THE TYPE OF CASE WE DO

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INFANT; MENINGITIS; DELAY IN DIAGNOSIS; CATASTROPHIC BRAIN INJURY FINDING OF LIABILITY AGAINST GP FOR FAILING TO REFER TO HOSPITAL AND FINDING THAT PROMPT REFERRAL WOULD HAVE AVOIDED CATASTROPHIC BRAIN INJURY

L V DR J WALDRON (2008)

Aged 7 months L developed a febrile illness. The onset of the illness was at about 9 am. L was hot and feverish. He was taken to surgery but there was no GP available to assess him.

L vomited on the way home and was taken back to surgery where he was seen by a GP at about 11 am. A diagnosis of non specific viral febrile infection was made. L's mother was advised to give him paracetamol (Calpol) and fluids and to return should L's condition deteriorate.

L's condition deteriorated during the day and his mother took him to the out of hours GP clinic. L was assessed at 21.45. A diagnosis of viral infection was made and L's mother reassured.

L's condition continued to deteriorate and he was taken to hospital the next day arriving at about 12.50pm. He was noted to be acutely ill and was transferred to a second hospital where diagnosis of meningitis was made and subsequently to a tertiary referral centre for treatment.

L recovered from his meningitis however suffers from severe neurological injuries. He has a right hemiparesis, ataxic gait, epilepsy, and severe learning difficulties. He is dependent on others for activities of daily living and is prone to uninhibited and aggressive behaviour.

BREACH OF DUTY

It was L's case that he should have been referred immediately to hospital following assessment at the out of hours GP clinic at 21.45.

CAUSATION 

It was agreed that L was suffering from meningococcal septicaemia when he attended the GP out of hours clinic and that had he been sent to hospital at that time he would have made a good recovery from his illness.

OUTCOME

The case went to a defended trial on the issue of whether the GP was negligent in failing to refer L to hospital following assessment at 21.45. The Judge found that L's deterioration and symptoms between his first attendance at 11 am and his repeat attendance at 21.45 were such that he should have been sent to hospital following assessment at 21.45.

The Judge found that L's injuries were caused by the failure to send him to hospital following attendance at 21.45. The case has been adjourned whilst valuation investigations are undertaken.