An inquest hearing has examined whether a nationwide shortage of antibiotics contributed to the death of a Southport toddler from the infection Strep A.

The government’s Department for Health and Social Care was called to give evidence before a jury at the hearing, after a pharmacy was unable to provide antibiotics for Ava Hodgkinson that were prescribed by a locum GP due a shortage. 

Ava’s family were represented at the three-day hearing that took place this week at County Hall, Preston, by Bryony Doyle, a specialist medical negligence solicitor at JMW. Whilst the jury recorded a conclusion that Ava’s death was due to natural causes, a coroner overseeing the proceedings is to write to Health Secretary Wes Streeting to demand action over how the issue of low antibiotic stocks may be dealt with in the future. The coroner’s letter to Mr Streeting will take the shape of an official Prevention of Future Deaths Report, which will ask for a review into whether pharmacists can be given the power to issue a different dose of an antibiotic, if the requested one is out of stock, without the need for a new GP prescription.

There had been a delay in the Amoxicillin prescription being issued to Ava’s pharmacy, after she attended the GP with Adam at 12.30pm on 13 December 2022, due to an administrative issue at the surgery. However, once the prescription arrived later that afternoon, the pharmacy found it did not have the required dose of Amoxicillin in stock and had to request an alternative prescription from the surgery. The pharmacy did have a different suitable dose in stock, but under current legislation it could not be dispensed by the pharmacy without a new prescription

An amended prescription was issued for a different dose of the antibiotic the following morning (14th December) and Ava had her first dose at 9.30am. However, Ava deteriorated and was rushed to Ormskirk and District General Hospital by Jade later that afternoon. When Ava arrived at hospital she had collapsed, and a crash team tried to revive her. However, Ava tragically died and was found to have been overwhelmed by sepsis. Microbiology later concluded that Ava likely had the Strep A infection.

Bryony said: “Jade and Adam have showed incredible strength and bravery in the face of unimaginable pain, which they and Ava’s siblings will carry for the rest of their lives.

“The inquest process, whilst harrowing for the family, has helped to piece together what happened to Ava and provided some of the answers they were seeking. I hope Ava’s story will see changes made that can protect other patients. We are grateful to the jury for considering Ava’s treatment so carefully, which will hopefully go some way to preventing other families from suffering as Ava’s has.”

Ava’s parents Jade and Adam Hodgkinson said: “There are not enough words to express the magnitude of pain and devastation we feel as a family at the loss of our beautiful daughter, Ava Grace. Ava radiated beauty both inside and out - the purest of souls; gentle, kind and loving and whose love for nature, wildlife, and those around her shone through. Comfort is very difficult to come by, but we take some from the light that has been shone on Strep A, its potentially devastating consequences, and the need for urgent treatment to be available when a child needs it. Ava was let down by the shortage of antibiotics and this should never happen again to any other child.”

Ava had not previously been tested for Strep A by the locum GP, but due to the prevalence of the infection amongst children at the time, the GP had prescribed antibiotics as a precaution.