A GP who negligently delayed the referral to hospital of an infant with symptoms of a seriously worsening condition, has been found liable at the Appeal Court for the child’s permanent injuries.
The judgement overturned the initial hearing verdict, which had accepted the GP’s claim that the hospital’s subsequent delay in diagnosis and providing the correct antibiotic treatment would have still taken place even if the patient had been promptly referred.
The claimant - an eleven month old girl – who had fallen ill with chickenpox had developed a high temperature and an excessively rapid heartbeat. Upon first admittance to hospital, the baby developed a bacterial infection of the hip bone, which the hospital had failed to diagnose by the time of her discharge three days later.
The child was still suffering significant discomfort, and upon returning to her GP on the same day, the mother was advised to “get in contact” if the condition failed to improve. By the next day, the mother believed that her daughter’s condition was "considerably worse" as she was lethargic, feverish, anorexic and suffering from diarrhoea. At mid-afternoon, the mother called her GP, but then failed to make arrangements to see the child.
Two days later, the girl’s condition had seriously deteriorated with existing symptoms intensifying, and her hands and feet starting to swell and turn blue. The GP practice was called again late afternoon and another doctor immediately referred the child to the hospital with a letter expressing his concerns.
Denied liability for the permanent damage
At the hospital, the girl was administered with different courses of antibiotics over the next 72 hours, which failed to improve her condition. It was only on the third day that the patient was seen by a consultant who failed to make a proper diagnosis until the following day when an ultrasound scan confirmed the baby was also suffering septic arthritis as well as the bone infection. As a result, the hip bone had seriously degenerated, leaving the child with a permanently unstable hip and restricted mobility.
At the court hearing, the GP defendant admitted his delay in referring the girl to hospital but denied liability for the permanent damage caused by the subsequent negligent treatment at the hospital.
The judge pointed out that the crucial point was “the extent to which the GP's negligence shortened the period available to the hospital to provide effective treatment and increased the risk that she would suffer permanent harm.”
Had the GP referred the child back to the hospital on the day the mother first returned with her concerns over the worsening symptoms “as he should have done” ... she would have recovered... “with none of the permanent damage which she has suffered.” The Judge concluded that the girl is entitled to claim for the whole of the damage she suffered, irrespective of what would have happened if she had been referred to the hospital on the same day.