A 5-year-old girl died at home from a burst appendix after doctors wrongly diagnosed her as having a stomach bug, a coroner said.
Elspeth Moore was rushed to Southampton General Hospital in England in June 2018 after she suffered diarrhea, and vomiting, and stomach pain.
The family’s doctor found the girl dehydrated with a high temperature and referred her to the hospital’s pediatric unit. While the family waited at the hospital, the girl told her parents her stomach was “on fire,” reported the Advertiser & Times.
A pediatrician, Dr. Faye Hawkins, examined Elspeth and diagnosed gastroenteritis. She told her parents to give her water every five minutes.
Elspeth Moore, 5, died after medics mistook appendicitis for stomach bug https://t.co/Ry1E5Q5AGV
— Stephen McCaffrey (@McCaffreyLaw) March 8, 2019
About an hour later, Elspeth was sleepy but hadn’t been given a bed, so her father approached Hawkins.
“The message we were given was that if we were happy to go, we could. Given that when we arrived we were freaking out, for want of a better word, to be told she had a virus, I felt quite relieved and happy to go, based on that,” he told the court on March 8 during an inquest into the death. “We were told we could always come back, but we weren’t given specific advice on when to come back or things to look out for.”
Two days later Elspeth got worse and at 11 p.m. she made a weird noise and became unresponsive. She was pronounced dead at the hospital just after midnight.
Dr. Darren Fowler, who carried out the postmortem, said Elspeth was suffering from peritonitis, which he said was a severe infection after her appendix had burst.
Dr. Hawkins told the court that she considered appendicitis but thought since the girl didn’t have a tender abdomen she thought it was less likely than gastroenteritis.
Speaking of her decision to send the family home, she added: With retrospect, should I have encouraged you to stay? Maybe. It’s a very tricky situation. When you send a child home, that discussion is shared. As a clinician, we are told to listen to parents.”
Worth another look… head of our #MedicalNegligence team, David Simpson @simbowin looks at the danger of misdiagnosed #appendicitis. https://t.co/k8CtwHy59J #TheLegalHour #misdiagnosis #solicitors #Poole pic.twitter.com/rjfLxxWhCD
— Coles Miller LLP (@ColesMillerLLP) January 23, 2019
Louisa Green, the divisional head or nursing, said in a report that there had been “a missed diagnosis of evolving sepsis, secondary to appendicitis.”
“Given that the presentation of appendicitis in children of this age overlaps with those of gastroenteritis, there may have been confirmation bias that this was gastroenteritis, given the history of watery diarrhea and vomiting,” the report added.
Coroner Grahame Short said the diagnosis was “not unreasonable” but said, “there was insufficient advice given to Mr. and Mrs. Moore on how to care for her at home and more importantly, what to look out for to bring her back to [the] hospital.”
Dr. Peter Wilson, clinical director for women and children’s services at University Hospital Southampton NHS Foundation Trust, told The Sun that the death was “a tragic event.”
clinical presentation of acute #appendicitis is often varied in pediatric patients <5 years old & the diagnosis may be overshadowed by other medical conditions. #Gastroenteritis is the most common misdiagnosis, with a history of diarrhea present in 33-41% of pediatric patients.
— SeretisCare, Inc (@SeretisCare) March 2, 2019
“Elspeth’s death was a tragic event and no words can express the profound regret we feel in such circumstances,” he said. “Diagnosing appendicitis early can be difficult due to overlapping or missing symptoms and this was acknowledged by the coroner, however, an extensive investigation highlighted a number of areas in need of improvement.”
Meanwhile, Elspeth’s parents launched a crowdfunding campaign on JustGiving recently.
“After being left completely devastated by her loss, my husband & I have taken it upon ourselves to make sure her legacy of kindness & humor is not lost in the community she was very much a part of,” her mother wrote.
“Next year I hope to walk to the top of Ben Nevis and place a stone on the peak—which Elspeth decorated with a picture of herself before she died. I am hoping with the donations I receive for this challenge, to give every penny to fund a sensory garden in Elspeth’s name for the preschool she once loved. In this, we hope to make her proud.”