Discussion:
Why your GP should always be the first port of call.
(too old to reply)
The Todal
2017-02-27 13:23:00 UTC
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For those who think you should never bother A&E if your GP is the best
person to see.

http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html

Shanice arrived at the surgery with Ellie-May just after 5pm. According
to the NHS report, Shanice said she arrived at ‘about 5.08pm’.

However, she insisted to this paper it was 5.04pm. Mother and daughter
then waited several minutes while the receptionist dealt with a phone
call and another patient.

The receptionist finally addressed Shanice at 5.18pm, the report notes,
calling through to Dr Rowe to ask if she would see them. According to
the receptionist’s account, the GP then ‘shouted something like “No I’m
not seeing her, she’s late”.’

When the health board investigated, it found Dr Rowe gave incorrect
information, including her claim to be with another patient at the time.
They also found that staff were ‘fearful of questioning’ Dr Rowe due her
‘angry outbursts’.

It concluded the ‘root cause’ of the child’s death was that Dr Rowe
‘refused to see EM [Ellie-May] because she was brought in late’. It also
noted that months earlier a hospital paediatrician had written to Dr
Rowe warning that Ellie-May was ‘at risk of another episode of severe /
life-threatening asthma’.

Despite this, the report said, Dr Rowe ‘did not make any clinical
assessment of EM before refusing to see her’ and failed to give her
mother any ‘safety netting advice’.

The ‘serious concern’ was passed to the GMC but Dr Rowe was allowed to
continue practising with only minor restrictions.
pamela
2017-02-27 13:52:20 UTC
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Post by The Todal
For those who think you should never bother A&E if your GP is
the best person to see.
http://www.dailymail.co.uk/news/article-4260108/Girl-5-
died-asthma-attack-GP-refused-her.html
Shanice arrived at the surgery with Ellie-May just after 5pm.
According to the NHS report, Shanice said she arrived at ‘about
5.08pm’.
However, she insisted to this paper it was 5.04pm. Mother and
daughter then waited several minutes while the receptionist
dealt with a phone call and another patient.
The receptionist finally addressed Shanice at 5.18pm, the report
notes, calling through to Dr Rowe to ask if she would see them.
According to the receptionist’s account, the GP then ‘shouted
something like “No I’m not seeing her, she’s late”.’
When the health board investigated, it found Dr Rowe gave
incorrect information, including her claim to be with another
patient at the time. They also found that staff were ‘fearful of
questioning’ Dr Rowe due her ‘angry outbursts’.
It concluded the ‘root cause’ of the child’s death was that Dr
Rowe ‘refused to see EM [Ellie-May] because she was brought in
late’. It also noted that months earlier a hospital
paediatrician had written to Dr Rowe warning that Ellie-May was
‘at risk of another episode of severe / life-threatening
asthma’.
Despite this, the report said, Dr Rowe ‘did not make any
clinical assessment of EM before refusing to see her’ and failed
to give her mother any ‘safety netting advice’.
The ‘serious concern’ was passed to the GMC but Dr Rowe was
allowed to continue practising with only minor restrictions.
I didn't know of this incident until you posted it. Thanks.

The GMC gave the doctor a mild slap on the wrist. Excess leniency
by the GMC led to the setting up of the Medical Practitioners
Tribunal Service after Shipman. However I'm not sure this sad
case got as far as being referred to the MPTS because there's
nothing about it on the MPTS site.

Too often a medical tribunal looking into significant misconduct
by a doctor ends with the usual waffle from the panel saying the
doctor seems of good character and probably won't do it again.
Therefore nothing needs be done to protect the public and the
doctor gets let off perhaps with a minor warning.

Medical tribunals usually dice the case into the smallest parts
and then test each one, often leniently, without ever looking at
the wider and usually far more incriminating picture. Here's is
how the GMC viewed this case.

What a pity Legal Aid is no longer available for such cases.


-------------------------- START -------------------------
Joanne Louise Rowe. GMC number 3116133

On 26 January 2015, you declined to see a child patient who
attended after the time of their booked emergency appointment,
advising that the child should come back the next day. You did not
consider the medical history of the child, or provide advice on
how the child’s parents could access alternative medical care. The
child had a history of severe asthma, and had experienced
breathing problems that day. The child died later that evening of
asthma.

Your failure to see and assess this child does not meet with the
standards required of a doctor. It risks bringing the profession
into disrepute and it must not be repeated. The required standards
are set out in Good medical practice and associated guidance. In
this case, paragraph 15 of Good Medical Practice is particularly
relevant:

15. You must provide a good standard of practice and care. If
you assess, diagnose or treat patients, you must:

(a) adequately assess the patient’s conditions, taking account
of their history (including the symptoms and psychological,
spiritual, social and cultural factors), their views and
values; where necessary, examine the patient

(b) promptly provide or arrange suitable advice, investigations
or treatment where necessary

(c) refer a patient to another practitioner when this serves
the patient’s needs.

Whilst this failing in itself is not so serious as to require any
restriction on your registration, it is necessary in response to
issue this formal Warning.

This Warning will be published on the List of Registered Medical
Practitioners (LRMP) for a period of five years and will be
disclosed to any person enquiring about your fitness to practise
history. After five years, the Warning will cease to be published
on the LRMP. However, it will be kept on record and disclosed to
employers on request.
-------------------------- END -------------------------
GB
2017-02-27 14:00:01 UTC
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Post by The Todal
For those who think you should never bother A&E if your GP is the best
person to see.
Clearly, if urgent attention is needed and the GP is unavailable, most
people would think that A&E is probably the next port of call.

This child had had 5 previous 'episodes of severe / life-threatening
asthma’. The mother should have known what to do in those
circumstances, namely call 999 or bundle the child into a car and take
her to A&E.

These attacks come on very quickly, and the child did not have a severe
attack until over 5 hours later. She may have been reasonably okay at
the time she visited the surgery. Certainly, the mother had plenty of
time to seek the attention needed.

This is a sad case, and the GP could have acted better. So could the
mother.
The Todal
2017-02-27 14:19:48 UTC
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Post by GB
Post by The Todal
For those who think you should never bother A&E if your GP is the best
person to see.
Clearly, if urgent attention is needed and the GP is unavailable, most
people would think that A&E is probably the next port of call.
This child had had 5 previous 'episodes of severe / life-threatening
asthma’. The mother should have known what to do in those
circumstances, namely call 999 or bundle the child into a car and take
her to A&E.
These attacks come on very quickly, and the child did not have a severe
attack until over 5 hours later. She may have been reasonably okay at
the time she visited the surgery. Certainly, the mother had plenty of
time to seek the attention needed.
This is a sad case, and the GP could have acted better. So could the
mother.
It's very hurtful to blame the mother. Where do we see official guidance
saying "if your GP has no time to see you, go to A&E?" The gist of what
we're continually reading is quite the contrary - don't go to hospital
unless your GP tells you that's the appropriate place.

If your GP says she can't see you today so come back tomorrow, you are
entitled to assume that this is good advice.
GB
2017-02-27 16:16:47 UTC
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Post by The Todal
It's very hurtful to blame the mother. Where do we see official guidance
saying "if your GP has no time to see you, go to A&E?" The gist of what
we're continually reading is quite the contrary - don't go to hospital
unless your GP tells you that's the appropriate place.
If your GP says she can't see you today so come back tomorrow, you are
entitled to assume that this is good advice.
The child had been in the high dependency unit five times over her
asthma. The mother was utterly negligent in allowing this situation to
develop. She should have checked on the child at regular intervals and
used her own common sense in deciding whether the child needed treatment
urgently.

Clearly, the GP had no idea whether the child had stubbed her toe or
this was an emergency. To regard the statement that the surgery is
closed come back tomorrow as considered advice about the child's
condition is just silly, and it cost the girl her life. If the child had
never had asthma before, it's perhaps understandable. Given the history,
it's simply unbelievably stupid.

People need to take responsibility for their own lives and their own
decisions. The blame culture is all well and good if the harm done can
be compensated for by money, but that's sadly not the case here.

Yes, the doctor was at fault, but the mother still had ample opportunity
to prevent harm to her daughter. She let her daughter down, and I'd say
she was 99% responsible for the death.
burfordTjustice
2017-02-27 16:38:38 UTC
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On Mon, 27 Feb 2017 16:16:47 +0000
Post by GB
Post by The Todal
It's very hurtful to blame the mother. Where do we see official
guidance saying "if your GP has no time to see you, go to A&E?"
The gist of what we're continually reading is quite the contrary -
don't go to hospital unless your GP tells you that's the
appropriate place.
If your GP says she can't see you today so come back tomorrow, you
are entitled to assume that this is good advice.
The child had been in the high dependency unit five times over her
asthma. The mother was utterly negligent in allowing this situation
to develop. She should have checked on the child at regular intervals
and used her own common sense in deciding whether the child needed
treatment urgently.
Clearly, the GP had no idea whether the child had stubbed her toe or
this was an emergency. To regard the statement that the surgery is
closed come back tomorrow as considered advice about the child's
condition is just silly, and it cost the girl her life. If the child
had never had asthma before, it's perhaps understandable. Given the
history, it's simply unbelievably stupid.
People need to take responsibility for their own lives and their own
decisions. The blame culture is all well and good if the harm done
can be compensated for by money, but that's sadly not the case here.
Yes, the doctor was at fault, but the mother still had ample
opportunity to prevent harm to her daughter. She let her daughter
down, and I'd say she was 99% responsible for the death.
Very socialist mined of you...the government is always right.
The Todal
2017-02-27 17:39:58 UTC
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Post by GB
Post by The Todal
It's very hurtful to blame the mother. Where do we see official guidance
saying "if your GP has no time to see you, go to A&E?" The gist of what
we're continually reading is quite the contrary - don't go to hospital
unless your GP tells you that's the appropriate place.
If your GP says she can't see you today so come back tomorrow, you are
entitled to assume that this is good advice.
The child had been in the high dependency unit five times over her
asthma. The mother was utterly negligent in allowing this situation to
develop. She should have checked on the child at regular intervals and
used her own common sense in deciding whether the child needed treatment
urgently.
Clearly, the GP had no idea whether the child had stubbed her toe or
this was an emergency. To regard the statement that the surgery is
closed come back tomorrow as considered advice about the child's
condition is just silly, and it cost the girl her life. If the child had
never had asthma before, it's perhaps understandable. Given the history,
it's simply unbelievably stupid.
People need to take responsibility for their own lives and their own
decisions. The blame culture is all well and good if the harm done can
be compensated for by money, but that's sadly not the case here.
Yes, the doctor was at fault, but the mother still had ample opportunity
to prevent harm to her daughter. She let her daughter down, and I'd say
she was 99% responsible for the death.
I think that's an outrageous opinion to hold.

Many children have asthma. It's a very common condition. It is very
difficult for a parent or partner to assess how serious an asthma attack
is. Many people are totally unaware that an asthma attack can cause
death or brain damage, because there is little or no guidance in the
public media.

If your child, partner or friend has been prescribed medication to treat
an asthma attack it is reasonable to assume that if they have an attack
they should take the medication and all will be well. It isn't at all
easy for a layman to assess at what point they should assume that the
medication isn't working and an ambulance is necessary.

The first port of call for good advice about how to treat asthma is the
GP. Here, the GP offered no assessment and no advice. Why didn't the
mother take the child to hospital? Answer: because the mother didn't
realise that it was necessary. With proper advice she might have
realised that it was necessary. You evidently believe that you would
have acted very differently if it had been your child. Maybe that's
true. Or maybe it's wishful thinking.
pamela
2017-02-27 18:14:42 UTC
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Post by The Todal
Post by GB
Post by The Todal
It's very hurtful to blame the mother. Where do we see
official guidance saying "if your GP has no time to see you,
go to A&E?" The gist of what we're continually reading is
quite the contrary - don't go to hospital unless your GP tells
you that's the appropriate place.
If your GP says she can't see you today so come back tomorrow,
you are entitled to assume that this is good advice.
The child had been in the high dependency unit five times over
her asthma. The mother was utterly negligent in allowing this
situation to develop. She should have checked on the child at
regular intervals and used her own common sense in deciding
whether the child needed treatment urgently.
Clearly, the GP had no idea whether the child had stubbed her
toe or this was an emergency. To regard the statement that the
surgery is closed come back tomorrow as considered advice about
the child's condition is just silly, and it cost the girl her
life. If the child had never had asthma before, it's perhaps
understandable. Given the history, it's simply unbelievably
stupid.
People need to take responsibility for their own lives and
their own decisions. The blame culture is all well and good if
the harm done can be compensated for by money, but that's sadly
not the case here.
Yes, the doctor was at fault, but the mother still had ample
opportunity to prevent harm to her daughter. She let her
daughter down, and I'd say she was 99% responsible for the
death.
I think that's an outrageous opinion to hold.
Many children have asthma. It's a very common condition. It is
very difficult for a parent or partner to assess how serious an
asthma attack is. Many people are totally unaware that an asthma
attack can cause death or brain damage, because there is little
or no guidance in the public media.
If your child, partner or friend has been prescribed medication
to treat an asthma attack it is reasonable to assume that if
they have an attack they should take the medication and all will
be well. It isn't at all easy for a layman to assess at what
point they should assume that the medication isn't working and
an ambulance is necessary.
As you say, it is difficult for the mother to assess the severity
of asthma in such an instance. In the circumstances the mother
has acted reasonably.
Post by The Todal
The first port of call for good advice about how to treat asthma
is the GP. Here, the GP offered no assessment and no advice. Why
didn't the mother take the child to hospital? Answer: because
the mother didn't realise that it was necessary. With proper
advice she might have realised that it was necessary. You
evidently believe that you would have acted very differently if
it had been your child. Maybe that's true. Or maybe it's wishful
thinking.
The GP wasn't to know the child was very sick but that doesn't
mean the GP didn't contribute to her death. After all the GP had
"previously been warned the girl was at risk of suffering a life-
threatening seizure" according to the Mail.

Seems an inquiry by the health board that controls the surgery
found the GP had "failed to make any clinical assessment".

The article mentions an official report which the Mail had got
hold of. Is there a link to a copy?
GB
2017-02-27 18:34:12 UTC
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Post by The Todal
Post by GB
Yes, the doctor was at fault, but the mother still had ample opportunity
to prevent harm to her daughter. She let her daughter down, and I'd say
she was 99% responsible for the death.
I think that's an outrageous opinion to hold.
Many children have asthma. It's a very common condition. It is very
difficult for a parent or partner to assess how serious an asthma attack
is. Many people are totally unaware that an asthma attack can cause
death or brain damage, because there is little or no guidance in the
public media.
There's an enormous amount about asthma care on the www. Try
https://www.asthma.org.uk/advice/

This child was in the HDU five times! It's inconceivable that the
mother wasn't told multiple times how serious this condition is and what
to do about it.

Two of our children had asthma. One had to be nebulized in hospital
several times.
Post by The Todal
If your child, partner or friend has been prescribed medication to treat
an asthma attack it is reasonable to assume that if they have an attack
they should take the medication and all will be well.
No. It's sensible to take the medication as a first line of defence, if
there's time. Then monitor the situation very, very carefully with a
view to seeking emergency help if that is necessary.
Post by The Todal
It isn't at all
easy for a layman to assess at what point they should assume that the
medication isn't working and an ambulance is necessary.
I can assure you that it's very obvious!

The starting point is to keep the child with you at all times, until you
are quite sure he/she is better. The mother in this case clearly didn't
take that elementary precaution.
Post by The Todal
The first port of call for good advice about how to treat asthma is the
GP.
Quite probably, if you have a fairly straightforward case. If you have
got as far as the HDU on multiple occasions, I assume that you'd have
consultant-led care in a specialised clinic.
Post by The Todal
Why didn't the
mother take the child to hospital? Answer: because the mother didn't
realise that it was necessary.
I don't know the reason for the mother's extraordinary lack of care. I
can think of a number of explanations - none of them very complimentary
about her, I am afraid. What I am not prepared to accept is your
suggestion that nobody told her about asthma.
Post by The Todal
You evidently believe that you would
have acted very differently if it had been your child. Maybe that's
true. Or maybe it's wishful thinking.
We certainly *did* act completely differently on several occasions.
Maybe because of that our children never ended up in the HDU, or maybe
this child was more seriously ill. Either way, this mother needed to
exercise greater care than she did.
The Todal
2017-02-27 18:49:54 UTC
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Post by GB
Post by The Todal
Post by GB
Yes, the doctor was at fault, but the mother still had ample opportunity
to prevent harm to her daughter. She let her daughter down, and I'd say
she was 99% responsible for the death.
I think that's an outrageous opinion to hold.
Many children have asthma. It's a very common condition. It is very
difficult for a parent or partner to assess how serious an asthma attack
is. Many people are totally unaware that an asthma attack can cause
death or brain damage, because there is little or no guidance in the
public media.
There's an enormous amount about asthma care on the www. Try
https://www.asthma.org.uk/advice/
This child was in the HDU five times! It's inconceivable that the
mother wasn't told multiple times how serious this condition is and what
to do about it.
Two of our children had asthma. One had to be nebulized in hospital
several times.
Post by The Todal
If your child, partner or friend has been prescribed medication to treat
an asthma attack it is reasonable to assume that if they have an attack
they should take the medication and all will be well.
No. It's sensible to take the medication as a first line of defence, if
there's time. Then monitor the situation very, very carefully with a
view to seeking emergency help if that is necessary.
Post by The Todal
It isn't at all
easy for a layman to assess at what point they should assume that the
medication isn't working and an ambulance is necessary.
I can assure you that it's very obvious!
The starting point is to keep the child with you at all times, until you
are quite sure he/she is better. The mother in this case clearly didn't
take that elementary precaution.
Post by The Todal
The first port of call for good advice about how to treat asthma is the
GP.
Quite probably, if you have a fairly straightforward case. If you have
got as far as the HDU on multiple occasions, I assume that you'd have
consultant-led care in a specialised clinic.
Post by The Todal
Why didn't the
mother take the child to hospital? Answer: because the mother didn't
realise that it was necessary.
I don't know the reason for the mother's extraordinary lack of care. I
can think of a number of explanations - none of them very complimentary
about her, I am afraid. What I am not prepared to accept is your
suggestion that nobody told her about asthma.
Post by The Todal
You evidently believe that you would
have acted very differently if it had been your child. Maybe that's
true. Or maybe it's wishful thinking.
We certainly *did* act completely differently on several occasions.
Maybe because of that our children never ended up in the HDU, or maybe
this child was more seriously ill. Either way, this mother needed to
exercise greater care than she did.
So all this is you reassuring yourself that this terrible tragedy can
never happen to your child. I hope you feel better for saying so. And I
hope that the unfortunate mother in the case under discussion doesn't
read your unpleasant post.
GB
2017-02-27 19:15:10 UTC
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Post by The Todal
So all this is you reassuring yourself that this terrible tragedy can
never happen to your child.I hope you feel better for saying so.
My children have outlived their childhood asthma, thanks. Most children
do, because their parents take proper care of them.
Post by The Todal
And I
hope that the unfortunate mother in the case under discussion doesn't
read your unpleasant post.
Yes, I hope very much that she doesn't read this either. But are you
seriously suggesting we should all pretend that she had no
responsibility, for fear that she might chance upon our posts in an
obscure and out of date messaging system?
Nick
2017-02-27 19:49:34 UTC
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Post by GB
Post by The Todal
So all this is you reassuring yourself that this terrible tragedy can
never happen to your child.I hope you feel better for saying so.
My children have outlived their childhood asthma, thanks. Most children
do, because their parents take proper care of them.
Post by The Todal
And I
hope that the unfortunate mother in the case under discussion doesn't
read your unpleasant post.
Yes, I hope very much that she doesn't read this either. But are you
seriously suggesting we should all pretend that she had no
responsibility, for fear that she might chance upon our posts in an
obscure and out of date messaging system?
Yes.

She showed responsibility. She organised an emergency doctor's
appointment at 4.30 and got there at 5.04 (she claims 4 minutes late,
the surgery claim 8 minutes late).

The doctor refused to see her. Many doctors take a paternalistic
attitude where they become annoyed if patients question their judgement
or ask too many questions. You are in their "care" they say.

It is quite reasonable for a normal parent to assume that the Doctor did
not consider the case urgent. She had discussed the matter with the
surgery less than an hour earlier. It is also quite likely that the
parent would feel too intimidated to take the child to A&E. Especially
given all the recent negative press about time wasters.

I'm actually sceptical of the GP surgery approach for this type
emergency. How would a normal member of the public know if a medical
issue is an emergency? You don't know how many non eventful asthma
attacks this girl had. I think instead of criticising people for going
to A&E the government should make it easier to get GP level care at A&E
The Todal
2017-02-27 20:20:00 UTC
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Post by GB
Post by The Todal
So all this is you reassuring yourself that this terrible tragedy can
never happen to your child.I hope you feel better for saying so.
My children have outlived their childhood asthma, thanks. Most children
do, because their parents take proper care of them.
Or more likely because they don't have a serious and sudden asthma
attack at a time when medical help cannot be obtained.
Post by GB
Post by The Todal
And I
hope that the unfortunate mother in the case under discussion doesn't
read your unpleasant post.
Yes, I hope very much that she doesn't read this either. But are you
seriously suggesting we should all pretend that she had no
responsibility, for fear that she might chance upon our posts in an
obscure and out of date messaging system?
I think you should refrain from apportioning responsibility when you
only have half a story. It's callous and irresponsible. Why would this
parent fail to call a doctor when her child is having an asthma attack?
Or that parent fail to call a doctor when her child hit his head falling
from a tree? Or that other parent fail to call a doctor when her child
has a severe attack of chickenpox? Could it be because they are stupid
people? Or that they wish harm on their children? Or could it be because
they are doing their best with the facts at their disposal?

Perhaps somewhere there is a website where the parents of children who
have drowned in swimming pools or garden ponds are told what dimwits
they are and how they really ought to blame themselves.
GB
2017-02-28 09:37:59 UTC
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Post by The Todal
Post by GB
Post by The Todal
So all this is you reassuring yourself that this terrible tragedy can
never happen to your child.I hope you feel better for saying so.
My children have outlived their childhood asthma, thanks. Most children
do, because their parents take proper care of them.
Or more likely because they don't have a serious and sudden asthma
attack at a time when medical help cannot be obtained.
You are right about one thing. In the unlikely event the mother comes
across this thread, it could cause her great distress. So, perhaps we
should stop discussing it altogether.

Nevertheless, one point is worth making. Either the child was in the
throes of a "serious and sudden asthma attack" when taken to the GP or
she wasn't.

If she was, all the GP could realistically have done is told the mother
to use the inhalers and go to A&E, perhaps by ambulance The mother would
have been told this previously, many times.

As the child was taken to the GP, let's assume the attack was not yet
serious at that time. All the GP would have done is told the mother to
keep using the inhalers and to keep the child under observation with a
view to going to A&E if necessary. Advice the mother would have had many
times before.

So, that's why I said the responsibility for the death was 1% doctor/
99% mother. Thinking about it some more, that's very unkind to the
mother, because it ignores the possibility - really quite likely given
the history - that the attack came on very quickly and nothing could be
done about it. In which case the responsibility for the death was 0%
doctor/ 0% mother. I did cover that possibility in my first post on this
thread.

What I am really objecting to is your use of a newspaper article and
your earlier posts that blame the doctor for the child's death. The
doctor provided very poor customer service, and that's what she has been
chastised for by the GMC.
Post by The Todal
I think you should refrain from apportioning responsibility when you
only have half a story. It's callous and irresponsible.
Exactly the same applies to you in relation to the GP. Of course, she
hasn't lost her child, but she is now the victim of a witch hunt in
which you seem to be taking part with gusto.
Post by The Todal
Or could it be because
they are doing their best with the facts at their disposal?
It is simply daft to keep repeating that the mother did not have the
information to deal with this situation.
Post by The Todal
Perhaps somewhere there is a website where the parents of children who
have drowned in swimming pools or garden ponds are told what dimwits
they are and how they really ought to blame themselves.
If that leads to pools being fenced in, as in other countries, some good
would come of it. Likewise, analysing the real reasons for this child's
death from asthma could help others. Blaming the GP could have precisely
the opposite effect.
harry
2017-02-28 07:24:22 UTC
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Post by The Todal
Post by GB
Post by The Todal
It's very hurtful to blame the mother. Where do we see official guidance
saying "if your GP has no time to see you, go to A&E?" The gist of what
we're continually reading is quite the contrary - don't go to hospital
unless your GP tells you that's the appropriate place.
If your GP says she can't see you today so come back tomorrow, you are
entitled to assume that this is good advice.
The child had been in the high dependency unit five times over her
asthma. The mother was utterly negligent in allowing this situation to
develop. She should have checked on the child at regular intervals and
used her own common sense in deciding whether the child needed treatment
urgently.
Clearly, the GP had no idea whether the child had stubbed her toe or
this was an emergency. To regard the statement that the surgery is
closed come back tomorrow as considered advice about the child's
condition is just silly, and it cost the girl her life. If the child had
never had asthma before, it's perhaps understandable. Given the history,
it's simply unbelievably stupid.
People need to take responsibility for their own lives and their own
decisions. The blame culture is all well and good if the harm done can
be compensated for by money, but that's sadly not the case here.
Yes, the doctor was at fault, but the mother still had ample opportunity
to prevent harm to her daughter. She let her daughter down, and I'd say
she was 99% responsible for the death.
I think that's an outrageous opinion to hold.
Many children have asthma. It's a very common condition. It is very
difficult for a parent or partner to assess how serious an asthma attack
is. Many people are totally unaware that an asthma attack can cause
death or brain damage, because there is little or no guidance in the
public media.
If your child, partner or friend has been prescribed medication to treat
an asthma attack it is reasonable to assume that if they have an attack
they should take the medication and all will be well. It isn't at all
easy for a layman to assess at what point they should assume that the
medication isn't working and an ambulance is necessary.
The first port of call for good advice about how to treat asthma is the
GP. Here, the GP offered no assessment and no advice. Why didn't the
mother take the child to hospital? Answer: because the mother didn't
realise that it was necessary. With proper advice she might have
realised that it was necessary. You evidently believe that you would
have acted very differently if it had been your child. Maybe that's
true. Or maybe it's wishful thinking.
Anybody with close contact with n asthma sufferer is well aware of all this stuff.
The mother is trying to make excuses for herself.
The "Not my fault gov."syndrome.
Probably going to apply for compensation.
Ophelia
2017-02-28 10:19:27 UTC
Permalink
Raw Message
Post by The Todal
Post by GB
Post by The Todal
It's very hurtful to blame the mother. Where do we see official guidance
saying "if your GP has no time to see you, go to A&E?" The gist of what
we're continually reading is quite the contrary - don't go to hospital
unless your GP tells you that's the appropriate place.
If your GP says she can't see you today so come back tomorrow, you are
entitled to assume that this is good advice.
The child had been in the high dependency unit five times over her
asthma. The mother was utterly negligent in allowing this situation to
develop. She should have checked on the child at regular intervals and
used her own common sense in deciding whether the child needed treatment
urgently.
Clearly, the GP had no idea whether the child had stubbed her toe or
this was an emergency. To regard the statement that the surgery is
closed come back tomorrow as considered advice about the child's
condition is just silly, and it cost the girl her life. If the child had
never had asthma before, it's perhaps understandable. Given the history,
it's simply unbelievably stupid.
People need to take responsibility for their own lives and their own
decisions. The blame culture is all well and good if the harm done can
be compensated for by money, but that's sadly not the case here.
Yes, the doctor was at fault, but the mother still had ample opportunity
to prevent harm to her daughter. She let her daughter down, and I'd say
she was 99% responsible for the death.
I think that's an outrageous opinion to hold.
Many children have asthma. It's a very common condition. It is very
difficult for a parent or partner to assess how serious an asthma attack
is. Many people are totally unaware that an asthma attack can cause
death or brain damage, because there is little or no guidance in the
public media.
If your child, partner or friend has been prescribed medication to treat
an asthma attack it is reasonable to assume that if they have an attack
they should take the medication and all will be well. It isn't at all
easy for a layman to assess at what point they should assume that the
medication isn't working and an ambulance is necessary.
The first port of call for good advice about how to treat asthma is the
GP. Here, the GP offered no assessment and no advice. Why didn't the
mother take the child to hospital? Answer: because the mother didn't
realise that it was necessary. With proper advice she might have
realised that it was necessary. You evidently believe that you would
have acted very differently if it had been your child. Maybe that's
true. Or maybe it's wishful thinking.
Anybody with close contact with n asthma sufferer is well aware of all this
stuff.
The mother is trying to make excuses for herself.
The "Not my fault gov."syndrome.
Probably going to apply for compensation.

=====

She was well aware of the seriousness of her daughter's condition. Any
mother worth her salt would have turned up well in advance and in this case,
explained to staff the seriousness of the situation and have refused to be
turned away. I think you are right. She is looking for compensation. She
is a disgrace.

I am very well aware of the seriousness of asthma and I am sure that mother
was too.
--
http://www.helpforheroes.org.uk
Nick
2017-02-28 11:15:09 UTC
Permalink
Raw Message
Post by harry
Post by pamela
Post by GB
It's very hurtful to blame the mother. Where do we see official >>
guidance
Post by GB
saying "if your GP has no time to see you, go to A&E?" The gist of what
we're continually reading is quite the contrary - don't go to hospital
unless your GP tells you that's the appropriate place.
If your GP says she can't see you today so come back tomorrow, you are
entitled to assume that this is good advice.
The child had been in the high dependency unit five times over her
asthma. The mother was utterly negligent in allowing this situation to
develop. She should have checked on the child at regular intervals and
used her own common sense in deciding whether the child needed
treatment
Post by GB
urgently.
Clearly, the GP had no idea whether the child had stubbed her toe or
this was an emergency. To regard the statement that the surgery is
closed come back tomorrow as considered advice about the child's
condition is just silly, and it cost the girl her life. If the child
had
Post by GB
never had asthma before, it's perhaps understandable. Given the
history,
Post by GB
it's simply unbelievably stupid.
People need to take responsibility for their own lives and their own
decisions. The blame culture is all well and good if the harm done can
be compensated for by money, but that's sadly not the case here.
Yes, the doctor was at fault, but the mother still had ample
opportunity
Post by GB
to prevent harm to her daughter. She let her daughter down, and I'd say
she was 99% responsible for the death.
I think that's an outrageous opinion to hold.
Many children have asthma. It's a very common condition. It is very
difficult for a parent or partner to assess how serious an asthma attack
is. Many people are totally unaware that an asthma attack can cause
death or brain damage, because there is little or no guidance in the
public media.
If your child, partner or friend has been prescribed medication to treat
an asthma attack it is reasonable to assume that if they have an attack
they should take the medication and all will be well. It isn't at all
easy for a layman to assess at what point they should assume that the
medication isn't working and an ambulance is necessary.
The first port of call for good advice about how to treat asthma is the
GP. Here, the GP offered no assessment and no advice. Why didn't the
mother take the child to hospital? Answer: because the mother didn't
realise that it was necessary. With proper advice she might have
realised that it was necessary. You evidently believe that you would
have acted very differently if it had been your child. Maybe that's
true. Or maybe it's wishful thinking.
Anybody with close contact with n asthma sufferer is well aware of all this stuff.
The mother is trying to make excuses for herself.
The "Not my fault gov."syndrome.
Probably going to apply for compensation.
=====
She was well aware of the seriousness of her daughter's condition. Any
mother worth her salt would have turned up well in advance and in this
case, explained to staff the seriousness of the situation and have
refused to be turned away. I think you are right. She is looking for
compensation. She is a disgrace.
She had 28 minutes to get to the surgery from when the appointment was
booked. Perhaps she had to get her child dressed, calm her down and got
caught in traffic? The receptionist seems to have suffered significant
delays in the surgery is it not conceivable the mother also was
unavoidably delayed.
Post by harry
I am very well aware of the seriousness of asthma and I am sure that
mother was too.
Do you know how to tell when a mild attack will become more serious?
Jeff
2017-02-28 11:48:19 UTC
Permalink
Raw Message
Post by Nick
Do you know how to tell when a mild attack will become more serious?
If the attack got worse whist at the surgery all the doctor would have
been able to do is us the inhaler and call an ambulance; both of which
the mother was capable of doing.

If it got worse after they left the mother was quite capable of using
the inhaler and calling an ambulance, as I am sure she had done in the past.

Jeff
The Todal
2017-02-28 11:58:12 UTC
Permalink
Raw Message
Post by Jeff
Post by Nick
Do you know how to tell when a mild attack will become more serious?
If the attack got worse
Worse than what?
Post by Jeff
whist at the surgery all the doctor would have
been able to do is us the inhaler and call an ambulance; both of which
the mother was capable of doing.
The GP has access to the sort of drugs that an ambulance paramedic has,
and more.
Post by Jeff
If it got worse
Worse than what?
Post by Jeff
after they left the mother was quite capable of using
the inhaler and calling an ambulance, as I am sure she had done in the past.
You're sure, are you?

If you had a member of the family or a friend who was having an asthma
attack and was puffing on an inhaler, you'd know, would you, at what
point to call an ambulance?

How about if (as happened here) you put your child to bed and an hour
later the child has an asthma attack, and dies a few minutes later? Does
that mean you should go back in time and call an ambulance before the
child goes to bed?
GB
2017-02-28 12:06:50 UTC
Permalink
Raw Message
Post by The Todal
Post by Jeff
whist at the surgery all the doctor would have
been able to do is us the inhaler and call an ambulance; both of which
the mother was capable of doing.
The GP has access to the sort of drugs that an ambulance paramedic has,
and more.
On the premises? Your reference for that is ....?
Post by The Todal
How about if (as happened here) you put your child to bed and an hour
later the child has an asthma attack, and dies a few minutes later? Does
that mean you should go back in time and call an ambulance before the
child goes to bed?
In the circumstances of a child that had been in the HDU so many times,
it was most unwise to put the child to bed unless the original attack
was definitely over.

If it was over, and the child then had a further attack, I don't see
what anybody could have done.
The Todal
2017-02-28 13:21:26 UTC
Permalink
Raw Message
Post by GB
Post by The Todal
Post by Jeff
whist at the surgery all the doctor would have
been able to do is us the inhaler and call an ambulance; both of which
the mother was capable of doing.
The GP has access to the sort of drugs that an ambulance paramedic has,
and more.
On the premises? Your reference for that is ....?
Post by The Todal
How about if (as happened here) you put your child to bed and an hour
later the child has an asthma attack, and dies a few minutes later? Does
that mean you should go back in time and call an ambulance before the
child goes to bed?
In the circumstances of a child that had been in the HDU so many times,
it was most unwise to put the child to bed unless the original attack
was definitely over.
If it was over, and the child then had a further attack, I don't see
what anybody could have done.
You don't see, because you have no medical training presumably.

What was needed was to assess the child's current medical state and to
give advice about whether she needed additional drugs and whether she
should go to hospital for them.

Rather than "she's five minutes late, I'm not seeing her".
GB
2017-02-28 15:35:48 UTC
Permalink
Raw Message
Post by The Todal
Post by GB
Post by The Todal
Post by Jeff
whist at the surgery all the doctor would have
been able to do is us the inhaler and call an ambulance; both of which
the mother was capable of doing.
The GP has access to the sort of drugs that an ambulance paramedic has,
and more.
On the premises? Your reference for that is ....?
Post by The Todal
How about if (as happened here) you put your child to bed and an hour
later the child has an asthma attack, and dies a few minutes later? Does
that mean you should go back in time and call an ambulance before the
child goes to bed?
In the circumstances of a child that had been in the HDU so many times,
it was most unwise to put the child to bed unless the original attack
was definitely over.
If it was over, and the child then had a further attack, I don't see
what anybody could have done.
You don't see, because you have no medical training presumably.
What was needed
You don't know what was needed, "because you have no medical training
presumably".

This is a daft argument, because you seem to be doubting the GMC's
knowledge and ability. If the GMC thought the doctor's conduct led to
the death, they'd have ruled accordingly.
Post by The Todal
was to assess the child's current medical state and to
give advice about whether she needed additional drugs and whether she
should go to hospital for them.
Rather than "she's five minutes late, I'm not seeing her".
The GMC ruled that this was a breach. Nobody's arguing with you about it.
Ophelia
2017-02-28 15:26:30 UTC
Permalink
Raw Message
Post by Nick
Do you know how to tell when a mild attack will become more serious?
If the attack got worse whist at the surgery all the doctor would have
been able to do is us the inhaler and call an ambulance; both of which
the mother was capable of doing.

If it got worse after they left the mother was quite capable of using
the inhaler and calling an ambulance, as I am sure she had done in the past.

Jeff

====

+1
--
http://www.helpforheroes.org.uk
Nick
2017-02-28 21:09:16 UTC
Permalink
Raw Message
Post by Jeff
Post by Nick
Do you know how to tell when a mild attack will become more serious?
If the attack got worse whist at the surgery all the doctor would have
been able to do is us the inhaler and call an ambulance; both of which
the mother was capable of doing.
If it got worse after they left the mother was quite capable of using
the inhaler and calling an ambulance, as I am sure she had done in the past.
The point is that the Doctor could have assessed the risk of a severe
episode happening in the immediate future. She could have prescribed
preventative treatment or recommended observation in hospital.

The fact that the NHS report concluded that Dr Rowe's failure to see
Ellie-May was the "root cause" of Ellie-May's death suggests that Dr
Rowe could have taken effective action to save Ellie-May.

AIUI it is almost inevitable that doctors will make mistakes that cost
patients their life. The seriousness of the mistake is not judged on the
consequence, the death of the patient, but if the mistake fell below a
reasonable level of professional competence. In this case it was
considered a serious professional error and hence Dr Rowe was given a
written warning. In most jobs I've had a written warning is a very
serious matter.

I don't know why the mother was slightly late for the appointment.
Perhaps it was her fault perhaps not. Her biggest mistake seems to have
been to trust that the Doctor's judgement that is was ok to defer the
appointment to the next day. I think the best lesson we can learn from
this thread is not to trust Doctors or the NHS.
Post by Jeff
Jeff
GB
2017-02-28 21:23:47 UTC
Permalink
Raw Message
Post by Nick
Post by Jeff
Post by Nick
Do you know how to tell when a mild attack will become more serious?
If the attack got worse whist at the surgery all the doctor would have
been able to do is us the inhaler and call an ambulance; both of which
the mother was capable of doing.
If it got worse after they left the mother was quite capable of using
the inhaler and calling an ambulance, as I am sure she had done in the past.
The point is that the Doctor could have assessed the risk of a severe
episode happening in the immediate future. She could have prescribed
preventative treatment or recommended observation in hospital.
The fact that the NHS report concluded that Dr Rowe's failure to see
Ellie-May was the "root cause" of Ellie-May's death suggests that Dr
Rowe could have taken effective action to save Ellie-May.
Do you have a ref to that report, please?
Post by Nick
AIUI it is almost inevitable that doctors will make mistakes that cost
patients their life. The seriousness of the mistake is not judged on the
consequence, the death of the patient, but if the mistake fell below a
reasonable level of professional competence. In this case it was
considered a serious professional error and hence Dr Rowe was given a
written warning. In most jobs I've had a written warning is a very
serious matter.
I don't know why the mother was slightly late for the appointment.
Perhaps it was her fault perhaps not. Her biggest mistake seems to have
been to trust that the Doctor's judgement that is was ok to defer the
appointment to the next day.
Did the doctor actually say that?
Post by Nick
I think the best lesson we can learn from
this thread is not to trust Doctors or the NHS.
What's the alternative?
Post by Nick
Post by Jeff
Jeff
Nick
2017-02-28 22:23:06 UTC
Permalink
Raw Message
Post by GB
Post by Nick
Post by Jeff
Post by Nick
Do you know how to tell when a mild attack will become more serious?
If the attack got worse whist at the surgery all the doctor would have
been able to do is us the inhaler and call an ambulance; both of which
the mother was capable of doing.
If it got worse after they left the mother was quite capable of using
the inhaler and calling an ambulance, as I am sure she had done in the past.
The point is that the Doctor could have assessed the risk of a severe
episode happening in the immediate future. She could have prescribed
preventative treatment or recommended observation in hospital.
The fact that the NHS report concluded that Dr Rowe's failure to see
Ellie-May was the "root cause" of Ellie-May's death suggests that Dr
Rowe could have taken effective action to save Ellie-May.
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.

<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>

The NHS report was said to be confidential.

Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
Post by GB
Post by Nick
AIUI it is almost inevitable that doctors will make mistakes that cost
patients their life. The seriousness of the mistake is not judged on the
consequence, the death of the patient, but if the mistake fell below a
reasonable level of professional competence. In this case it was
considered a serious professional error and hence Dr Rowe was given a
written warning. In most jobs I've had a written warning is a very
serious matter.
I don't know why the mother was slightly late for the appointment.
Perhaps it was her fault perhaps not. Her biggest mistake seems to have
been to trust that the Doctor's judgement that is was ok to defer the
appointment to the next day.
Did the doctor actually say that?
Again from the article.

"They were sent home and told to return in the morning"

A patient at a surgery told to return in the morning after the
receptionist consults with the doctor would reasonably assume the
message comes from the doctor.
Post by GB
Post by Nick
I think the best lesson we can learn from
this thread is not to trust Doctors or the NHS.
What's the alternative?
Question the doctor, refuse to leave the surgery without seeing a
doctor, consult an alternative doctor, go to A&E when a doctor refuses
an immediate appointment, request medical records using A SAR.

Isn't some of that what you were suggesting the mother was negligent for
not doing?
Jeff
2017-03-01 07:43:15 UTC
Permalink
Raw Message
Post by Nick
Post by GB
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.
<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>
The NHS report was said to be confidential.
Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
The Daily Mail also said:

"Dr Rowe was warned the girl was at risk of suffering a life-threatening
seizure"

So it is clear that the mother knew that a life threatening situation
existed, but what did she do, go to A&E, call an ambulance? No she went
home and put the child to bed!!

Jeff
Brian Reay
2017-03-01 08:25:53 UTC
Permalink
Raw Message
Post by Jeff
Post by Nick
Post by GB
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.
<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>
The NHS report was said to be confidential.
Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
"Dr Rowe was warned the girl was at risk of suffering a life-threatening
seizure"
So it is clear that the mother knew that a life threatening situation
existed, but what did she do, go to A&E, call an ambulance? No she went
home and put the child to bed!!
Jeff
That is the most damning fact which really can't be disputed. A
responsible parent who has a child with asthma knows the drill.

While I'm not blindly defending the GP, trial by media based on the
parent's version and a 'cherry picked' leaked report isn't something
anyone who claims to be involved in the legal profession should give the
time of day to.
--
Suspect someone is claiming a benefit under false pretences? Incapacity
Benefit or Personal Independence Payment when they don't need it? They
are depriving those in real need!

https://www.gov.uk/report-benefit-fraud
Nick
2017-03-01 08:36:29 UTC
Permalink
Raw Message
Post by Jeff
Post by Nick
Post by GB
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.
<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>
The NHS report was said to be confidential.
Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
"Dr Rowe was warned the girl was at risk of suffering a life-threatening
seizure"
So it is clear that the mother knew that a life threatening situation
existed, but what did she do, go to A&E, call an ambulance? No she went
home and put the child to bed!!
Jeff
OK. It is hard to know how to reply to people sometimes.

The girl did not spend all her time in hospital. So you understand that
this risk was not a constant thing, it changed with time?

Assessing the risk is easy in hindsight but more difficult prior to the
event.
Brian Reay
2017-03-01 09:10:09 UTC
Permalink
Raw Message
Post by Nick
Post by Jeff
Post by Nick
Post by GB
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.
<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>
The NHS report was said to be confidential.
Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
"Dr Rowe was warned the girl was at risk of suffering a life-threatening
seizure"
So it is clear that the mother knew that a life threatening situation
existed, but what did she do, go to A&E, call an ambulance? No she went
home and put the child to bed!!
Jeff
OK. It is hard to know how to reply to people sometimes.
The girl did not spend all her time in hospital. So you understand that
this risk was not a constant thing, it changed with time?
Assessing the risk is easy in hindsight but more difficult prior to the
event.
If you mean, can the severity of the asthma 'attack' change with time,
yes and sometimes quite quickly- 10 minutes from 'no sign' to distress-
and that is in someone who wasn't considered a serious sufferer. By
distress I mean serious wheezing etc, not in danger.

If your child is subject to frequent episodes, you would surely know the
signs and drill.

Episodes can be long, a friend had a daughter who suffered problems for
days or more at a time. Other people it can be a short thing, may be
under a few hours.

I'm not a medic, the above is based on being a parent and talking to
other parents. Fortunately, our daughter grew out of it, by her teens it
was history. Her twin sister never had a problem.
--
Suspect someone is claiming a benefit under false pretences? Incapacity
Benefit or Personal Independence Payment when they don't need it? They
are depriving those in real need!

https://www.gov.uk/report-benefit-fraud
Nick
2017-03-01 09:19:34 UTC
Permalink
Raw Message
Post by Brian Reay
Post by Nick
Post by Jeff
Post by Nick
Post by GB
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.
<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>
The NHS report was said to be confidential.
Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
"Dr Rowe was warned the girl was at risk of suffering a life-threatening
seizure"
So it is clear that the mother knew that a life threatening situation
existed, but what did she do, go to A&E, call an ambulance? No she went
home and put the child to bed!!
Jeff
OK. It is hard to know how to reply to people sometimes.
The girl did not spend all her time in hospital. So you understand that
this risk was not a constant thing, it changed with time?
Assessing the risk is easy in hindsight but more difficult prior to the
event.
If you mean, can the severity of the asthma 'attack' change with time,
yes and sometimes quite quickly- 10 minutes from 'no sign' to distress-
and that is in someone who wasn't considered a serious sufferer. By
distress I mean serious wheezing etc, not in danger.
If your child is subject to frequent episodes, you would surely know the
signs and drill.
Yes the drill is to seek medical advice. The parent sought medical
advice. By refusing to see the patent the doctor implicitly gave medical
advice.
Brian Reay
2017-03-01 09:31:15 UTC
Permalink
Raw Message
Post by Nick
Post by Brian Reay
Post by Nick
Post by Jeff
Post by Nick
Post by GB
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.
<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>
The NHS report was said to be confidential.
Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
"Dr Rowe was warned the girl was at risk of suffering a
life-threatening
seizure"
So it is clear that the mother knew that a life threatening situation
existed, but what did she do, go to A&E, call an ambulance? No she went
home and put the child to bed!!
Jeff
OK. It is hard to know how to reply to people sometimes.
The girl did not spend all her time in hospital. So you understand that
this risk was not a constant thing, it changed with time?
Assessing the risk is easy in hindsight but more difficult prior to the
event.
If you mean, can the severity of the asthma 'attack' change with time,
yes and sometimes quite quickly- 10 minutes from 'no sign' to distress-
and that is in someone who wasn't considered a serious sufferer. By
distress I mean serious wheezing etc, not in danger.
If your child is subject to frequent episodes, you would surely know the
signs and drill.
Yes the drill is to seek medical advice. The parent sought medical
advice. By refusing to see the patent the doctor implicitly gave medical
advice.
Nonsense- and that isn't because I'm defending the doctor.
--
Suspect someone is claiming a benefit under false pretences? Incapacity
Benefit or Personal Independence Payment when they don't need it? They
are depriving those in real need!

https://www.gov.uk/report-benefit-fraud
Ophelia
2017-03-01 10:29:52 UTC
Permalink
Raw Message
Post by Nick
Post by Brian Reay
Post by Nick
Post by Jeff
Post by Nick
Post by GB
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.
<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>
The NHS report was said to be confidential.
Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
"Dr Rowe was warned the girl was at risk of suffering a
life-threatening
seizure"
So it is clear that the mother knew that a life threatening situation
existed, but what did she do, go to A&E, call an ambulance? No she went
home and put the child to bed!!
Jeff
OK. It is hard to know how to reply to people sometimes.
The girl did not spend all her time in hospital. So you understand that
this risk was not a constant thing, it changed with time?
Assessing the risk is easy in hindsight but more difficult prior to the
event.
If you mean, can the severity of the asthma 'attack' change with time,
yes and sometimes quite quickly- 10 minutes from 'no sign' to distress-
and that is in someone who wasn't considered a serious sufferer. By
distress I mean serious wheezing etc, not in danger.
If your child is subject to frequent episodes, you would surely know the
signs and drill.
Yes the drill is to seek medical advice. The parent sought medical
advice. By refusing to see the patent the doctor implicitly gave medical
advice.
Nonsense- and that isn't because I'm defending the doctor.

====

Anyone with a chronically asthmatic child *knows* what that child needs!

Two have my children had asthma when they were young and there is no way on
earth, I would see my child struggling to breathe and put them to bed.
--
http://www.helpforheroes.org.uk
Brian Reay
2017-03-01 17:43:46 UTC
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Post by Brian Reay
Post by Nick
Post by Brian Reay
Post by Nick
Post by Jeff
Post by Nick
Post by GB
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.
<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>
The NHS report was said to be confidential.
Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
"Dr Rowe was warned the girl was at risk of suffering a
life-threatening
seizure"
So it is clear that the mother knew that a life threatening situation
existed, but what did she do, go to A&E, call an ambulance? No she went
home and put the child to bed!!
Jeff
OK. It is hard to know how to reply to people sometimes.
The girl did not spend all her time in hospital. So you understand that
this risk was not a constant thing, it changed with time?
Assessing the risk is easy in hindsight but more difficult prior to the
event.
If you mean, can the severity of the asthma 'attack' change with time,
yes and sometimes quite quickly- 10 minutes from 'no sign' to distress-
and that is in someone who wasn't considered a serious sufferer. By
distress I mean serious wheezing etc, not in danger.
If your child is subject to frequent episodes, you would surely know the
signs and drill.
Yes the drill is to seek medical advice. The parent sought medical
advice. By refusing to see the patent the doctor implicitly gave medical
advice.
Nonsense- and that isn't because I'm defending the doctor.
====
Anyone with a chronically asthmatic child *knows* what that child needs!
Two have my children had asthma when they were young and there is no way
on earth, I would see my child struggling to breathe and put them to bed.
Exactly.
Ophelia
2017-03-01 10:26:49 UTC
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Raw Message
Post by Nick
Post by Jeff
Post by Nick
Post by GB
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.
<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>
The NHS report was said to be confidential.
Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
"Dr Rowe was warned the girl was at risk of suffering a life-threatening
seizure"
So it is clear that the mother knew that a life threatening situation
existed, but what did she do, go to A&E, call an ambulance? No she went
home and put the child to bed!!
Jeff
OK. It is hard to know how to reply to people sometimes.
The girl did not spend all her time in hospital. So you understand that
this risk was not a constant thing, it changed with time?
Assessing the risk is easy in hindsight but more difficult prior to the
event.
If you mean, can the severity of the asthma 'attack' change with time,
yes and sometimes quite quickly- 10 minutes from 'no sign' to distress-
and that is in someone who wasn't considered a serious sufferer. By
distress I mean serious wheezing etc, not in danger.

If your child is subject to frequent episodes, you would surely know the
signs and drill.

Episodes can be long, a friend had a daughter who suffered problems for
days or more at a time. Other people it can be a short thing, may be
under a few hours.

I'm not a medic, the above is based on being a parent and talking to
other parents. Fortunately, our daughter grew out of it, by her teens it
was history. Her twin sister never had a problem.

===

I agree, absolutely! As you say, anyone who has a child with asthma
'knows the drill'!
--
http://www.helpforheroes.org.uk
Brian Reay
2017-03-01 17:52:51 UTC
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Raw Message
Post by Brian Reay
Post by Nick
Post by Jeff
Post by Nick
Post by GB
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.
<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>
The NHS report was said to be confidential.
Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
"Dr Rowe was warned the girl was at risk of suffering a life-threatening
seizure"
So it is clear that the mother knew that a life threatening situation
existed, but what did she do, go to A&E, call an ambulance? No she went
home and put the child to bed!!
Jeff
OK. It is hard to know how to reply to people sometimes.
The girl did not spend all her time in hospital. So you understand that
this risk was not a constant thing, it changed with time?
Assessing the risk is easy in hindsight but more difficult prior to the
event.
If you mean, can the severity of the asthma 'attack' change with time,
yes and sometimes quite quickly- 10 minutes from 'no sign' to distress-
and that is in someone who wasn't considered a serious sufferer. By
distress I mean serious wheezing etc, not in danger.
If your child is subject to frequent episodes, you would surely know the
signs and drill.
Episodes can be long, a friend had a daughter who suffered problems for
days or more at a time. Other people it can be a short thing, may be
under a few hours.
I'm not a medic, the above is based on being a parent and talking to
other parents. Fortunately, our daughter grew out of it, by her teens it
was history. Her twin sister never had a problem.
I agree, absolutely! As you say, anyone who has a child with asthma
'knows the drill'!
We were fortunate, the episodes were mild compared to those some suffer
but even so 'scary' at times.

This case is, of course, a tragedy but trial by media isn't the answer.
A proper investigation, yes, and if the Dr's action was irresponsible
then action. BUT the media are not the people to investigate this.
Ophelia
2017-03-01 17:57:25 UTC
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Raw Message
Post by Brian Reay
Post by Nick
Post by Jeff
Post by Nick
Post by GB
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.
<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>
The NHS report was said to be confidential.
Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
"Dr Rowe was warned the girl was at risk of suffering a life-threatening
seizure"
So it is clear that the mother knew that a life threatening situation
existed, but what did she do, go to A&E, call an ambulance? No she went
home and put the child to bed!!
Jeff
OK. It is hard to know how to reply to people sometimes.
The girl did not spend all her time in hospital. So you understand that
this risk was not a constant thing, it changed with time?
Assessing the risk is easy in hindsight but more difficult prior to the
event.
If you mean, can the severity of the asthma 'attack' change with time,
yes and sometimes quite quickly- 10 minutes from 'no sign' to distress-
and that is in someone who wasn't considered a serious sufferer. By
distress I mean serious wheezing etc, not in danger.
If your child is subject to frequent episodes, you would surely know the
signs and drill.
Episodes can be long, a friend had a daughter who suffered problems for
days or more at a time. Other people it can be a short thing, may be
under a few hours.
I'm not a medic, the above is based on being a parent and talking to
other parents. Fortunately, our daughter grew out of it, by her teens it
was history. Her twin sister never had a problem.
I agree, absolutely! As you say, anyone who has a child with asthma
'knows the drill'!
We were fortunate, the episodes were mild compared to those some suffer
but even so 'scary' at times.

This case is, of course, a tragedy but trial by media isn't the answer.
A proper investigation, yes, and if the Dr's action was irresponsible
then action. BUT the media are not the people to investigate this.
=====

Agreed!
--
http://www.helpforheroes.org.uk
Ophelia
2017-03-01 10:22:57 UTC
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Post by GB
Post by Nick
Post by Jeff
Post by Nick
Do you know how to tell when a mild attack will become more serious?
If the attack got worse whist at the surgery all the doctor would have
been able to do is us the inhaler and call an ambulance; both of which
the mother was capable of doing.
If it got worse after they left the mother was quite capable of using
the inhaler and calling an ambulance, as I am sure she had done in the past.
The point is that the Doctor could have assessed the risk of a severe
episode happening in the immediate future. She could have prescribed
preventative treatment or recommended observation in hospital.
The fact that the NHS report concluded that Dr Rowe's failure to see
Ellie-May was the "root cause" of Ellie-May's death suggests that Dr
Rowe could have taken effective action to save Ellie-May.
Do you have a ref to that report, please?
No. I am repeating what was in the Daily Mail url posted by Todal.

<http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html>

The NHS report was said to be confidential.

Are you disputing the accuracy of the Daily Mail, in this case? I mean
obviously they are weasels a lot of the time, however in this case what
they are saying seems to be explicit enough to be libellous if not
substantially true.
Post by GB
Post by Nick
AIUI it is almost inevitable that doctors will make mistakes that cost
patients their life. The seriousness of the mistake is not judged on the
consequence, the death of the patient, but if the mistake fell below a
reasonable level of professional competence. In this case it was
considered a serious professional error and hence Dr Rowe was given a
written warning. In most jobs I've had a written warning is a very
serious matter.
I don't know why the mother was slightly late for the appointment.
Perhaps it was her fault perhaps not. Her biggest mistake seems to have
been to trust that the Doctor's judgement that is was ok to defer the
appointment to the next day.
Did the doctor actually say that?
Again from the article.

"They were sent home and told to return in the morning"

A patient at a surgery told to return in the morning after the
receptionist consults with the doctor would reasonably assume the
message comes from the doctor.
Post by GB
Post by Nick
I think the best lesson we can learn from
this thread is not to trust Doctors or the NHS.
What's the alternative?
Question the doctor, refuse to leave the surgery without seeing a
doctor, consult an alternative doctor, go to A&E when a doctor refuses
an immediate appointment, request medical records using A SAR.

Isn't some of that what you were suggesting the mother was negligent for
not doing?

===

+1
--
http://www.helpforheroes.org.uk
GB
2017-03-01 11:35:03 UTC
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Post by Nick
Post by GB
Post by Nick
I think the best lesson we can learn from
this thread is not to trust Doctors or the NHS.
What's the alternative?
Question the doctor, refuse to leave the surgery without seeing a
doctor, consult an alternative doctor, go to A&E when a doctor refuses
an immediate appointment, request medical records using A SAR.
That all sounds like trusting doctors, which you told us all not to do.
I think what you suggest is all sensible advice.

"go to A&E when a doctor refuses an immediate appointment"
Absolutely agree, provided it is more than a minor ailment, and it's
something that needs urgent treatment.
Post by Nick
Isn't some of that what you were suggesting the mother was negligent for
not doing?
Yes, it is. The logic runs like this:
1. Suppose the DM is right and "The ‘root cause’ of the girl’s death was
Dr Rowe’s refusal to see her".
2. Then the girl must have been severely ill at the time she saw the doctor.
3. The mother must have known what to do in the circumstances and didn't
take those steps.

I don't accept that being turned away from the surgery was at all the
same as obtaining medical assistance, nor was it medical advice that the
matter was non-urgent.
Nick
2017-03-01 16:33:06 UTC
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Post by GB
Post by Nick
Post by GB
Post by Nick
I think the best lesson we can learn from
this thread is not to trust Doctors or the NHS.
What's the alternative?
Question the doctor, refuse to leave the surgery without seeing a
doctor, consult an alternative doctor, go to A&E when a doctor refuses
an immediate appointment, request medical records using A SAR.
That all sounds like trusting doctors, which you told us all not to do.
I think what you suggest is all sensible advice.
"go to A&E when a doctor refuses an immediate appointment"
Absolutely agree, provided it is more than a minor ailment, and it's
something that needs urgent treatment.
I don't believe a patient can always reliably judge when a condition
requires urgent treatment.
Post by GB
Post by Nick
Isn't some of that what you were suggesting the mother was negligent for
not doing?
1. Suppose the DM is right and "The ‘root cause’ of the girl’s death was
Dr Rowe’s refusal to see her".
2. Then the girl must have been severely ill at the time she saw the doctor.
What do you mean severely ill? Illnesses do not always manifest
themselves clearly. A person who misses a routine cancer scan may not
realise the seriousness as they would not realise they have cancer.

I'm not a doctor so I do not understand all the risk factors associated
with asthma. I'm not convinced they are all as obvious as you are
suggesting.

If the symptoms are as obvious as you claim why bother going to a GP
surgery at all?
Post by GB
3. The mother must have known what to do in the circumstances and didn't
take those steps.
In what circumstances?
Post by GB
I don't accept that being turned away from the surgery was at all the
same as obtaining medical assistance, nor was it medical advice that the
matter was non-urgent.
I would hope professional standards apply. A surgery has a duty of care
to patients. This extends to the receptionist. If the surgery cannot
offer immediate assistance to an emergency patient they should suggest
alternative sources of assistance. The moment the surgery suggested a
next day appointment they were offering what appears to be professional
advice. A receptionist should be trained not to do this off her own back.

The NHS and another doctor at the surgery appear to agree with this view.
GB
2017-03-01 21:41:20 UTC
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Raw Message
Post by Nick
I don't believe a patient can always reliably judge when a condition
requires urgent treatment.
You must be right, but what do you deduce from that? Always go to A&E
if you cut your finger?
Post by Nick
Post by GB
Post by Nick
Isn't some of that what you were suggesting the mother was negligent for
not doing?
1. Suppose the DM is right and "The ‘root cause’ of the girl’s death was
Dr Rowe’s refusal to see her".
2. Then the girl must have been severely ill at the time she saw the doctor.
What do you mean severely ill?
I mean that she either had an acute asthma attack at the time or she didn't.
Post by Nick
If the symptoms are as obvious as you claim why bother going to a GP
surgery at all?
Indeed.
Post by Nick
Post by GB
3. The mother must have known what to do in the circumstances and didn't
take those steps.
In what circumstances?
Asthma attack.

Ophelia
2017-02-28 15:27:13 UTC
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Post by harry
Post by pamela
Post by GB
It's very hurtful to blame the mother. Where do we see official >>
guidance
Post by GB
saying "if your GP has no time to see you, go to A&E?" The gist of what
we're continually reading is quite the contrary - don't go to hospital
unless your GP tells you that's the appropriate place.
If your GP says she can't see you today so come back tomorrow, you are
entitled to assume that this is good advice.
The child had been in the high dependency unit five times over her
asthma. The mother was utterly negligent in allowing this situation to
develop. She should have checked on the child at regular intervals and
used her own common sense in deciding whether the child needed
treatment
Post by GB
urgently.
Clearly, the GP had no idea whether the child had stubbed her toe or
this was an emergency. To regard the statement that the surgery is
closed come back tomorrow as considered advice about the child's
condition is just silly, and it cost the girl her life. If the child
had
Post by GB
never had asthma before, it's perhaps understandable. Given the
history,
Post by GB
it's simply unbelievably stupid.
People need to take responsibility for their own lives and their own
decisions. The blame culture is all well and good if the harm done can
be compensated for by money, but that's sadly not the case here.
Yes, the doctor was at fault, but the mother still had ample
opportunity
Post by GB
to prevent harm to her daughter. She let her daughter down, and I'd say
she was 99% responsible for the death.
I think that's an outrageous opinion to hold.
Many children have asthma. It's a very common condition. It is very
difficult for a parent or partner to assess how serious an asthma attack
is. Many people are totally unaware that an asthma attack can cause
death or brain damage, because there is little or no guidance in the
public media.
If your child, partner or friend has been prescribed medication to treat
an asthma attack it is reasonable to assume that if they have an attack
they should take the medication and all will be well. It isn't at all
easy for a layman to assess at what point they should assume that the
medication isn't working and an ambulance is necessary.
The first port of call for good advice about how to treat asthma is the
GP. Here, the GP offered no assessment and no advice. Why didn't the
mother take the child to hospital? Answer: because the mother didn't
realise that it was necessary. With proper advice she might have
realised that it was necessary. You evidently believe that you would
have acted very differently if it had been your child. Maybe that's
true. Or maybe it's wishful thinking.
Anybody with close contact with n asthma sufferer is well aware of all this stuff.
The mother is trying to make excuses for herself.
The "Not my fault gov."syndrome.
Probably going to apply for compensation.
=====
She was well aware of the seriousness of her daughter's condition. Any
mother worth her salt would have turned up well in advance and in this
case, explained to staff the seriousness of the situation and have
refused to be turned away. I think you are right. She is looking for
compensation. She is a disgrace.
She had 28 minutes to get to the surgery from when the appointment was
booked. Perhaps she had to get her child dressed, calm her down and got
caught in traffic? The receptionist seems to have suffered significant
delays in the surgery is it not conceivable the mother also was
unavoidably delayed.
Post by harry
I am very well aware of the seriousness of asthma and I am sure that
mother was too.
Do you know how to tell when a mild attack will become more serious?

====

Having had asthma for most of my life, yes. If she was not concerned, why
did the Mother make an appointment? She will be very aware of any
difficulties of time to get there.
--
http://www.helpforheroes.org.uk
pamela
2017-02-27 14:52:26 UTC
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Post by GB
Post by The Todal
For those who think you should never bother A&E if your GP is
the best person to see.
Clearly, if urgent attention is needed and the GP is
unavailable, most people would think that A&E is probably the
next port of call.
This child had had 5 previous 'episodes of severe /
life-threatening asthma’. The mother should have known what to
do in those circumstances, namely call 999 or bundle the child
into a car and take her to A&E.
These attacks come on very quickly, and the child did not have a
severe attack until over 5 hours later. She may have been
reasonably okay at the time she visited the surgery. Certainly,
the mother had plenty of time to seek the attention needed.
This is a sad case, and the GP could have acted better. So could
the mother.
There is a line of thinking which says the GP is not for any
emergency. However in many cases surgeries are branching out into
areas such as minor surgical procedures and various clinics if they
are in a health-centre based. No surgery should turn away a patient
in obvious need of attention.

In this case, the doctor seems to be saying she wasn't told it was
urgent or she would have done something. That too could be said in
many disasters. I don't think it's a very good excuse.

Here we have an unforeseen consequence of poor behaviour. The GMC
seems to be focussing on the poor behaviour (not seeing the patient)
rather than the deadly consequence.

I would say if we have guidelines, such those from the GMC or even
the Highway Code, then they should be followed (even the sillier
seeming ones) because if not then the trangression could be taken
into account in assessing responsibility for any tragic outcome.
Graham.
2017-02-27 17:50:08 UTC
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Post by GB
Post by The Todal
For those who think you should never bother A&E if your GP is the best
person to see.
Clearly, if urgent attention is needed and the GP is unavailable, most
people would think that A&E is probably the next port of call.
This child had had 5 previous 'episodes of severe / life-threatening
asthma’. The mother should have known what to do in those
circumstances, namely call 999 or bundle the child into a car and take
her to A&E.
These attacks come on very quickly, and the child did not have a severe
attack until over 5 hours later. She may have been reasonably okay at
the time she visited the surgery. Certainly, the mother had plenty of
time to seek the attention needed.
This is a sad case, and the GP could have acted better. So could the
mother.
Quite. I would also say the "Arrogant physician" as personified by
James Robertson Justice should be rooted out as far as possible before
they enter medical school.
--
Graham.
%Profound_observation%
Handsome Jack
2017-02-27 15:08:43 UTC
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Raw Message
Post by The Todal
For those who think you should never bother A&E if your GP is the best
person to see.
http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attac
k-GP-refused-her.html
The poor accessibility of some GP practices is an important reason why
A&E attendances are higher than they need be. I think that's pretty
generally accepted.
--
Jack
burfordTjustice
2017-02-27 16:39:39 UTC
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Raw Message
On Mon, 27 Feb 2017 13:23:00 +0000
Post by The Todal
For those who think you should never bother A&E if your GP is the
best person to see.
http://www.dailymail.co.uk/news/article-4260108/Girl-5-died-asthma-attack-GP-refused-her.html
Shanice arrived at the surgery with Ellie-May just after 5pm.
According to the NHS report, Shanice said she arrived at ‘about
5.08pm’.
However, she insisted to this paper it was 5.04pm. Mother and
daughter then waited several minutes while the receptionist dealt
with a phone call and another patient.
The receptionist finally addressed Shanice at 5.18pm, the report
notes, calling through to Dr Rowe to ask if she would see them.
According to the receptionist’s account, the GP then ‘shouted
something like “No I’m not seeing her, she’s late”.’
When the health board investigated, it found Dr Rowe gave incorrect
information, including her claim to be with another patient at the
time. They also found that staff were ‘fearful of questioning’ Dr
Rowe due her ‘angry outbursts’.
It concluded the ‘root cause’ of the child’s death was that Dr Rowe
‘refused to see EM [Ellie-May] because she was brought in late’. It
also noted that months earlier a hospital paediatrician had written
to Dr Rowe warning that Ellie-May was ‘at risk of another episode of
severe / life-threatening asthma’.
Despite this, the report said, Dr Rowe ‘did not make any clinical
assessment of EM before refusing to see her’ and failed to give her
mother any ‘safety netting advice’.
The ‘serious concern’ was passed to the GMC but Dr Rowe was allowed
to continue practising with only minor restrictions.
This is a Resume enhancement for a government employee.
Soon the DR. will be promoted...watch and see.
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