Investigation and inquest
On the 20 August 2023, I commenced an investigation into the death of Eleanor Curley-Bennett. The investigation concluded at the end of the inquest on 9 December 2024. The conclusion of the inquest was a narrative conclusion.
The cause of death was:
1a) Positional Asphyxia
Circumstances of the death
i) Eleanor Curley-Bennett, 3 weeks old, was in a baby carrier with her mother, on the 18 Augustd 2023. She was at a local, family friendly, music festival. Her mother realised something was wrong and that Eleanor Curley-Bennett, has stopped breathing.
ii) She was taken to Festimed, who provided medical care for the music festival. The carried out basic life support on Eleanor Curley-Bennett, before ad during the ambulance journey to the Princess Royal Hospital, Shropshire, where she passed away in the early hours of the morning the following day, the 19 August 2023.
iii) During evidence it was disclosed that Festimed did not carry the correct basic life support equipment, in the correct sizing for a baby of Eleanor Curley-Bennett’s age. Specifically. a) oropharyngeal airway; b) i-gel airway; and c) Tracheal tube. It was disclosed that there was no intubation equipment available. It was disclosed that there were no prefilled, diluted, adrenaline that would be suitable to be used on a patient of Eleanor Curley Bennetts age.
Coroner’s concerns
1. The lack of availability of the equipment and adrenaline described above