No care failures in toddler's death, inquest finds

A two-year-old girl who was allowed to die against the wishes of her parents was not failed by medics, an inquest has concluded.

Alta Fixsler, from Salford, suffered a brain injury at birth and doctors said she had no chance of recovering.

She died in 2021 when her ventilator was switched off - against the wishes of her ultra-Orthodox Jewish parents - after a High Court ruling.

Her parents alleged failures by St Mary's Hospital in Manchester but district coroner Zak Golombeck said there had been none that had "more than minimally contributed to her death".

Mr Golombeck found Alta was "profoundly unwell" when she was delivered, and she received "reasonable and appropriate treatment throughout her short life".

Alta was born in 2018 through an emergency Caesarean section after her mother Chaya Fixsler suffered a serious condition known as a placental abruption when 34 weeks' pregnant.

She was born without a heartbeat and needed to be resuscitated, which caused the severe brain injury from which medics said she had no prospect of recovery.

Mr Golombeck said "regrettable" claims by doctors at St Mary's that delays in Mrs Fixsler agreeing to the c-section contributed to her hypoxia as "wrong medically and legally".

Abraham Fixsler, speaking before the inquest concluded, said he and his wife managed to build a relationship with Alta, who was a baby they both wanted and waited for "for quite a few years".

"I used to talk to her a lot, I used to sing her songs," he said of his time by his daughter's bedside in hospital.

"We really loved her as part of the family."

A lengthy court case led the High Court find in favour of Manchester University NHS Foundation Trust.

The court ruled it was in Alta's best interests to remove her life support, despite the objections of her family.

"Each time before we went to court I told her [Alta], 'We are going to fight for you'," Mr Fixsler said.

"Although she never answered, I was able to see sometimes when we sung to her... I could see her cry."

Alta was recorded to have died when her ventilation was removed, and due to the "severity" of the brain injury at birth.

Mr Golombeck said he could not reach a conclusion of death through natural causes, as the removal of life support was "unnatural in a legal sense".

Instead, he said a narrative conclusion "is the most appropriate conclusion to return".

The coroner passed on his wishes to the Fixslers, adding "no one should have to go through the loss of their child".

The late disclosure of information from the hospital trust had delayed the coroner's decison on whether to issue a prevention of future deaths report, the inquest heard.

David Pojur, a barrister for the family, said the family "cannot have closure because the trust throughout this process have given late disclosure".

Manchester University NHS Foundation Trust said its staff had acted "professionally and compassionately and in [Alta's] best interests at all times".

Toli Onon, its joint chief medical officer said the trust offered its condolences to Alta's family

She said: "It is clear from the evidence at this inquest that Alta’s prognosis was never going to change and, sadly, that she could not live without life sustaining support.

"Her clinical teams did everything they could for her, from the moment she was delivered and resuscitated at birth and then throughout her short life.

"We will carefully review the coroner’s findings and conclusions to identify any further learning opportunities and consider what additional steps are required."

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