Doctor claims he ‘did not check’ infant’s blood results

A doctor at the centre of a fitness-to-practise inquiry into the treatment of a 16-month-old patient with chickenpox who developed sepsis has made an undertaking to not repeat the conduct which led to a complaint against him.

Dr Matthew Thomas, a paediatric consultant at Letterkenny University Hospital, claimed he "did not check" his patient's blood test results which showed signs of infection requiring antibiotic treatment.

Mia Carlin, who was 16 months old at the time, was brought into hospital on June 24th 2013 with a serious case of chickenpox.

Over the course of the next number of days her condition deteriorated and she developed sepsis and toxic shock syndrome.

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A Medical Council inquiry examined whether Dr Thomas had failed to expedite a blood sample on June 26th 2013, and had failed to start antibiotic treatment when the blood results showed they were required.

The allegations were of poor professional performance and professional misconduct.

Speaking at the inquiry on Friday Dr Thomas said he was told the results of the blood tests he ordered at 10:15am were unavailable when he finished his round of the ward that evening, before going home for the day.

Later that evening around 7:30pm staff working on the ward followed up on the blood tests, which showed high levels of C-Reactive Protein (CRP), indicating a secondary infection, and began treating the infant with antibiotics.

Subsequently the young child was transferred to the intensive care unit in Our Lady’s Crumlin Hospital the next day.

'Miserable'

Dr Thomas told the inquiry that he ordered a blood test that morning, but “the blood test was not done for whatever reason”, and was only carried out at 2:10pm when he followed up on it.

Evidence provided to the inquiry by a nurse working on the ward detailed the infant was in a “miserable condition.”

The inquiry heard the results of the blood tests were available from 4:29pm on the laboratory information system, and a nurse who previously gave evidence said she discussed the test results with Dr Thomas between 5pm and 6pm.

However, Dr Thomas said when he attended the ward that evening he recalled “asking if the blood tests was available, and being told the results were not available.”

He told the inquiry that he could not recall which junior doctor on his team had informed him the tests were not available.

Dr Thomas told the inquiry the first time he became aware of the high levels of CRP revealed in the blood tests was around 8pm when he received a call from another doctor after he had left work.

“If I was aware of a blood result anytime earlier… the antibiotic would have been started,” he said.

The mother of Mia Carlin made a complaint to the Medical Council over the care of her daughter by Dr Thomas at Letterkenny, which led to the inquiry examining the issue.

Dr Donough O’Donovan, consultant paediatrician at Galway University Hospital, gave expert testimony to the inquiry and said the incident “was definitely a shortcoming of care”.

He said “if the labs (tests) were available at 6pm and they didn’t act on them that was a poor choice.”

But said he felt the shortcomings did not amount to the charge of poor professional performance against Dr Thomas.

Simon Mills, barrister for Dr Thomas, told the inquiry his client understood the ordeal had been an “unpleasant experience for him and his family”, and for the family of Mia Carlin.

Following that he said his client agreed to an undertaking not to repeat the conduct which was the subject of the complaint against him, which concluded the inquiry.