Source: Radio New Zealand
Azariah Levi was 11 weeks and four days old (file photo). 123rf
The Coroner has found the death of weeks-old baby whose parents were deeply mistrusting of the health system, was preventable.
Though it can’t be said for sure how Azariah Levi died, the findings say timely medical intervention would have likely changed the course of events.
In a ruling released on Monday, Coroner Ian Telford said all children should have regular check-ups, and 111 should be called immediately if a child is struggling.
Azariah, and parents Ariana and Allan Levi, lived near Matamata in Waikato when the infant died in late 2023.
He was 11 weeks and four days old.
His parents never got any antenatal or postnatal care and he was born at home without a midwife.
The findings show mother Ariana Levi as saying that was was driven by a deep mistrust of the health system after earlier pregnancies.
She also believed shortcomings in earlier care of one of her children in 2017 led to long-term health issues.
In Azariah’s case, his mother reported that the pregnancy was normal and that he was born on 27 August 2023 without complications and that he breast-fed normally.
But on November 12, Azariah’s parents noticed he wasn’t his usual self and he was crying more than normal and not settling.
The family went to church and after getting home noticed his colour looked off, but it was not serious.
The next day, baby Azariah’s feeding noticeably reduced – he kept breast-feeding, but for less time.
His parents noticed he was sleeping for longer and his cheeks were going flat, which made them concerned.
They started weighing him before and after feeds and could see his weight was slowly dropping.
On 15 November, Azariah breast-fed well in the morning but refused in the evening and was given breast milk by syringe.
At about 6pm he had problems breathing, with his parents saying he was holding his breath and his lips were turning blue.
The pair decided to take him to hospital, but it was not immediate.
While still at home, Azariah vomited a clear liquid, held his breath for a long time and rolled his eyes back.
An ambulance was called at 11.24pm and the baby’s parents tried to resuscitate him with the help of the 111 call-taker.
After FENZ and St John staff arrived, Azariah was taken to Waikato Hospital but could not be revived.
Hospital staff later expressed concern and Police investigated – ultimately unable to establish any criminal liability.
Police recovered a recording of a man speaking about “healing in religious terms” and offering a prayer of anointing over concerns about Azariah’s weight.
Faltering Growth
The Coroner said evidence suggested the baby’s growth problems started soon after he was born.
At post mortem, Azariah was found to be “markedly thin and underweight”.
There was food in his stomach and waste in his intestines and no evidence of dehydration, supporting his parents’ account of regular feeding.
No specific disorder of underlying cause of death could be found, but a pathologist considered a metabolic disorder to be the most likely explanation.
That was supported, in part, by Azariah’s older sibling having the earlier health issues of their own.
That child suffered “sudden cardiovascular collapse” needing intubation and ventilation.
The significantly underweight child was found to have severe metabolic acidosis.
A paediatrician the Coroner asked to investigate after Azariah’s death advised his head was smaller than normal which can sometimes indicate a neurological problem.
But, there was no information about his development milestones to confirm this.
Photos from shortly after he was born suggested a normal birthweight and appearance, but that changed in other photos about four-and-a-half weeks later.
“In these images, there is a noticeable prominence of the bony landmarks of his face, and his features appear less rounded…’ Coroner Ian Telford said.
Further photos, at about 11 weeks old showed facial bones that were “markedly prominent”.
The paediatrician agreed Azariah may have had a metabolic disorder affecting his body chemistry and parts of his brain.
“By the time of his death, at 11 weeks old, his weight was around 3kg, which is about what a newborn weighs,” he said.
The Coroner noted an 11 week old would normally weigh almost twice this, indicating he had not been gaining weight as expected.
His inquiry has found Azariah had faltering growth, a preferred term for the term “failure to thrive”.
For reasons unknown, he did not grow as expected.
,A preventable death
Coroner Telford said it was his view Azariah’s death was preventable, while also saying he was mindful of not wanting to add to his parents’ profound grief.
He said there was evidence his parents were closely watching him and taking steps they thought would help.
Scene photographs showed a diary with feeding and nappy times and a stethoscope on a bed.
“This case nonetheless highlights the vital role of regular assessment and monitoring of children’s health by suitably trained health professionals,” Telford said.
The Coroner also said it was clear the parents should have sought help as soon as he had problems breathing and changed colour, because these are a medical emergency.
“I note that Azariah’s parents had previously experienced concerns and frustrations in their interactions with healthcare providers following an episode of care involving one of his siblings… it is apparent that these experiences influenced their decisions about accessing antenatal, perinatal and paediatric care for Azariah,” Telford said.
“I acknowledge that these situations can be challenging and emotionally complex,” he added.
“Even so, when a baby does not appear to be feeding or growing as expected, this may reflect an underlying health concern, and seeking medical assessment provides an important opportunity to ensure the child’s needs are properly understood and supported.”
A child’s well-being “must always” remain the first consideration, Telford said.
He said in his recommendations released on Monday that parents and caregivers should call 111 immediately if a young child is struggling to breath, develops blue lips, has problems swallowing, pauses in breathing or sudden changes in behaviour.
The Coroner also said every child should be enrolled with the free Well-Child Tamariki Ora service and have regular check-ups.
He found Azariah died of natural but unascertained causes, and offered his sincere condolences to his family.
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– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand