To be seriously annoyed with this A+E doctor?

[toesandbt]

DD is 15, she was in a lot of pain, had been for a few days but it was getting worse and she was generally just feeling crap, took her to A+E, due to the abdominal pain. Gave her IV pain relief and other meds, doctor came back (bloods were clear) he asked her how she was feeling now and she said worse and he laughed, yes laughed! He then looked at me and said she's fine to go home DD was crying in my arms saying how she really can't be sent home, I didn't know what to say to her? Doctor said she was fine to and the meds would kick in properly at home, so I took that advice. A couple of days later she was getting bad spells of pain still and was still feeling crappy, I admit I told her that it would get better ( she got some oral meds too and he said up to a week to work) so she needs to persevere. She then began fainting and vomiting some odd stuff. I took her back to A+E in which they were seriously concerned about her (had developed sepsis) from a bad gallbladder/liver infection from a blocked gallstone! She was admitted and needed an ultrasound and IV antibiotics for the week. She has been discharged this morning with lots of meds and an MRI soon.

AIBU to think that initial doctor was awful? To be honest, it's my fault too I kept telling her to persevere. She must have felt so unwell.

I would suggest you put in a complaint and request that they investigate why your concerns weren't taken seriously and the attitude of the A&E doctor. This will ensure that lessons are learned from your experience and measures can be put in place to ensure no one else suffers like your daughter did.

I hope she's on the mend

Yeah, I was unsure if a complaint was warranted. I think it is!

Thank you

Hard to say if bloods showed nothing whether the doctor is at fault- it's not polite or professional to laugh, but he will have seen so many dramatic teens and malingering adults that it's kind of understandable that he would write her off in those circumstances.

However! That said, there may have been more tests they could/ should have done and not being a medical person I don't know. So yes, he could be really crap.

Either way, you've had a horrible experience and I really feel for you. I started to develop sepsis earlier this year (appendix related) and it was horrible- and it sounds as though it had progressed much further in her. You're not to blame in any way. It is quite unusual for a teen to have gall bladder problems and there was no way you could know. I'm pleased to hear she's come through and wish you both well.

Silver, doctor the second time said it was wrong because gallstones don't always show in bloods but it only showed after as the infection had got really bad.

A doctor laughed at her and fobbed you off, and all along she'd had bloody sepsis. Too fucking right it warrants complaint

Very rare diagnosis for a teen, so bloods being clear, plus unlikely diagnosis might Just lead to a patient being discharged home wrongly. But his attitude was way out of line, and he needs to raise his game, which a complaint from you would facilitate.

Hope she is on the mend.

Don't blame yourself, you trusted the person who was supposed to know what he was doing and didn't. I suspect that there would have been other symptoms showing that this wasn't just a case of over-dramatics by a teenager, for example the pain affecting her pulse rate. I agree that you should enter a complaint.

I would complain. If bloods were clear he should have looked for other ways to diagnose, such as the ultrasound she had when you returned. I doubt a teenager would fake being in that much pain for fun ( sure I'll be told differently!) and dangerous to only go on bloods, so many things don't show. I had similar shitty attitude from minor injuries with my teenager who had broken bone in foot, he was really sarcastic and nasty til he got the X-ray back when suddenly changed his tune. Nowhere near as serious as your situation but same not taking us seriously attitude.
Hope she recovers quickly.

You can get all the help you need to make a complaint via your local PALS

www.nhs.uk/chq/pages/1082.aspx?CategoryID=68

Good luck

And it's not your fault too, you could only go on what you were told by the doctor

I only learned about this recently (possibly from here!) but apparently Sepsis is a hugely dangerous thing that's massively underdiagnosed because doctors don't always know to read the signs properly (only human, I guess). It's not every day common, but it does happen A Lot.

So on that basis, I'd complain - partly about the poor behaviour with the laughing, and partly to ask them what they're going to do to sharpen up spotting sepsis symptoms.

I'm also really pissed off on your daughter's behalf: how dare he laugh at her pain? I've heard so many stories of teenage girls' pain not being taken seriously, it really riles me up. Like they can't be trusted to explain how their own bodies feel.

There's a trust thing with information here - sepsistrust.org/ with some fairly harrowing stories on it, fair warning if you're feeling fragile.

Sepsis would likely have set in during the week between visits, she would have had pain from the blocked duct (with gallstone) but they would not have expected that in someone so young to be honest and the pain meds for it do take time to kick in as some of it is anti inflammatory so takes time to reduce the swelling internally. But yes his approach and attitude was wrong and it should have been a couple of days and back not a flipping week

She didn't necessarily (in fact almost certainly) have sepsis the first time she went to A&E, so he may well not have "missed" that as it probably developed further down the line. It's not possible to tell whether they should have done more tests the first time she went to A&E as it would depend on the whole clinical picture, which we don't have.

He should not have been rude, and it is possible that something was missed clinically the first time, but sometimes the diagnosis only becomes clear as the condition progresses, so nobody on here could say if he was negligent or not.

She was still in a lot of pain after IV pain relief? You don't think that needed further looking into?

Please write a letter.

Even if it wasn't picked up in the blood tests yet, he was unprofessional and completely discounted a teenage girl's symptoms, presumably because she was a teenage girl. And that's just not on.

Poor thing - I had an acute gallbladder infection that came on very quickly, and I can honestly say it took me the very edge of my pain threshold. I was on morphine for 3 days, high dose antibiotics that meant liver testing every 12 hours and was admitted for 5 days. I was vomiting green bile, and they couldn't get my temperature down for well over 24 hours. It was worse than childbirth, and I would say that you really must complain. To be in that level of pain and have it dismissed is unfathomable. The fact it is unusual in a teenager is neither here nor there. I felt rubbish for weeks after too. Hope she gets better soon.

She wasn't septic in A+E the first time. Her bloods were normal.
The doctor took her pain seriously and gave her painkillers.

You did the right thing in taking her back when she got worse, and then the cause was clear and she was treated.

Sorry you've both been through so much pain and stress, from what sounds like an unavoidable illness, but what exactly is the complaint for?
You objected to his approach in what sounds like just a few seconds of a process which probably took a few hours, and you're going to complain to his employer?

I am shocked that after having severe pain for several days that he didn't do more than look at her blood and give her pain killers. I'm not a doctor so I wouldn't really know..... but wouldn't an ultrasound have shown up the gall stones? A simple, cheap, non-invasive procedure. Worse is that he probably thought she just had period pains!

That's why I suggested PALS. They will be able to answer all your questions, or point you in the direction of someone who can.

If it had been a man or even a teenage boy crying in pain, they would have taken her seriously.

I'd say the Drs attitude warrants a complain, yes.

But, I work in a paediatric A&E and to be frank, if bloods showed up clear it'd be likely we would have sent her home too, expecting the pain to settle. Ultrasounds are a relatively rare and not foolproof way of diagnosing in children and not regularly used in our ED, unless there were signs of infection and pain that could not be explained in other ways, for example in appendicitis.

Sadly, it is not uncommon for parents to bring back children when the condition worsens, abdo pain and brochiolitis being common causes of this. We had one child at the weekend that ended up very unwell from bronchiolitis that had been sent home from A&E the day previously. Parents were, understandably, very upset and angry about this. But the simple fact is, we can only go on the symptoms that we see in front of us at that time. There are simply not enough beds available to admit all children who present well enough to be discharged at that time but who may or may not deteriorate.

And yes, it is extremely common to see children coming in with injuries unable to weight bear who score their pain as a 10/10 who end up skipping out happily after an x Ray comfirms no fracture. Sometimes all that can be done is discharging home from A&E with good safety net advice about when to return if nothing improves or if it gets worse over the coming days.

Please don't feel guilty about not pushing harder at the time. Hope she is feeling better very soon

When did you meet them, Tinkly?

Are they always such misogynistic pillocks?

What I don't understand is that, irrespective of the fact that the bloods were OK first time, they didn't twig that something was seriously wrong anyway. Bloods don't reveal everything.

Pain tells us something i.e something is wrong.