Bancroft said.

Pippa’s mother, Annah White, earlier told the inquest that Potter-Bancroft advised her to wait for treatment at home because the ED was too busy. The nurse disputed this, saying she explained that there was “another sick kid coming in, [and] there’s going to be a wait”.

Annah went home but returned a short time later when Pippa’s condition deteriorated. She was then transferred to the paediatric ward at Orange Base Hospital.

The court was played a video of Pippa, taken by her mother at 2am, struggling to breathe while hooked up to a number of observational machines on the paediatric ward.

Roslyn Sadler, a nurse on the ward, told the inquest she “made half a dozen or so calls” to Dr Christopher Morris, the registrar on call, before he arrived to take bloods and conduct a further assessment of Pippa.

Asked if a rapid response should have been called as Pippa’s condition deteriorated further, Sadler said: “In hindsight, probably yes.”

Dozens of family members and supporters packed the courtroom at Lidcombe Coroners Court, wearing yellow, Pippa’s favourite colour. Those who did not fit listened to the inquest next door.

Pippa White with parents Annah and Brock, sisters Tamika, Sophie, and Lucy, twin brother Leo, and brother Bodhi.

Earlier in the day, Pippa’s father, Brock, told the inquest the loss of his daughter had been an unfathomable “nightmare” in a life defined by tragedy.

The loss of his father when he was eight years old and his mother when he was 17 taught him he could overcome anything, but losing his daughter had left him “a shell of my former self”.

“I wanted a huge family so when I was gone my children would have each other to lean on,” White told the inquest.

He returned to playing rugby league and union to “show my kids there was a positive way to deal with” the tragedy.

Pippa’s grandmother, Marianne Stonestreet, a retired nurse, told the inquest she left Orange Base Hospital the evening before the toddler’s death “sick with worry”.

“I know this should not have happened,” she said. “I will always be Pippa’s Ma and I will always love her with every beat of my broken heart.”

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