Investigation into whether Glan Clwyd diesel fumes caused baby’s death

Annie-Jo Mountcastle, along with twin sister Florence-Rose, was born on February 5, 2017, which was 12 weeks prior to their due date.

The twins remained in hospital until late April, but Ms Mountcastle died at her family’s home, near Llanfair Talhaiarn, on November 17, 2017.

Both twins also developed chronic lung disease after their births.

At a pre-inquest hearing, held in Ruthin today (March 23), it was heard that the baby’s parents, David Mountcastle and Amy Dean, raised concerns during their time in hospital.

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The ongoing works, regarding a neonatal unit at the hospital, were being carried out simultaneously by BAM Construction.

It is the belief of both parents, who appeared at today’s inquest in person, that diesel fumes transmitted from the works entered into the area where Ms Mountcastle was being kept.

Their perception is that those events may have been contributory to the subsequent loss of their daughter, albeit a number of months later.

Annie-Jo's siblings sat on her memorial bench on Pensarn Beach (Image: Amy Dean)

John Gittins, senior coroner for North Wales East and Central, said the assessment of current evidence obtained indicated “significant exposure” to diesel fumes during the baby’s neonatal stage.

But as yet, he said, there is “no objective evidence that this had long-term effects on the respiratory system”, nor was there evidence of bronchiolitis obliterans found at her post-mortem.

A report from Professor Sailesh Kotecha, professor and head of child health at Cardiff University; and Professor Jonathan Grigg, professor of paediatric respiratory and environmental medicine at Queen Mary, University of London, said that the assessment of the works should have been more robust, and vindicated the parents’ concerns that their twins were likely exposed to air pollution.

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But, it added, there is no evidence that it was the cause of Ms Mountcastle’s death.

Janine Wolstenholme, counsel for Ms Mountcastle’s parents, said that there are “gaps in the evidence at this stage”.

Both twins were said to already be requiring oxygen therapy following their premature births.

The notion that an incubator provided the babies with a “barrier” to the fumes was, Ms Wolstenholme said, “fundamentally wrong”.

She added: “One of the major concerns from Ms Mountcastle’s parents is the extent of that ingress of fumes – contrary to the hospital’s assertions that an incubator would have been a barrier, it would have actually exacerbated it and made it worse.

“What we don’t know is the effects of the symptoms that her parents say she suffered at the time.

“What none of us have is the clinical opinion sought, and therefore the amount of exposure.

“These girls were suffering with swellings and respiratory symptoms that might ordinarily look like colds, but the parents’ genuine belief is that the symptomatology related to exposure from pollution.”

“From the parents’ point of view, it’s not just about whether fumes caused her death, it’s whether fumes led to additional clinical treatment which exacerbated an already respiratory compromised baby.”

Ms Wolstenholme added that Ms Mountcastle’s parents would like the opportunity to provide a single statement, as well as requesting a further pre-inquest hearing, to which Mr Gittins agreed.

Colin Moore, representing BAM Construction, said that there is “obviously a gap in terms of causation”, and that the firm contests the extent of the alleged exposure.

He said that Professors Kotecha and Grigg, when writing their report, “did not have the complete picture, but seemed willing to make assumptions and form conclusions based on those assumptions”.

Mr Moore said his client is “keen to assist” in the investigation, albeit its evidence may be limited given the passage of time.

Enquiries will also be made into the working hours of the construction at the time.

Patricia Gaskell, representing Betsi Cadwaladr University Health Board, requested eight weeks for the organisation to carry out investigations, which Mr Gittins said was the “maximum I would be prepared to allow that to happen”.

Mr Gittins said efforts must be made to make “every possible investigation” and “tick every single box” in discerning the cause of Ms Mountcastle’s death.

He also stressed his desire to hear from the baby’s parents, and to conclude matters for her family.

“They remain at the heart of my investigation,” he added.

“It is far, far too long for them to wait to try and get answers.”