Doctor prescribed painkillers for boy with E.coli

Mar 14 2008 by Madeleine Brindley, Western Mail

A GP who prescribed painkillers to a young boy with E.coli O157 symptoms said he did not know there was an outbreak in the South Wales Valleys.

The first time “Dr V” was alerted to the outbreak was on September 20, 2005 – four days after the outbreak control team declared the outbreak and on the same day a worried mother, who had reported her son’s diarrhoea and vomiting to the Rhymney Valley practice, had the boy admitted to hospital.

The revelation yesterday comes after the E.coli public inquiry heard that the National Public Health Service for Wales said it had taken significant steps to alert GP practices, out-of-hours services and hospitals across South Wales about the outbreak, which was declared on September 16.

The young boy from the Rhymney area – known only as case six – suffered kidney failure and was transferred to a specialist children’s hospital in England.

The names of the children, medical professionals and the hospitals where they were treated have been anonymised for the purposes of the inquiry.

The boy, who was a pupil at Upper Rhymney Primary School, began to feel ill on September 18 – two days after the E.coli O157 outbreak was declared. His mother initially thought that his stomach cramps had been caused by the “quantity of sweets he had eaten the previous day”.

But the following day, September 19, he began vomiting and had diarrhoea. She said, “My sister rang me to see how he was doing. I told her his symptoms and she told me to watch the news, as there was an item about E.coli in the South Wales Valleys.

“I put the phone down and watched the news that was on at the time. On viewing it, I decided to contact my GP and inform him of my son’s symptoms.”

She asked for a doctor to visit her son, who did not have bloody diarrhoea at the time, at home, because he was feeling so ill, but the surgery told her that one would not be coming.

Instead the mother said, in her witness statement to the inquiry, that the surgery called her back later that day and said a prescription for “disprol” had been written for her son and was available to collect from the practice.

The mother said, “As no doctor had seen my son, I could not understand how they could prescribe disprol, so I did not collect it.”

Dr V, who was the on-call GP at the family’s local surgery, said he had spoken to the boy’s father that day about his son’s illness. He told the inquiry yesterday, “The complaint of diarrhoea and vomiting in children is quite common in general practice.

“Generally speaking, advice is often appropriate initially and we try, where possible, to get patients to come to the surgery where there can be more appropriate examination facilities than on house calls.”

He said he was unaware at that time that an E.coli outbreak had been declared. He only became aware of the outbreak on September 20, when the practice received a call from the local environmental health department.

Dr V told the inquiry, “If I had known there was an E.coli outbreak it would have focused the mind to the possibility that any child presenting with diarrhoea and vomiting might have had this particular illness.

“You would be thinking more along the lines of, could this child have this particular infection, rather than what might be regarded as the normal, run of the mill gastroenteritis.”

The boy was admitted to hospital on September 20 and tested positive for E.coli O157 the following day. He was initially transferred to a larger Welsh hospital and moved to intensive care, before being taken to the English hospital.

His mother said, in her statement, “On reaching the intensive care unit, I was told by a doctor to contact family members as the illness may be fatal.”

The boy was later transferred to the English hospital where he underwent dialysis. His mother said he lost two stone in weight during the course of his illness and was off school until December 2005.

The E.coli public inquiry resumes on Monday