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Case ref:201709235
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Date:October 2018
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Body:A Medical Practice in the Lothian NHS Board area
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Sector:Health
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Outcome:Not upheld, no recommendations
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Subject:clinical treatment / diagnosis
Summary
Mr C complained about the care and treatment provided by the practice to his late child (Baby A). Baby A was taken to the practice with a blocked nose and congestion. The doctor considered that Baby A was suffering from a respiratory tract infection, but that there was no evidence of a more serious infection requiring any treatment or hospital admission at that time. The following day, Baby A suffered cardiac arrest at home and was taken by ambulance to hospital. They did not regain consciousness and died a number of weeks later.
Mr C complained that the practice failed to carry out an adequate assessment and failed to make a hospital referral for further investigation, despite Baby A's history of bronchiolitis (a lower respiratory tract infection that affects babies). Prior to Baby A's death, they were found to have been positive for Respiratory Syncytial Virus (RSV - a virus which causes respiratory tract infections, and the most common cause of bronchiolitis). Mr C complained that the practice failed to detect RSV.
We took independent advice from a GP adviser. We found that the doctor's assessment was reasonable and in line with relevant guidelines, which did not indicate that a hospital admission was required, based on the clinical findings. We found that hospital admission with bronchiolitis is normally only required when there are difficulties breathing or feeding, and the GP assessment did not identify any difficulties in Baby A in either regard. We found that the hospital consultant did not consider that RSV and bronchiolitis was the definitive cause of Baby A's death. We found no evidence that the practice overlooked any relevant factors in their assessment of Baby A and we did not uphold the complaint.