Misdiagnosed 5-Year-Old’s Fatal Appendicitis as a Tummy Bug: Doctor Receives Warning

Dr Faye Hawkins, a consultant paediatrician at Southampton General Hospital who assessed and misdiagnosed Elspeth Moore’s, 5, fatal appendicitis as vital gastroenteritis, has been let off with a written warning—avoiding a possible striking off order or suspension. A Medical Practitioners Tribunal Service said she had ‘learned from her mistakes and remediated fully’.

Despite Elspeth complaining that her stomach ‘felt like it was on fire’, the paediatrician sent her home without a second assessment. According to Elspeth’s parents, Frances and Steven Moore from Lymington, they were discharged without proper instruction on ‘when to come back or things to look out for’.

The five-year-old girl’s health deteriorated, and she was pronounced dead two days later, on July 6, 2018, after her misdiagnosed appendicitis developed into peritonitis and sepsis.

Fatal Misdiagnosis

Frances Moore rushed her daughter for treatment at Southampton General Hospital’s Paediatric Assessment Unit on July 3, 2018, a day after she was sent home from school with diarrhoea.

Elspeth had been dealing with abdominal pains for a week and had been barely feeding. She was dehydrated, lethargic, had an increased heart rate, and a fever of 380 C.

The inquest heard Elspeth was seen by Dr Faye Hawkins at around 7 pm, who diagnosed her with ‘viral gastroenteritis – mild dehydration’.

In what was described as a ‘serious falling below the standard expected’, Dr Hawkins discharged Elspeth without proper assessment of her “red flag” symptoms, a second examination of her stomach, and ‘adequate safety-netting advice’ on how to observe Elspeth’s condition.

Although the child initially improved the next day, her health ‘deteriorated’ on July 5, and she went into cardiac arrest. Her parents called for an ambulance, but Elspeth was pronounced dead on July 6, 2018, at 12.05 am upon arrival at Southampton General Hospital’s A&E.

Speaking at the Winchester Coroner’s Court during a March 2019 inquest, Elspeth’s father said:

 “Given that when we arrived we were freaking out, and then to be told actually your daughter’s got viral Gastroenteritis that will work its way out, I actually felt quite relieved.

“We weren’t given specific advice on when to come back or things to look out for.

“That evening] I stayed up, went into Elspeth’s room every half hour to check on her. At about 11pm I went in and she was still awake.

“I said ‘I’m going to stay in here with you’, and lay down on the floor next to her. I said ‘love you’ and she said ‘love you daddy’.

“It can only have been five or 10 minutes later, I heard her making a weird noise, like something was catching in her throat. I said ‘what’s that noise all about Elspeth, that doesn’t sound right.’ She didn’t respond.

“I said ‘do you want to sit up darling.’ I sat her up, at which point her head just flopped back and her eyes rolled up.”

Grahame Short, the Central Hampshire coroner, recorded Elspeth’s cause of death under ‘natural causes’ from active peritonitis, sepsis and acute appendicitis.

Let Off With a Warning Having ‘Learned from her Mistakes’

The Medical Practitioners Tribunal Service ruled Dr Hawkin’s care of Elspeth as “a failure which amounted to misconduct which is serious.

By failing to adequately consider these symptoms and explore them with [Elspeth] and her parents, Dr Hawkins failed to provide a good standard of care.

”Prior to her discharge she failed to adequately examine [Elspeth]… she did not assess her hydration status, check for the development of any further ‘red flag’ symptoms or signs, or carry out a second examination of her abdomen.”

But because the tribunal deemed Dr Hawkins’ fatal misdiagnosis of Elspeth an ‘isolated case’, it did not find adequate evidence of impaired fitness to practice. The decision also factored in the finding that Dr Hawkins had successfully cared for thousands of patients before and since the serious misconduct.

The tribunal’s verdict stated it was “impressed with Dr Hawkins’ comprehensive remediation efforts and considered that Dr Hawkins has fully reflected on her failings regarding [Elspeth].

“Dr Hawkins has demonstrated a commitment to ongoing personal and professional development with an emphasis on the events concerning [Elspeth].

“The tribunal was satisfied that, over the four years since she treated [Elspeth], she has sought out many opportunities to address the failings identified in the case in several different ways in order to develop and improve her practice.

“Given that Dr Hawkins has shown that she has learned from her mistakes and has remediated fully, the Tribunal considered that there was little more that Dr Hawkins could have done to demonstrate that her fitness to practise is no longer impaired.

“A finding of impairment is not required to maintain proper professional standards or to maintain public confidence.”

Dr Hawkins avoided a striking off order or suspension as the Medical Practitioners Tribunal Service let her off with a written warning, saying she had ‘learned from her mistakes and remediated fully’.

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