A three-year-old boy died from a severe asthma attack despite never suffering one before, an inquest has heard.
Faris Aly was rushed to hospital with breathing problems but his condition deteriorated rapidly upon arrival, and medics were unable to revive him.
An inquest on Monday heard that Faris had been generally unwell for several days beforehand with a suspected virus, although he had not had any problems with his asthma the previous winter.
His wheezing was treated with steroids and inhalers and Faris responded, but relapsed in the early hours of May 16, 2018.
Paramedics arrived at the family home in Penzance, Cornwall, at around 3am, and treated Faris with reliever medicine to open up his airways, delivered through a nebuliser.
This treatment continued at the Royal Cornwall Hospital in Truro and at around 5am his mother, Natasha Aly, noticed that his lips had turned blue, and medics rushed to his bedside.
Faris was in cardiac arrest, and despite resuscitation efforts which lasted over 50 minutes, he passed away shorty before 6am.
Dr Samantha Holden, a consultant paediatric pathologist, concluded that Faris died as a result of acute asthma, likely to have been caused by a bronchial spasm or mucus plugging.
A post-mortem found he also suffered from a genetic condition called congenital adrenal hyperplasia (CAH), which affects the adrenal glands above the kidneys.
The condition may have decreased Faris’ ability to react to having an asthma attack, Dr Holden said.
Mrs Aly told the inquest that she was not completely satisfied with the way her son was treated.
She argued that Faris should have been given steroids upon arrival at the hospital, as his condition was worsening and he had already been treated with a nebuliser for over an hour.
Mrs Aly also questioned whether medics reacted quickly enough to Faris’ rapid deterioration.
Dr Michael Williams, one of the doctors who treated Faris at the hospital, said asthma treatment protocol was followed, and medics were “working towards” steroid treatment.
“The nebuliser is used to reduce inflammation in the airways, to open them up, and the next point would have been steroids as per protocol,” Dr Williams said.
“I don’t think there’s anything else that could have been done to change the unfortunate outcome. Everything was performed as per guidelines and in a timely fashion and we responded as the situation unfortunately developed.
“I don’t think that within the timescale, steroids would have made any difference.”
Andrew Cox, the acting coroner for Cornwall, concluded that Faris died from natural causes.
He added: “It looks as though he has had a virus of some sort, a background illness.
“The issue none of us are able to understand is why has that virus led to Faris to have that acute deterioration that he has not had on previous occasions?
“When he has gone into the hospital, something acute has happened within the emergency department which led to his very rapid deterioration. On the balance on probability, that was more likely than not either a bronchial spasm or mucus plugging.”
While acknowledging the family’s concern over the steroid administration, Mr Cox accepted Dr Williams’ explanation.
“I have to be guided by the clinician, it seems that you don’t start by administering steroids, they are part of the protocol, what you have to do is work through the protocol,” he added.
“Even if steroids had been administered, say 20 minutes into the process, would that have had a bearing, and would that have reversed the outcome within 15 minutes? On the evidence I have heard, the answer is no.”
Mr Cox was also satisfied that staff at the hospital had recognised the severity of Faris’ condition.