Toddler suffering meningococcal meningitis repeatedly dismissed by GP

Ali*, a usually healthy 18-month-old, became ill with a fever and vomiting and his concerned mother Hana* took him to the out of hours GP service at Central Middlesex Hospital.

He had a temperature of 39.1°C, a raised pulse of 156 beats per minute and the duty doctor diagnosed Ali with tonsilitis and prescribed a course of antibiotics. The clinic notes were immediately sent to Ali's local GP in northwest London, including his high temperature, raised heart rate and history of vomiting.

Hana took him to the GP the following morning as his symptoms had worsened overnight. He had been moaning, vomiting and had diarrhoea and would not drink or feed as usual. The toddler seemed dazed, did not make eye contact and had become extremely pale, which was unusual as he has dark skin.

His worried mother told the GP that Ali couldn't keep anything down and kept vomiting up the antibiotics. The GP said this was of no concern and suggested that her little boy had nothing more serious than a cold. He advised her to stop the antibiotics and continue administering infant paracetamol and ibuprofen.

She returned to the GP the following day, his health continuing to deteriorate. She was desperate for help and fearing her son could die. After a brief assessment the GP said he was fine, and she was told to go home.

The next day he remained seriously unwell with increasing lethargy, he had developed shivering and rigors and was vomiting at the surgery. They returned to the surgery and Hana begged the GP to make an urgent hospital referral. Even at this stage, the GP appeared to underestimate the seriousness of Ali's condition. The GP did not call an ambulance as he should have done and left Hana to make their own way to hospital via a taxi.

In his notes to Northwick Park hospital the GP summarised Ali's case in two lines with no mention of his out-of-hours attendance or a proper description of his symptoms.

At each appointment the GP failed to properly examine the little boy or follow national guidelines on his symptoms, which would have led to an urgent hospital referral and further specialist paediatric care.

On attendance at hospital, the doctors immediately recognised that Ali was very unwell. Ali was intubated and put on a ventilator before being transferred to the Paediatric Intensive Care Unit (PICU) at Great Ormond Street Hospital. A lumbar puncture confirmed the diagnosis of meningococcal meningitis, and he was treated with antibiotics.

Due to the delay in his diagnosis and treatment, Ali suffered a brain injury and by the time he was discharged he could no longer sit independently, walk or talk as he had done previously. Ali, now 9-years-old, has signs of emerging intellectual disability and is functioning well below his peers educationally. He has an Education. Health and Care Plan (EHCP). He also has hearing damage and regressive speech amongst other injuries. The full extent of his neurological injuries is not yet known due to his young age.

The defendant maintained a denial of liability throughout the claim. Christina issued proceedings and trial was listed to take place, to deal with the issue of liability. Some admissions in respect of causation were made in the defence, A settlement meeting was held a few months before trial was due to take place and the defendant agreed to resolve liability in the claimant's favour.

Counsel Clodagh Bradley KC at 1 Crown Office Row was instructed by Christina.

* names changed

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