Mum Demands Answers after Catalogue of Clinical Errors by 999 Helplines Lead To Death of Diabetic Son
22/04/2010
North West Ambulance Service
A distraught mother who lost her eight year old son from a sudden onset of diabetes has demanded immediate action after an inquest found that a catalogue of blunders and missed opportunities by 999 staff were responsible for his death.
Melanie Austin was told by a Coroner today that whilst her son Louis died of natural causes, clinical negligence on the part of North West Ambulance Service was a major contribution to his tragic death.
Mrs Austin from Old Trafford, Manchester, and her family did not receive an apology from North West Ambulance Service until the inquest and has since asked clinical negligence solicitors at Irwin Mitchell to help her to ensure that lessons are learned from her son’s tragic death.
Melanie Austin and family friend Owen frantically called the emergency services when eight-year-old Louis became ill and was struggling to stay awake, breathing with difficulty and rapidly losing weight. But despite describing these symptoms first to an emergency medical call handler, and later a senior paramedic, his potentially fatal condition was not deemed serious enough for an ambulance to be sent.
Ms Austin and Owen were told Louis's case would instead be referred to a GP and to expect a call but, desperate for help, Ms Austin made the call to the out-of-hours service, Mastercall, herself. She was then called back by Dr Leigh, the on call GP, who told her that her son had swine flu and should be quarantined. She was told to give him Tamiflu but, less than 48 hours later, Louis passed away on July 13, 2009.
The family are yet to receive an apology from Mastercall.
Speaking on the family's behalf, solicitor Sue Tyson, from Irwin Mitchell in Manchester, said: "The family are truly devastated to have lost a much loved son and brother. But to learn that his death could have been avoided has, understandably, made them question the systems and procedures in place for the emergency services and indeed out of hours GP's.
"Miss Austin and her family have had to wait nine months for any kind of apology, and to hear the full story about how he was failed so badly by the system. That is simply not acceptable. They deserve far better than that.
"They now know that, on three separate occasions, medical staff failed to appreciate the serious nature of Louis's symptoms and so the opportunity to treat the condition that, eventually, took the life of an eight-year-old boy was missed. For his mother, Melanie, that is almost too much to bear."
Miss Tyson continued: "Louis's family didn’t know he had diabetes and placed their trust in the healthcare experts they spoke to. They were badly let down and are determined to hold the organisations concerned to account to ensure this never happens to any other family in the future, anywhere in the NHS.
"We will be continuing to investigate the way the emergency services initially handled the call for help. Louis's family deserve answers and a reassurance from the highest levels that every step will be taken in the future to ensure this cannot happen again."
Following Louis’s death, investigations were conducted by Trafford Primary Care Trust (PCT) into the care provided by the North West Ambulance Service and Mastercall.
The final report issued following the investigation found that the emergency medical dispatcher at NWAS did not correctly code the call in line with the Advanced Medical Despatch Priority System and failed to asses Louis's condition correctly. Had the operator done so, an ambulance would have been sent within 19 minutes.
The investigation also found that the senior paramedic failed to ask at least seven of the necessary questions that, had she done so, would have prompted the decision for an ambulance to be send within eight or 19 minutes. The report also concluded that Mastercall failed to provide good clinical care in line with recommendations made by the General Medical Council (GMC) during a pandemic situation.
The PCT obtained a report from the Dr Amin, Consultant paediatric Endocrinologist, who confirmed during the inquest that a blood test, carried out within minutes of Louis arriving at the hospital, would have confirmed the diagnosis of diabetic Ketoacidosis. With treatment at that time Louis would have made a full recovery.
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