After a year-long inquiry, the State Coroner Adam Nakhoda ruled on Apr. 9 that there was no definitive cause of death for a six-month-old boy who passed away while he was under the care of his nanny.

The nanny had put the boy, Yong Jing Yu, to bed in her flat at Sengkang but found him lying face down and not breathing three hours later.

Nakhoda added that there was no foul play involved, The Straits Times reported.

Left house to run errands

ST reported that the nanny’s full name was not stated in court proceedings.

Yong had been under the nanny's care since he was around three months old.

Investigation officer (IO) Russel Tong said on the first day of the coroner’s inquiry on Mar. 27, 2023 that the nanny fed Yong milk before putting him to bed at around 3pm on Dec. 28, 2021.

Nakhoda said the nanny had placed Yong face up on the mattress.

The nanny then left her flat in Sengkang to run errands. Her 13-year-old son was alone at home with Yong and the two other babies she was caring for at the time.

The IO said the nanny had assumed that her son would be the one taking care of the three children. However, there was no evidence that he had checked on Yong, or the two other babies, while the nanny was out.

Pronounced dead in hospital

The nanny returned home sometime after 6pm, and found Yong lying face down at around 6:20pm.

He was not breathing and his face had turned blue at that point.

The nanny called for an ambulance and followed the Singapore Civil Defence Force's (SCDF) instructions to try and resuscitate Yong.

Paramedics took over resuscitation efforts when they arrived, and conveyed Yong to Sengkang General Hospital (SKGH), where he was pronounced dead.

No conclusive cause of death

Nakhoda said there was no foul play involved and there were three possible causes behind the child's death.

1) Positional asphyxia

A forensic pathologist from the Health Sciences Authority (HSA), Audrey Yeo, suggested that one of the possible causes was positional asphyxia, as Yong was found face down.

However, Nakhoda noted that there were no signs of pallor around Yong’s nose and mouth, which would have pointed towards positional asphyxia.

He added that signs of pallor might not be present after a person has undergone resuscitation and thus, ruled that it is not definitive that Yong's death was caused by positional asphyxia.

The coroner also noted there seemed to be some gaps between the mattress and the netted walls of the cot, but said there is no conclusive evidence of an unsafe sleeping position.

He said parents and carers should ensure a safe sleeping area for infants, including ensuring that there are no gaps between the mattress and cot.

2) Pneumonia

While Yeo said she found some acute inflammation in Yong’s lungs, it was not extensive enough to point to pneumonia and thus, did not sufficiently prove that pneumonia was a possible cause of death.

3) Gene mutation

The third possible cause of death was a gene mutation that Yeo found during the autopsy.

The gene mutation affects the transportation of ions to the heart and is known to cause fatal irregular heartbeats.

However, Yeo was unable to ascertain if this caused Yong’s death.

It was revealed during the inquiry that the nanny fed Yong 1ml of Zenmolin, a medicinal syrup used for relief and prevention of bronchospasm, two days before his death, without his parents' consent.

Nakhoda said the nanny did so as she had observed that Yong was "coughing badly" and "kept hearing wheezing sounds" from him.

However, it was unlikely that the medicine caused Yong's death as it did not show up on his toxicology report.

Despite this, Nakhoda stressed that nannies should not give medication to infants without seeking express consent from their parents.

Parents disappointed with hearing outcome

Based on the evidence, however, none of them was conclusive and Nakhoda said he was "constrained in this case to return an open verdict".

"Losing a child is always a devastating event, perhaps more so when the child is a very young infant with no record of serious medical issues, as in the case with Jing Yu," Nakhoda expressed.

The child’s parents — Yong Chen Seng and Toh Jinq Lay — told ST after the hearing that they were disappointed at the outcome as they thought that at least one of the three causes could explain their child's death.

The boy's father said they will consult lawyers before deciding on further legal action.

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Top image from Shin Min Daily News