A morbidly obese 13-year-old boy who needed a heart transplant died after doctors said he was too fat for surgery, an inquest heard.
Adrian Balog was left receiving palliative care after two hospitals couldn’t treat his health problems because of his weight.
Now a coroner has written to Education Secretary Nadhim Zahawi to say that obesity can be as serious a sign of child abuse as starvation.
The Chorlton schoolboy had been morbidly obese since the age of three and was hospitalized with dilated cardiomyopathy, a heart condition where the organ fails to pump blood properly.
But because of his weight he was not eligible for a heart transplant or any interim measures to prepare him for the operation.
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He was then diagnosed with heparin induced thrombocytopenia, a blood disorder that can cause clots, further preventing any interim measures.
He was transferred from the Royal Manchester Children’s Hospital to Freeman Hospital, Newcastle, to explore further options.
But they decided there was nothing they could do and he was returned to RMCH where he underwent palliative care before dying 15 days later on April 2, 2015.
In a narrative verdict at an inquest held in Manchester last week his cause of death was given as multiorgan failure, dilated cardiomyopathy, morbid obesity and heparin induced thrombocytopenia.
Adrian was never taught how to eat healthily and had no contact with weight management services in his short life, coroner Zak Golombeck said.
Mr Golombek said: “The deceased died from natural causes contributed to by his longstanding morbid obesity, which itself contributed significantly to his death in that it rendered him ineligible to receive appropriate treatment.
“Those parentally responsible for him did not educate the deceased on the correct foods to eat nor on how to live a healthy lifestyle, and did not take him to (or access support from) weight management services.
“Throughout his childhood he was fed an unhealthy diet and allowed to continue with this diet into his early teenage years.”
He added: “The inquest explored evidence in relation to matters relating to public health concerns in view of the deceased’s morbid obesity and whether this should have led to a referral to children’s services by clinicians in primary care and/or staff at the deceased’s school. “
He said attitudes to obesity had moved on since 2015, but added: “It was accepted that an obese child – and particularly a morbidly obese child – may be a child at risk, even in the absence of other signs of neglect.”
The current head of Adrian’s school, Loreto High School, said that Department of Education documents about safeguarding children were used but there is no reference to obesity relating to signs and symptoms of neglect in children.
Mr Golombek added: “The absence of such a reference is a matter of concern as to how obesity in children is viewed as a public health issue in comparison to malnourished or underweight children which are both referenced as signs and symptoms of neglect.”
Outlining Adrian’s death, he said: “In February 2015 he was diagnosed with dilated cardiomyopathy.
“As a result of his morbid obesity, the deceased was not eligible to undergo heart transplantation, or any interim measures pending transplantation for his weight to reduce to a transplantable level.
“The deceased was hospitalized in February 2015 and was diagnosed with heparin induced thrombocytopenia which was a further factor in the deceased not being eligible for interim measures, including mechanical support of his heart.
“The deceased was transferred from Royal Manchester Children’s Hospital (RMCH) to Freeman Hospital, Newcastle, on March 15, 2015 for consideration of treatment options.
“No treatment options were viable, and therefore the deceased returned to RMCH on March 18, 2015 and a decision was made for him to receive palliative care.
“The Deceased died April 2, 2015 at RMCH.”
Mr Zahawi now has 56 days to respond to the coroner’s ‘Preventing future deaths report’.
His reply must contain details of action taken or proposed to be taken and set out the timetable for action.
Health Secretary Sajid Javid was copied in along with the Chief Coroner, Loreto High School, three doctors, Manchester City Council, Salford City Council, Manchester Safeguarding Partnership, Manchester University NHS Foundation Trust and The Newcastle upon Tyne Hospital NHS Foundation Trust.