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From: Jo
Sent: 30 July 2025 08:23
To: LADO@essex.gov.uk; enquiries@cqc.org.uk; concerns
Cc: Pam Cox MP
Subject: Urgent immediate support required CQC- CAS-971405-HOL4S5 Child B transfer

Child B is being transferred to Colchester; she has had no bowel scan, she had had no bowel prep she was given medicine last night to stimulate the bowel and this causes her pain it always has done it also doesn’t work.  Seepage was on 20th July but no actual bowel movements were evident-Child B can go 3 wks without bowel movement - this also shouldn’t actually cause significant pain if the bowel is just slow transit only and not instead  a nerve or bowel obstruction problem

The obs yesterday were abnormal and low the heart machine had been turned off the last 2 nights after every night documented bradycardia the lowest videoed 35 beats and 11:10 breaths no echo or cardiology review had took place during 10 plus days

The machine had also been clearly moved out of the bay  and at one point was actually covered by the curtain - this would be in view of the cctv cameras at the nurses station level 3 Princess Elisabeth ward

Today I’ve checked with Vera and they were normal.   When pressed she said well low bp and low heart rate, but would go up with weight again.  I’ve recorded evidence Child B was also pre synscope on walking to the ambulance and the ambulance was aware.  However transfer commenced I did not fight this for the below reason

In discharge summery it stated Meal plan was followed - however issues with sticking too and following.  I consider physical symptoms not addressed caused this alone and I consider forced feeding or coercion when someone is clearly ill emotionally harm - I repeatedly requested ng tube with some form of relaxant or sedative (not full anaesthesia unless the hirschprung biopsy was being done in which case 2 birds one stone).

I was bringing foods in and they clearly listed as well as me documenting

I’m also raising that bloods were normal when first done on ward, yet prints show Magnesium too high and Zinc deficiency as well as other issues. More bloods were taken 2 days ago. I was refused results yesterday by doctor who walked away, however on form today low alp 100 see comments on il6ra stat3
Magnesium from high 1.1 now borderline low 0.86
CRP / ESR not done for inflammation, no white cell or haemoglobin, no zinc - if same as sibling il6ra auto antibodies esr and crp will be suppressed and low. Child B's esr is always too low, critical inflammation will be missed ditto alp - blunted signalling

Due to threats of ng tube via security- this was also Vera (I am concerned that Vera was perfectly amicable but may have had some pressure exerted in relation to what has transpired last night and today), Child B forced herself to continue eating.  This was also at Jenni demands causing significant pain and discomfort and worsening symptoms on the days she ate almost 2k the next she would experience significant discomfort- this is not ed this is medical neglect

There is factually incorrect info in discharge summary - Dr Rupasinge states normal colonoscopy.  I have a letter stating it had to be abandoned due to poor bowel prep!  This is a factually incorrect statement for him to make.

He also states he will see her in October.  This was when he was due to see her, and yet the GOSH letter from spinal team quite clearly states -

Mum was clearly distressed as was Child B in clinic today, as she was having severe abdominal pain which I understand is a chronic problem, and when she suffers from this, she finds it difficult to walk and has to use a wheelchair. I understand this is a longstanding issue problem but is getting worse and is causing significant weight loss. She has been referred to a Dietitian but has not been reviewed yet.

On examination, Child B was lying in the clinic waiting room because of her abdominal pain. She was able to walk into the clinic room but needed support from her mum. Child B assumed a forward slumped posture in the consultation room relating to her abdominal pain. She was able to stand for a short period without support and has the presence of a moderate thoracolumbar scoliosis. Child B was too distressed to perform any further examination today. She was of low BMI and underweight.

Child B's spinal radiographs today which were performed after the brace show no significant changes from her original x-rays in February 2024. The curve look slightly worse than her previous x-rays in September 2024, but she was wearing the brace in those films so it is unlikely there has been any progression or change. There was evidence of faecal loading on her XR today.

I have explained this to mum and we will continue to manage Child B in her spinal brace. We will likely continue this until we feel that she is at skeletal maturity which is normally marked by the menarche in females.

I am copying her Gastroenterology team at King's into this letter. I understand that Child B is due further follow-up with you in October, but I wanted to alert you to these concerns in advance of this and see if her consultation could be expedited.

Dr Rupasinge has also repeatedly refused to do Hirschprung biopsy.
I now believe that Dr Rupasinge poses a physical risk to Child B of physical and emotional harm, and that is the only reason I have not fought harder to keep her at a gastro hospital.  I fear Colchester will now take any fall for the whatever condition Child B actually has if they are not on their toes and abreast of the situation