A doctor has been warned for discharging a 5-year-old girl with a stomach bug – after she died from appendicitis two days later.
Elspeth Moore, from Lymington, told doctors her tummy ‘ felt like it was on fire’ but Dr Faye Hawkins, a consultant paediatrician on the Paediatric Assessment Unit at Southampton General Hospital, discharged her.
She told Elspeth’s parents she simply had a viral infection and was told to take her home without proper instructions on how to monitor their daughter’s symptoms, HampshireLive reported.
Tragically she died in her bed two days later as her father lay next to her.
The tribunal was told that despite being diagnosed as having viral gastroenteritis, Elspeth was actually suffering from appendicitis which developed into peritonitis and sepsis.
But despite failing to carry out a second assessment of Elspeth’s pain before she discharged her, the Medical Practitioners Tribunal Service has ruled Dr Hawkins can continue to practice, as she has ‘learned from her mistakes and remediated fully’.
She therefore avoided a possible suspension or striking off order and was instead handed a warning about her serious misconduct.
Elspeth Moore told doctors her tummy ‘felt like it was on fire’ but her parents were told she simply had a viral infection (
Image: Family/Solent News)
On July 3 2018, Elspeth was rushed to hospital by her mother, after she was sent home from school the previous day with diarrhoea and her GP said she should be put on an IV drip.
The tribunal heard Elspeth had been sick for a week with abdominal pains and had barely been eating or drinking.
She had a fever of 38C, an increased heart-rate and was so dehydrated she had dry lips and a coated tongue.
After an assessment at 7pm, Dr Hawkins recorded Elspeth’s condition as ‘viral gastroenteritis – mild dehydration’.
About an hour later, Elspeth was discharged despite Dr Hawkins not carrying out a second assessment or noting the ‘red flag’ symptom of lethargy in Elspeth’s notes.
The tribunal heard the schoolgirl initially improved on July 4 but the following day, two days after she was discharged, her condition ‘deteriorated’ and she went into cardiac arrest.
An ambulance was called and Elspeth was rushed to hospital but could not be resuscitated. The causes of death were noted as active peritonitis, sepsis and acute appendicitis.
The tribunal ruled Dr Hawkins had failed to adequately consider Elspeth’s symptoms of lethargy, fatigue and raised temperature during the initial consultation and that, ‘By failing to adequately consider these symptoms and explore them with [Elspeth] and her parents, Dr Hawkins failed to provide a good standard of care’.
The tribunal ruled this was ‘a failure which amounted to misconduct which is serious’.
It added: “Prior to her discharge she failed to adequately examine [Elspeth]… she did not assess her hydration status, check for the development of any further ‘red flag’ symptoms or signs, or carry out a second examination of her abdomen.”
The tribunal noted this was a missed opportunity to conduct a second examination of Elspeth’s symptoms and described this as a ‘serious falling below the standard expected’. Elspeth was allowed to leave Southampton Children’s Hospital (pictured) (
The tribunal also noted Dr Hawkins had failed to provide ‘adequate safety-netting advice’ about how frequently they should observe Elspeth’s pain and temperature.
However as this was an ‘isolated case’ four years ago and Dr Hawkins has ‘successfully treated thousands of patients before and since’, the tribunal did not find that her fitness to practise was impaired.
It concluded: “The tribunal was impressed with Dr Hawkins’ comprehensive remediation efforts and considered that Dr Hawkins has fully reflected on her failings regarding [Elspeth].
“Dr Hawkins has demonstrated a commitment to ongoing personal and professional development with an emphasis on the events concerning [Elspeth].
The tribunal was satisfied that, over the four years since she treated [Elspeth], she has sought out many opportunities to address the failings identified in the case in several different ways in order to develop and improve her practice.
“Given that Dr Hawkins has shown that she has learned from her mistakes and has remediated fully, the Tribunal considered that there was little more that Dr Hawkins could have done to demonstrate that her fitness to practise is no longer impaired.
“A finding of impairment is not required to maintain proper professional standards or to maintain public confidence.”
Dr Hawkins was instead handed a warning. In March 2019, Elspeth’s father, systems analyst Steven Moore, gave evidence at Winchester Coroner’s Court.
He told the hearing: “Given that when we arrived we were freaking out, and then to be told actually your daughter’s got viral Gastroenteritis that will work its way out, I actually felt quite relieved. We weren’t given specific advice on when to come back or things to look out for.
“[That evening] I stayed up, went into Elspeth’s room every half hour to check on her. At about 11pm I went in and she was still awake.
“I said ‘I’m going to stay in here with you’, and lay down on the floor next to her. I said ‘love you’ and she said ‘love you daddy’.
“It can only have been five or 10 minutes later, I heard her making a weird noise, like something was catching in her throat.
“I said ‘what’s that noise all about Elspeth, that doesn’t sound right.’ She didn’t respond. I said ‘do you want to sit up darling.’ I sat her up, at which point her head just flopped back and her eyes rolled up.”
Central Hampshire coroner Grahame Short recorded the cause of death as ‘natural causes’.