Nurse says doctor told her he saw blood-test results in chicken pox sepsis case

Letterkenny University Hospital

A nurse said a doctor facing allegations of poor professional performance for his treatment of a child who had chicken pox told her he had seen blood-test results, but had failed to write these on a medical chart.

Mia Carlin was admitted to Letterkenny University Hospital on June 24, 2013, with chicken pox, but developed sepsis. Blood tests were ordered the day before she was transferred from Letterkenny to Our Lady’s Children’s Hospital, in Dublin, but there was a delay in taking the sample, a Medical Council inquiry heard.

Matthew Thomas, Oak Grove, Woodlands, Letterkenny, is before this fitness-to-practice inquiry, relating to his care of Mia, who was 16 months old at the time.

At a resumed inquiry hearing into the allegations of poor professional performance over the care of the child, a nurse said she asked Dr Thomas about the test results between 5pm and 6pm on June 26, 2013.

The nurse said she was having tea at the nurses’ station, when Dr Thomas approached and they discussed the child’s blood-test results.

“The doctor said he had seen the results,” the nurse said. “He’d seen the results, but had not written that on the chart.”

Simon Mills, barrister for Dr Thomas, previously told the inquiry that the doctor had directed that the sample be taken that morning, but it was not taken until the afternoon.

The blood test was taken at 2.10pm. Mr Mills said there was a computer printout from the lab, with the results, showing an abnormally raised C-Reactive Protein level (inflammation) at 4.29pm, but these were not brought to the attention of the attending team at 5pm.

Mr Mills said the results of the test were not available to Dr Thomas when he asked for them between 6.30pm and 7pm that evening.

Mia was irritable, miserable, and crying most of the day, according to the nurse. She was treated with an anti-itch cream earlier that day and started on IV fluids shortly after 5pm.

The nurse said there was “no new intervention” for Mia following Dr Thomas’s review of the child at 6pm.

Mr Mills said Dr Thomas did not recall a conversation with the nurse about the blood-test results and said the first he became aware of the elevated C-Reactive Protein level was during a phone call later that evening.

The child was seen at 7pm by registrar Quram Ali, who described her as “clinically stable”.

Giving evidence via video link, Dr Ali said he proposed antibiotics to deal with a secondary infection if one was present.

Dr Ali said the blood-test results were not available to him at 7pm. He said the normal turnaround time for blood-test results is two hours.

“But if there is anything unusual, the lab call us,” said Dr Ali.

“There was no result available at 7pm, that is certain.”

The child was being treated with antibiotics and fluids and was stable, Dr Ali said.

He said this was the same treatment that would have been afforded to her in the intensive care unit at Our Lady’s Children’s Hospital, in Crumlin, had she been there.

At around 7.40pm, the medical team was made aware of the blood-test results. The inquiry continues.


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