A 13 year old boy "sunny and friendly" died of a heart disease linked to a ten-year battle with obesity.
The young man's death led to changes in the way in which child negligence is identified after the professionals "never (had) a clear action plan" in place to help the family.
The review of the case shows that doctors have ruled out a heart transplant due to the weight of the child and the deterioration of conditions, Great Manchester police He said.
The family, who was not named, bought take-out food in the hospital for the baby weeks before he died.
"Although all professionals in contact with Child F1 were aware of their morbid obesity, there was never a clear plan of action or an early response (except for the Common Assessment Framework when F1 was hospitalized in the hospital); or an analysis if this was a safeguard concern ", reads the review of the case.
At the age of three, the child – known as F1 in the review of the severe case – weighed more than 30 kg and had a BMI in the 99.6th centile.
Family doctors, the school nurse, a nutritionist and weight control service have raised concerns or worked with the teenager. However, professionals have often not been proactive about connecting with other competent authorities, the report said.
On one occasion, a nutritionist failed to discuss his fears about F1 and siblings – which was also overweight at the time – with the school or family doctor, after the couple's mother accused the F1 for their weight and described them as "lazy" and a "donut".
From the other, the Greater Manchester school nurse agreed to follow up on F1 weight concerns with the GP, but the report suggests that this did not happen.
The report stated that even the child's mother – with whom F1 and their brothers lived – had not brought the child to various health appointments, even though F1 had raised their anxieties about their health and weight.
Video not available
Although F1 did well on an academic level, there were problems with their school attendance rate, which the mother blamed for health conditions.
The school was also concerned that F1 did not have a PE kit from the mother, who again claimed that she could not attend due to health and disability issues.
"This information was not true and although the school provided F1 with a PE kit, they found it difficult to challenge their mother to hinder the way F1 took part in something they enjoyed and that was beneficial to their well-being," says the relationship .
He also added that the school encouraged his mother to allow F1 to walk to school with their friends.
"They charted a route to school so F1 could meet friends along the way and avoid bullying reports. The mother was not happy with school interference and undermined their approach by continuing to drive F1 to school by car "the report states.
"The mother continued to blame the F1 child for not losing weight, saying they were lazy and disliked PE," he added.
Although F1 has participated in a diet, exercise and self-confidence program in a school set up by a physical education teacher – and that F1 has asked the school to keep quiet by its mother – the report states that it has become clear that the F1 had over 2000 calories before lunch, including a high calorie takeout as a second breakfast.
The F1 – which was described in the report as a "sunny and friendly disposition" – had also told the school nurse that they wanted to lose weight but found it difficult.
In December 2014, the child went to the family doctor for a scalp problem, but F1 also raised concerns about joint pain and asked if it was related to their weight. A second appointment was made to discuss it in detail, but F1 did not participate.
The GP made no further reference to the pediatrician due to the previous non-attendance.
"If F1 had been present, it would have been an opportunity to explore in depth with the F1 child what was really happening in his life and how it could be improved. The F1 child had gained 18 kg in the previous nine months," he says. the report.
"The situation for Child F1 was becoming increasingly serious and this should have led to a clear action plan and a mechanism to assess what the nature of the problem was and what could be done to solve it," he added.
In February 2015, the teenager was hospitalized and it was discovered that he had dilated cardiomyopathy, a blood clot and a long history of morbid obesity.
After a period of rest at home, they were readmitted to the hospital and transferred to an intensive care unit where their health "deteriorated significantly and there were considerable concerns about them".
"F1 was judged to be inadequate for a transplant because of their obesity and deteriorating heart conditions and F1 returned to the hospital where it was clear that they were now terminally ill and had little time to live," the report said.
During the last weeks of F1 in the hospital before their death in April 2015, concerns were again raised about the F1 mother, who "brought take-away food, was aggressive towards the staff and emotionally violent for F1 "the report states.
After the death of F1, criminal investigations were initiated but no action was taken, according to the report.
The review of the case, published at the end of last year, found: "The professionals worked in isolation from one another, the information was not always shared and the meetings were not held and not no holistic evaluation was undertaken.
"The complexity of the situation was not recognized and the longer the lack of serious actions continued, the more difficult it was for the professionals to consider or name this as a case of child abandonment," he added.
He established a series of recommendations that the agencies could take into consideration and help prevent such a tragedy from happening again.
Inside it, they stressed the "lack of professional clarity" about when childhood obesity should be considered as a concern for child abandonment and a lack of knowledge about how agencies should work together.
These included the updating of the Manchester obesity strategy to include the need for psychosocial assessments and a multi-agency approach to address the problem, as well as placing more emphasis on obesity in the abandonment strategy of the city.
A report prior to the meeting of the Children's Control Committee and last week at City Hall confirmed that negligence and obesity were highlighted as a new issue, adding that the abandonment strategy was "renewed" to include "l & Identification of factors such as obesity ".
During the meeting Councilor Jill Lovecy stated that in the past the schools that have highlighted obesity as a matter of abandonment in services for children "have not always found them willing to take seriously these issues ".
The chairman of the Manchester supervisory board, Julia Stephens-Row, said that there is a "workflow" around obesity.
Responding to reviews of serious cases involving negligence and obesity, he said: "It's about learning from those".
"It is again an area where everyone has to have those difficult conversations – it is not an easy conversation to talk to parents about their child's weight and also potentially their weight. It is that family environment.
"It is empowering those professionals to have those different conversations to take place," he said.
Early Help strategic agent Julie Heslop added that the team is seeing an increase in referrals, but said they are trying to get a "much more coordinated and effective response".
"There is a much stronger line of sight on obesity: our work is about trying to enter a much earlier phase," he said.
. (tagsToTranslate) Obesity (t) for parents (t) adolescents