New Report, page-2

FINDINGS OF INQUEST

How he died:Joshua died 18 days after a fourth time sternotomy and redo Konno procedure to upgrade his mechanical aortic valve, enlarge a patch to cover a ventricular septal defect and to enlarge the right ventricular outflow tract with a CardioCel patch. He had been returned to theatre on day 16 post- operatively for exploration and surgical debridement of a superficial infection of the sternotomy wound which had started to ooze on day 9 post-operatively. A VAC dressing was applied at this time with a plan to return him to theatre on day 18 post-operatively to reassess the wound and change the dressing. Joshua was actively investigated and treated for persisting fevers and tachycardia over the next two days, most likely caused by wound infection. In the early hours of day 18 post-operatively, Joshua developed an acute bleed through the sternotomy wound which filled the VAC canister and was collecting under the VAC dressing. He died in theatre approximately two hours later undergoing an emergency chest reopening which revealed the right ventricular outflow tract CardioCel patch had ruptured. Unfortunately surgeons were unable to fix the defect or control the catastrophic bleeding from the right ventricle. The Cardiocel patch ruptured because it had become inflamed but the cause of the inflammation remains uncertain.Joshua died at the Lady Cilento Children’s Hospital, Brisbane in the State of Queensland.Joshua died on 16 November 2015.Joshua died from cardiac haemorrhage due to or as a consequence of congenital aortic stenos (surgically repaired).