Inquest resumes into death of two-year-old who choked at Butlin’s in Bognor Regis

A two-year-old boy who choked on a piece of sausage at Butlin’s in Bognor Regis had been on a list to get his tonsils removed but ‘was not offered that surgery in time’, an inquest has heard.

James Manning choked on a sausage at Butlin's in Bognor Regis
James Manning choked on a sausage at Butlin's in Bognor Regis

James Manning, from Battle in East Sussex, had a history of choking and breathing problems and had been referred to a centre in Brighton for the procedure prior to the incident on June 6, 2018.

He died two weeks later at Southampton General Hospital.

An inquest into his death, which resumed at Crawley Coroner’s Court yesterday (Monday), heard that James had previously had a ‘near death’ incident in May 2017 after choking on a piece of popcorn chicken and was taken to hospital by paramedics.

After further choking incidents and breathing difficulties, he was referred to the East Sussex Healthcare NHS Trust by his GP in August.

He underwent a sleep study and, on January 5, was diagnosed with Severe Obstructive Sleep Apnea, a condition where your breathing stops and starts while you sleep.

The inquest also heard that James had enlarged tonsils which were at grade three level.

Paul Kirkland, an ENT consultant at East Sussex Healthcare NHS Trust, said that James should have been on an urgent pathway for a tonsillectomy – surgery to remove the tonsils.

This was a ‘very common and straightforward procedure’, he said.

Assistant coroner Karen Harrold asked if this should have been done sooner and he said: “I think it would have been preferable if it had happened earlier.”

When asked if it could have saved James’ life, Mr Kirkland said: “It’s a possibility.”

He explained that, at the time, it was ‘standard practice’ after a sleep study report was received to invite the patient and parents to another outpatient appointment to discuss the findings.

However the inquest heard that this had now changed, and now a referral can be sent directly to the tertiary centre – in this case in Brighton – where the surgery would take place.

The centre in Brighton received the referral letter on April 5.

Mr Kirkland said: “With hindsight the whole process should have occurred in quicker fashion.”

Thomas Coke-Smyth, the lawyer representing James’ mother Natalie Reeves, said of the tonsillectomy: “There was no doubt that’s the treatment he needed to have...the only reason James didn’t have the operation was because he was not offered that surgery in time?”

Mr Kirkland said: “He wasn’t offered the surgery. It was recommended that was the treatment he needed.”

James would have undergone an assessment in Brighton to consider his suitability for the treatment before it could take place, he confirmed.

The inquest previously heard that James, his mother and his grandmother, had been enjoying a holiday ‘full of excitement and joy’ at Butlin’s.

They were eating breakfast at the Ocean Drive restaurant one morning when Natalie realised James was choking and began to administer first aid.

Steve Andrews, one of the paramedics called to the scene, said a piece of sausage was lodged past James’ tonsils, which were ‘the biggest’ he had seen in a while and were ‘pretty much obscuring the back of the throat’.

The inquest continues.