Lila and her mum had gone to A&E after the little girl had spent hours suffering ‘classic’ meningitis symptoms, say the family’s legal representatives(Image: Family handout)

A nurse has told an inquest how she told a worried mum she was ‘confident’ her child did not have meningitis – hours before the five-year-old died from the life-threatening illness.

Lila Marsland’s mum, Rachael Mincherton, asked paediatric advanced nurse practitioner Claire Casey whether her child was suffering from meningitis amid ‘classic signs’ of the brain-swelling condition, heard Stockport Coroners Court today (May 29).

But Ms Casey told the jury how she believed a child’s neck pain was because of inflamed lymph nodes, and that her high heart rate was a result of the pain.

Meningitis remained a ‘differential diagnosis’, the court heard, but the nurse said her physical examination of Lila, and Lila’s blood test results, suggested the symptoms came from tonsillitis.

On the third day of an eight-day inquest into Lila’s death, the court heard how Lila and her mum had gone to A&E after the little girl had spent hours on December 27, 2023, experiencing headaches, a sore throat, a high heart rate, neck pain and limited neck movement, vomiting, lethargy, and was unable to pass urine.

Ms Casey, who worked at Tameside Hospital’s paediatric A&E department, examined Lila and was ‘clinically concerned’ that the symptoms could be coming from tonsillitis, meningitis or another underlying illness, like a virus.

The nurse found Lila’s lymph nodes were swollen and that her neck was so sore that the little girl ‘cried out in pain’.

But blood tests results came back suggesting Lila’s white blood cell count was normal, indicating there were no high levels of infection.

Lila Marsland, with her mother Rachael and sister

Legal representatives for the family quizzed the nurse about why Ms Casey did not diagnose Lila with meningitis. Sarah Edwards, representing the family, told Ms Casey that many of the symptoms Lila was experiencing were ‘classic signs’ of meningitis, submitting that the nurse should have made the diagnosis.

Ms Casey told the court that, although meningitis remained a concern, she felt that the condition would not have caused the neck to be so sore to the touch.

Ms Casey also gave evidence how she felt the blood tests would have shown much higher markers of infection had Lila been suffering meningitis.

The nurse added that she believed Lila’s high heart rate to be a result of the pain she was in, and the anxiety from being examined.

The only way of conclusively testing Lila for meningitis would have been a lumbar puncture, said the nurse. Ms Casey called the test ‘highly invasive and painful’, saying the procedure on a five-year-old would have to be done in an operating theatre, likely requiring a general anaesthetic.

Ms Casey told Coroner Chris Morris she never ruled out meningitis, but followed a working diagnosis and began treatment for tonsillitis.

“Rightly or wrongly, I made that diagnosis,” said the nurse. Instead of discharging Lila as a standard tonsillitis case might sent home, Ms Casey said she kept Lila in hospital for further observations and arranged a discussion with a paediatrician because she was still ‘concerned about something underlying’.

Lila Marsland was taken to hospital by her district nurse mum(Image: Submitted)

Ms Casey accepted that, ‘with hindsight’, she should have started investigations into whether Lila had sepsis with the ‘sepsis six bundle’. The bundle is a set of interventions for the rapid management of sepsis, including cases where sepsis is complicated by meningitis

At the end of her evidence, Ms Casey gave her condolences to Lila’s mum and dad. Sat in court, the devastated parents shook their heads in response.

Lila was found unresponsive in bed by her mum on the morning of December 28, 2023.

Around eight hours earlier, she had been discharged from Tameside Hospital. An inquest jury heard the family were told medics suspected Lila had tonsillitis but ‘couldn’t rule out’ meningitis, and gave her a dose of antibiotics.

After being discharged at around 2am, Ms Mincherton said they drove home, got in bed together and fell asleep.

Lila, from Hyde, woke up about 4am complaining of a headache and was given a half dose of Calpol. At around 9am, Ms Mincherton woke up and found Lila unresponsive.

She called 999 and attempted CPR. Paramedics arrived at the home and Lila was pronounced dead at 9.19am. A pathologist has said she believes Lila died as a result of ‘pneumococcal meningitis.’

Ms Mincherton, who at the time worked as a district nurse at the same hospital, has told the inquest she has concerns her daughter was discharged ‘inappropriately.’

Proceeding.