Background and diagnosis

Daniel Terziski, the third son of Kiril and Danica Terziski, was born on March 18, 1994, at the Misericordia General Hospital. An ultrasound done at six months gestation was reported as showing a normal fetus. At birth, Daniel was considered an active and healthy baby and was discharged with his mother on March 23. It is clear now that he was in fact suffering from a very serious heart condition at the time of his discharge.

One of the first questions raised in this case is the accuracy of the ultrasound done at six months gestation. In their joint report to this Inquest, Duncan and Cornel state:

The information contained in the medical record suggests that a fetal echo was done and reported as normal. This seems unlikely given the fact that there was only one atrio-ventricular valve. (Exhibit 354, page 6)

As Dr. Walter Duncan testified, Daniel did not have a tricuspid valve-therefore the scan could not have shown a healthy heart.

Cornel also noted that if the perinatal and neonatal diagnoses had identified the defects earlier, the treatment might have been more successful. Cornel testified:

When dealing with univentricular circulation, one of the things that we like to avoid as early in life as possible is massive volume overload of the ventricle. That means we like to try and control the amount of blood flow through the lungs so that the return to the ventricle is less than it might be, so that there is much less work for the heart to do. And earlier diagnosis and more precise management can reduce those problems, and sometimes earlier surgery is an advantage. (Evidence, page 44,790)

Very soon after going home, Daniel's mother noted that Daniel was weak, tired easily and had difficulty feeding. On at least two occasions his mother took him to a nursing clinic at the HSC Women's Pavilion. She testified that she also took Daniel to see the family doctor, Dr. Hugh Taylor, who encouraged her to supplement his feedings.