A young child became unwell overnight and started to vomit. The following morning there was some improvement but she later became sleepy and developed a high fever. Her mother called the surgery and was put through to a GP, who advised her to continue with oral fluids and liquid paracetamol. The doctor said he was unable to visit, as the surgery was very busy, but advised the mother to bring the child to the surgery the next morning if she was no better.
The following day another GP from the surgery made a home visit because the child was not taking feeds, was sleepy, pyrexial and was vomiting. No rash was present but some crepitations were and a diagnosis of chest infection was made. Oral antibiotics were prescribed. The parents were concerned about meningitis, as there had been a recent case locally, but the GP reassured them.
The child was found dead the following morning. Postmortem examination confirmed the cause of death as haemophilus influenza meningitis.
GP expert opinion said
- The absence of neck stiffness in a young child does not rule out meningitis
- The GP had not appreciated the extent to which the child was genuinely ill as opposed to the specific symptoms that were being exhibited
- The child should have been admitted to hospital, as the symptoms of meningitis are often non-specific
- The general drowsiness and the inability of the child to keep down fluids should have alerted the locum GP to the need for urgent hospital admission
The claim was settled for £18,000.
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