wrong diagnosis -negligence?

[trudles]

I have a very long story to tell you all. My dd In march became very unwell I was called in by the nursery at 1000hrs as she was turning blue. On my arrival she was blue from heat to foot and shivering concsous but distessed I rushed her straight to the gp who admitted her to hospital. On arrival her colour had improved but she had a temperature of 39.4 ten minutes later she was given some calpol half an hour later temp was 39 she was given neurofen.half an hour later we saw a doctor who sent her for a chest X-ray. The doctor told us the chest X-ray was clear by now her temp was normal and she was discharged by a senior doctor at2030hrs with open access.As soon as we got home her temp had gone up and she was shivering again the same happening at 0200hrs settling for short periods with calpol. The following morning yet again she was a greyish blue with purple lips and shivering so off we went again to the hospital.This time they took some blood samples and pumped her full of calpol and neurofen today her temp was spiking between 40 and 38 degrees another doctor came round and said it was a vius this time she was kept in overnight with her temp constanly high. The follwing morning the doctors discharged her and said to go to my gp in three days time if she hadnt improvred. well she didnt improve so two days later we went to the gp who immediatly put her on antibiotics and she was well within 48hrs. A month later she developes a severe chest infection and asthma attack gp starts antibiotics and steriod with good effect however my gp refers dd back to the hospital as he is thinking theres something not right maybe a heart defect. Any way this week we went to outpatients to se a paediatrician who tells us that when she was in hospital the test results show she had a severe bacterial infection and was aneamic and needs to start iron drops straight away. I informed her that we were told it was a virus but she said she couldnt comment as she wasnt there. I also found that her chest Xray wasnt reported by a specialist radiographer for a month after her discharge. If it was done sooner ie the day after it was taken she would have got better sooner and I wouldnt have had the worry that something was seriosly wrong. the consultant has repeated her blood tests and xray and done an ecg we have got to go back in three months. but she is really well at the moment so we should get the all clear. All I want is for somone to say they made a mistake and theyre very sorry.

[SofiaAmes]

trudles,
What a scary time you must have had. Unfortunately, it sounds like almost every experience I have had with the nhs and my son. Where do you live? St.Mary's in London (paddington) has a paediatric A&E which is absolutely brilliant. You always get seen by a paediatrician so they actually know what they are doing when it comes to children. They have a great waiting area full of toys and the nurses are sooo nice. They are only open 8-8 so you should call before you go to make sure they are open. I've even got great advice onthe phone from them.

[trudles]

unfortunatly for the doctors concerned I am a senior staff nurse in acute medicine In the same hospital( in the midlands) and am on good terms with other doctors and managers. and know that the chest xray should have been reported on sooner also any one who was that ill with a temperature that high and after being told what the blood results were It is an outrage that she wasnt put on antibiotics as a precaution. maybe my standards seem a bit high but but I am still very angry especialy when I knew they were missing somthing.I do not think she got the care that she needed.

[SofiaAmes]

Trudles, I agree with you. Your child did not get the care that she needed. And more appalling to me that as a nurse there, I would have thought that what you did get was more attentive care than the average person would have gotten.
I'm curious about this xray thing?...Last month when my son had a chest infection (only symptoms were a fever of 39.8 which he gets with every ear infection and a bit of wheezing), I took him straight to St.Mary's A&E (i never bother with my gp who's useless). He was immediately given nurofen+calpol by the nurse, then a paediatrician saw him within 1/2 an hour and sent him for an xray. Within another 1/2 an hour she had looked at the xray, diagnosed a chest infection and sent him home with antibiotics. He was fully recovered within a few days. Was there something else that should have happened with the xray? Or does it vary from hospital to hospital?

[WideWebWitch]

Trudles, my sympathy, what a horrible frightening time it must have been. I'm a believer in complaining and a great writer of stroppy letters but I'm not sure whether I would in your situation.

Mainly because a) your dd is, thankfully, ok b) complaining in a big way will take up your time and energy - do you have it to devote to being cross? (I say this as someone who realises that I have sometimes devoted too much energy to being angry and complaining: sometimes the only person who has suffered as a result is me - I'm getting calmer the older I get!) and c) you work there, so politically could it make life difficult for you?

OTOH, if you want to go ahead and complain, write and make a formal complaint to the director of the trust. I think NHS trusts have a set procedure for complaints and will investigate and respond to you. If it's a big hospital then it probably won't matter that you work there, they won't even realise. Glad your dd is OK and I hope the check up goes ok.

[honeybunny]

Trudles-I sympathise with what you've been through. There's nothing worse than watching your child go through hell, convinced that there is obviously something major wrong and not being in control of putting it right. Worse still, that nobody around you seemed to be getting it right. As a physio and wife of an anaesthetist, I know only too well that info in the wrong hands can mean nothing at all, but in anothers makes complete sense, in the medical prof. As SofiaAmes said, a jr dr may well miss something that a paeds consultant wouldnt, and in A+E you often only see the very jr drs. They can't really be blamed for their inexperience, sadly it happens. If initially it looked like a viral infection, a/biotics werent going to achieve anything either.
Medicine is movig away from bombarding everything with broad spectrum a/biotics because of multi-resistant strains of bugs.
It does all sound like a catalogue of errors that resulted in more worry for you and unnecessary illness for dd. I'm sure you are only too aware of how stretched the NHS is, and that more and more errors like this are happening. I'd suggest writing a letter of complaint to your MP. Its another example of where things are going wrong as a result of understaffing, and insufficient senior staff available to supervise jr staff, drs, nurses and profs supplementary to med alike.

[trudles]

she wasnt in A+E she was on a pediatric ward and was seen by a senior house officer and two pediatric regestrars. where i work its commen practise to get xrays reported with 24hrs not one month!!.

[honeybunny]

Trudles-a SHO has been qualified for just 1year, and a registrar may have done only 1yr as a junior house officer, a year as a SHO, plus maybe 6months of A+E, and be in his/her first rotation as a reg, therefore only one year more than the SHO. A consultant on the other hand will have had at least 7 years experience and passed 2-3sets of exams to prove his/her knowledge. Thats a major difference! Again, don't blame their inexperience, it really isn't their fault. The fault must lie with the fact that your dd wasn't seen by the consultant immediately who may have been able to diagnose your dd's illness much quicker. Surely as a nurse, you must realise how little you knew when first walking on the wards compared to now. But your senior colleagues may have been that more accessible to ask for guidance.

The x-ray will have been seen by these jnr drs, probably within an hour or two but may not have come to the consultant radiologists attention until a later date. At least they were able to tell from it that dd didn't have a major chest infection or worse. They certainly wouldn't have been able to tell whether there was a viral or bacterial cause for your dd's illness from that.

I completely understand how angry and let down you feel. Infact I'm not quite sure why I'm jumping to your hospitals defence. Only I read so many stories about people wanting to complain about drs inadequacies, and feel that its unfair to do so in so many instances. Everyone wants someone to blame, but drs are not god, they do get it wrong, or take a bit of time to get things right. Diagnosis is all about the process of elimination, unfortunately when people are ill they dont come with a written explanation as to cause and treatment. It has to be investigated, and information can only be obtained from whats in front of them at the time. And that may not be that obvious. Its always easier in hind sight.

[Harrysmum]

Sorry to correct, honeybunny, but the only SHOs with such short experience at SHO levels before progressing are radiologists and pathologists where the training structure is slightly different. It may have been a new SHO but it could equally have been an SHO with several years experience. You don't progress to registrar level until you have done your membership exams for the appropriate royal college and the exams require a minimum of experience in a hospital setting for each stage of the examination process. Once the exams have been passed then the next step is usually SHO3 posts in sub-specialties until they decide what to specialise in (these are usually short, 6 month posts). Registrar training is then 5 years. The 2 paeds registrars must carry much of the responsibility here.

[honeybunny]

Point taken, Harrysmum. I forget just how long dh spent in each of his "titles". But the regs still aren't considered senior drs by gvt/med standards. I think I was really just trying to point out that just because a dr comes with a title of SHO, it doesnt make them a "senior" doctor. They are really the baby of the speciality, aren't they, and the Regs may only be in their first year of their rotation, who knows, but again, they are still "in training" in their post. With yet more exams to come to prove their ability. And nobody is infallible.