Fiver-year-old girl died of meningitis after doctors ‘misdiagnosed symptoms as stomach bug’

April 4, 2013 | by | 0 Comments
Kelsey Smart died of meningitis after two doctors failed to spot the signs of the killer bug, an inquest heard

Kelsey Smart died of meningitis after two doctors failed to spot the signs of the killer bug, an inquest heard

A five-year-old died from meningitis after two doctors diagnosed her symptoms as a stomach bug, an inquest heard today.

Kelsey Smart was initially taken to see an out-of-hours GP who thought she had viral gastroenteritis, despite a rash on her stomach and leg.

When her condition continued to deteriorate her parents took her to their local surgery, where a second doctor said her “non-specific” rash was nothing to worry about.

But within hours she developed crippling stomach cramps and was rushed to hospital, where she died of Group B meningococcal meningitis, a bacterial strain of the disease.

Yesterday Kelsey’s devastated mum Hannah criticised her treatment and said she believed her daughter had been let down by her doctors.

But the two medics who examined her told the inquest that her rash did not bear the typical hallmarks of meningitis and her symptoms were too vague to pinpoint.

In a statement read out to Flax Bourton Coroner’s Court, near Bristol, Hannah, 25, said: “Kelsey had been let down by doctors who treated her.

“We miss Kelsey every day and want as many positive things to come out of her death as possible.

“We were concerned that the Frendoc service and staff at the GP surgery didn’t inform me about meningitis and the signs and symptoms to look out for.

“I believe now she had signs and symptoms pointing to meningitis but doctors missed those continuously.”

Blonde Kelsey, who loved playing with her friends and listening to pop star Justin Bieber, started developing symptoms on February 25 last year.

The schoolgirl, from Kingswood, Bristol, began being sick every hour and continued to be ill throughout the night and into the next day.

Her parents Hannah and Jamie, who also have three-year-old son Jayden, then noticed an unusual rash on her stomach.

Hannah then rang out-of-hours emergency GP service Frendoc on the evening of Sunday 26th, where a triage doctor referred her for an appointment.

Dr Jens Rohrbeck, who examined Kelsey, told the inquest he had been made aware of the rash but had dismissed it.

Jamie and Hannah Smart hold a photograph of their daughter Kelsey , outside of Flax Bourton Coroners Court, Bristol

Jamie and Hannah Smart hold a photograph of their daughter Kelsey , outside of Flax Bourton Coroners Court, Bristol

Her temperature was 37.2 degrees, which Dr Rohrbeck described as “slightly above normal”, and he was more concerned by her potential dehydration.

Describing the rash, he said: “There were very few pricks, very small and very inconspicuous. I drew the conclusion I was dealing with gastroenteritis.

“It was a non-blanching rash and as soon as you come up against this in any doctor’s mind, automatically the potential for meningitis will come up

“But in practice you see a lot of non-blanching rashes, you see them in infections quite frequently.

“It will have crossed my mind at some stage but I decided it was not a rash caused by meningitis because it was ever so small, only very few and a colour I wouldn’t have expected.”

Dr Rohrbeck diagnosed Kelsey with gastroenteritis because of her constant vomiting, but admitted in hindsight he should have referred the schoolgirl to hospital.

He added: “In hindsight, yes I should have referred her to hospital, but I thought I was dealing with viral gastroenteritis and I simply couldn’t imagine what was behind her very non-specific symptoms.

“My main concern was the vomiting.

“If there had been more signs pointing to meningitis I would have drawn that conclusion, I would expect signs of the illness to be much more obvious.”

Kelsey returned to the family home in Kingswood, Bristol, but did not improve overnight.

Her frantic mum then rang her own surgery, the Orchard Medical Centre in Kingswood, at 8am the following day and insisted on an appointment.

Kelsey was seen by Dr Sarah Grant, who recorded her temperature as ‘below 38 degrees’ and agreed with the first diagnosis.

She told the inquest: “I did think about meningitis but discredited that at the time.

“The rash didn’t seen to have progressed, she had been seen 12 hours previously and it hadn’t got any darker or any worse.

“If things are stable and no worse you are reassured that whatever it is is stable.

“The rash was sort of non-specific and didn’t look like anything I had expected a meningitis rash to look like.

“A lot of children who come into the general practice with non-specific symptoms have rashes of varying types which we have rarely put a specific diagnosis upon.”

Kelsey was again sent home, with instructions to ring doctors or the hospital if symptoms did not improve.

But once at home she continued to get worse and began scratching at the sofa and complaining that her stomach was hurting.

Hannah decided to take her into Bristol Children’s Hospital – where Jamie worked as a painter and decorator – after suspecting her daughter had appendicitis.

But on the way Kelsey began fitting, causing Hannah to stop the car and dial 999.

Emergency teams rushed Kelsey to the Bristol Children’s Hospital where she was treated with morphine and anti-inflammatories after doctors thought she may have had a stroke.

A neurosurgeon was brought in from neighbouring Frenchay Hospital to carry out an operation to try to remove fluid from the brain – but the disease had taken hold and Kelsey’s brain had swollen too much.

Hannah told the inquest: “She was connected to a life support machine.

“We were told the brain surgery had been unsuccessful and her brain had swollen so much she was brain damaged.

“Leaving Kelsey in that hospital and knowing her heart was still beating was one of the hardest things I have ever had to do.”

Kelsey, who was a Year 1 pupil at The Park Primary School, died on February 29.

Her parents have donated their daughter’s organs to help others – her heart has been given an eight-month-old baby, a three-month-old got her liver and many more will also benefit.

The inquest continues.

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