No- you didn't "miss it". Meningitis is a nightmare and this can
happen to any of us. It has happened to me.
I cannot see how your posting can breach ANY confidentiality either.
Awful though it would be, the lawyers wouldn't get any change out of
it too, unless there is a change of policy so that all kids with
undiagnosed fever go straight to paeds.
John
On 01/02/2010, Russell Brown <[log in to unmask]> wrote:
> Paul, I would say yes. This is uncommon enough to be significant
> regardless of the outcome.
>
> Don't forget to add it to your pdp
>
> Regards
>
> Russell
>
> On Monday, February 1, 2010, Julian Bradley <[log in to unmask]>
> wrote:
>>
>> saw a young baby with a high fever and diarrhoea in surgery one afternoon.
>> =
>> full h/o and o/e=2C including full set vital signs=2C and cns+skin
>> examinat=
>> ion=2C fortunately all properly documented. mother concerned but ok.
>> arrang=
>> ed to see baby next am if still feverish and 'safetynetted'- again all
>> docu=
>> mented. next morning=2C some 20 hours later=2C one of my good partners saw
>> =
>> baby as he was going the branch surgery clinic=2C baby was now
>> feverish+irr=
>> itable but nil found otherwise so he admitted baby. between seeing baby
>> and=
>> arriving on ward=2C baby developed x3 tiny non-blanching spots and so was
>> =
>> treated for meningococcal meningitis subsequently confirmed. baby was
>> surpr=
>> isingly well thruout and has made a quick and full recovery. =20
>>
>> when this happens=2C one always thinks "did i miss it?". in this case i
>> can=
>> not believe that the baby had a clinically diagnosable meningococcal
>> illnes=
>> s when i saw her nor if i had admitted the child-and there seemed no
>> clinic=
>> al reason to do so-do i really believe that the paeds would have found one
>> =
>> at that moment either=2C but knowing it and believing it is different.
>> moth=
>> er is ok about it=2C but if she wasnt=2C no amount of hard-nosed clinical
>> e=
>> xplanation is going to persuade her or her lawyers otherwise that a
>> potenti=
>> ally fatal illness had been missed=2C the emotional impact is simply too
>> gr=
>> eat.
>>
>> should this be notified as a significant event? and did you know that
>> 1-in-=
>> 3 cases of meningitis results in a formal complaint?
>>
>>
>> Paul,
>>
>> Provided of course that confidentiality hasn't been breached without
>> consent, many thanks for sharing. These accounts seem invaluable in
>> reminding us that uncommon things happen and are very difficult.
>>
>> You say the baby had meningococcal meningitis but presume you actually
>> mean meningococcal septicaemia - hence the rash (with or without
>> meningitis).
>>
>> I'm sure you've looked at http://www.meningococcal.org/symptoms.html which
>> reminds us that diarrhoea is a potential feature of meningococcal disease
>> and http://www.nice.org.uk/nicemedia/pdf/CG47QuickRefGuide.pdf still
>> appears extant.
>>
>> You don't mention age of baby or exact level of fever which could be of
>> interest.
>>
>> Overall however every sympathy to you and to the family - even near misses
>> are unpleasant.
>>
>> Worth significant event reporting to any group you can trust to use the
>> information wisely.
>>
>> Julian
>>
>
> --
>
>
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