THE doctor who misdiagnosed a young girl who later died from meningitis complications broke down in tears as he gave evidence at her inquest.
Jurors heard from Dr Halenahalli Vijayakumar yesterday on the third day of the hearing into the death of seven-year-old Kate Louise Pierce, of Rossett.
He described how the suspicion of Kate’s parents that he had not sought a second opinion about her condition when they asked him to was an accusation he had had to live with for more than a decade.
Now a practising GP in Leeswood, Flintshire, he was a junior doctor on the children’s ward at Wrexham Maelor Hospital on March, 29, 2006 when then nine-month-old Kate was referred by an out-of-hours GP.
Kate had been vomiting and presenting with green mucus.
Dr Vijayakumar diagnosed her with viral tonsillitis and she went home with her family at about midnight, but returned the next day and was subsequently diagnosed with meningitis.
She was rushed to Alder Hey Hospital in Liverpool and although her life was saved she suffered brain injuries and died while on a family holiday in Florida, aged seven,
Dr Vijayakumar was coming to the end of his rotational placements at the hospital when he examined Kate and had been in the children’s ward for eight weeks.
Just weeks earlier he had been on a training course specifically looking at children presenting with serious illnesses and, reading from the notes he made at the time, said meningitis was on his mind when examining Kate.
Dr Vijayakumar said he had “no recollection” of the night of March 29, 2006, either of examining Kate or meeting her parents Diane and Mark Pierce.
He said: “I came to know about the complaint five or six months later and learned what had happened.”
Dr Vijayakumara said there were specific symptoms suggestive of a chest infection.
David Lewis, deputy coroner for North East Wales and Central, asked about the Pierces’ recollection that Kate was asleep during her examination.
Dr Vijayakumara replied: “No way would I have done an examination if the child was sleeping.” And he added she was neither floppy nor unresponsive.
Asked about his diagnosis of tonsillitis, he explained that a lack of clinical evidence, as well as the presence of enlarged and inflamed tonsils, would have led him “to that probable diagnosis at that time”.
Mr Lewis asked about whether a second opinion had been sought, saying there were “two possibilities”.
“One that you failed to record it, and the second that no such conversation took place.”
Dr Vijayakumara said he could not remember what happened but in a 45 minute period between him leaving the room and returning he was “likely” to have discussed the case with the registrar, but had not made any note of the conversation.
It was his responsibility to make those notes.
When pressed by Martin Jones, the Pierces’ solicitor, about the second opinion, Dr Vijayakumara broke down in tears.
He said: “When parents request a second opinion I would take that seriously.
“It is a very serious accusation (that he did not seek a second opinion) that has lived with me for 10, 11 years. I had no reason to make that up. The parents have gone through so much.”
Evidence was also heard from Dr Sarah Piper, who was registrar on the night and had been working at the Maelor for four weeks at that point.
She also had no recollection of that night or Kate’s parents but “did not think she had been consulted”.
Dr Piper added: “Looking back 11 years later, and hearing his interpretation of the child, I can see it was possible he discussed it with me but I just don’t remember.”
“Listening to the evidence of
Dr Kumar (Vijayakumara) this morning, and how upset he was, I can’t say for certain he didn’t do that.”
Asked if she had been told a parent wanted a second opinion, would she have gone to see the child, Dr Piper said “yes”, but could not recall whether any conversation had been worded like that.
Dr Piper added that at every shift at least two children are referred with the same “presentation” Kate Pierce was showing, and she agreed that discharging her that night “was appropriate”.
The inquest in Abergele continues today with evidence from Wrexham Maelor Hospital’s consultant paediatrician Dr Nicholas Nelhans.