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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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