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Parents who did something
positive
(Filed: 18/06/2002)
Father believed legal action was vengeful, and
there was no point putting a doctor into the courts. Celia Hall
reports
A couple whose three-year-old daughter nearly died
after the correct diagnosis was repeatedly missed have developed a
ground-breaking computer system aimed at preventing similar mistakes
happening again.
Charlotte and Jason Maude, from south-west London,
have the full support of the Department of Health for the "on-line
second opinion" that will provide doctors with layers of knowledge
in seconds.
What doctors missed was necrotising fasciitis, the
potentially fatal flesh-eating bug, which is a rare but known
complication of chickenpox.
Instead of suing the doctors, Mr and Mrs Maude
invested a £35,000 shares windfall to set up a charity named after
their daughter, Isabel, to carry their project forward.
Isabel is now six and fully recovered but will need
several more plastic surgery operations in her teens.
Her mother said yesterday: "Three years ago, Isabel
had chickenpox and things went badly wrong. It was every parent's
worst nightmare."
Three days after her illness began, her mother took
her to the GP because her temperature was unusually high. She was
vomiting and had other symptoms. Mrs Maude was reassured by the
doctor.
The next day, Isabel had developed a rash on her
stomach and her parents took her to the local accident and emergency
department. A junior doctor sent them home. By the sixth day, Isabel
was much worse and the rash had turned purple.
They spoke to the GP on the phone and again took
their daughter to the hospital. A nurse took her blood pressure,
which was so low that there was no reading. "The nurse said they
would have to get the equipment checked," Mrs Maude said.
This time it was decided that Isabel was dehydrated
and doctors decided to put her on a drip. "Five minutes later she
collapsed in my arms. She had multiple organ failure. In fact, she
had toxic shock and the flesh-eating bug, necrotising
fasciitis."
Isabel was transferred to the paediatric intensive
care unit at St Mary's Hospital in Paddington, west London, and had
major surgery to remove the infected flesh.
"It was rocky for a time but Isabel came off the
ventilator. Then, about a week later, we had the call at 4am that
every parent dreads. She had had a cardiac arrest. They could not
find a pulse and we were warned of brain damage."
But Isabel survived. She spent a total of four weeks
in intensive care and another three in a high dependency unit. She
has already had some plastic surgery.
Mrs Maude was formerly a marketing manager and spends
her mornings working for the charity as well as caring for the
family's two other children, Sam, five and Joseph, one.
Mr Maude, formerly a stockbroker, gave up his
position as a research investment manager to set up the charity. He
said: "Many people have asked us why we did not sue.
"Really we felt it was not right. Suing has
essentially a revenge motive and there was no point in putting off
yet another doctor and sending him through years of legal issues
when we already knew this was a systems failure.
The Isabel Medical Charity has raised £400,000
already, including £20,000 from the National Health Service. They
need another £100,000 to complete the diagnostic system for children
and £300,000 more to extend it to adults.
The rapid system uses pattern recognition software to
search for information in paediatric textbooks, once it is given the
symptoms. It even builds in other doctors' experiences of making
mistakes.
Trials in four hospitals in the South-East have
proved that it works in more than 90 per cent of cases. It will now
be tested in a full clinical trial in 25 hospitals.
Dr Joseph Britto, paediatric consultant at St Mary's
who has led the development of the Isabel system, said that doctors
were expected to keep two million pieces of information in their
heads.
"Clinicians rely primarily on their reading and
experience. Isabel is an on-line second opinion. We are confident
that Isabel can now make a major contribution to the reduction of
medical errors in the NHS."
If the couple had sued, and the court found in their
favour, they might have been awarded up to £50,000 for Isabel's
scarring, according to medical law observers.
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