Lawyers Urge Improvements To Diagnostic Procedures After Boy Sent Home Three Times By Doctors Before Death

Medical law experts have called for improvements to NHS staff training and systems after a one-year-old boy died of pneumonia caused by a bacterial infection missed three times by doctors who instead sent him home without identifying the seriousness of his condition.

Lewis Mullins died just over a year ago, nine days after his first birthday, after suffering streptococcal pneumonia which he developed after having chickenpox. He was sent home from an NHS walk-in centre once and Rotherham Hospital twice in the three days prior to his death as doctors failed to spot his condition.

Medical law experts at Irwin Mitchell representing the family have today joined Lewis’ parents in calling for the walk-in centre and hospital to ensure they put procedures and training in place to prevent a similar tragedy in the future.

Lewis was initially treated for severe chickenpox at an NHS walk in centre on 30th March 2011 where he had presented with chickenpox spots and a high temperature.  A doctor sent him home with a prescription for acyclovir, an antiviral drug, but he was rushed by ambulance to A&E at Rotherham Hospital the following day (31st March) after developing a new rash, difficulty breathing, as well as a persistent very high fever.

He was discharged as doctors thought he was suffering from an allergic reaction to the acyclovir, but he had to visit hospital again on 1 April as his condition deteriorated further, with fever, spreading rash and difficulty breathing. He was seen by doctors but again discharged, on this occasion without even being seen by a paediatric specialist.  Lewis’ condition deteriorated further still the next morning.  He stopped breathing in his father’s arms and was rushed back to hospital by ambulance.  Unfortunately the doctors were not able to revive him and he died.  Basic blood tests or a chest x-ray in order to rule out bacterial infection were never considered by the doctors who saw Lewis. 

At an inquest at Rotherham Magistrate’s Court Coroner Nicola Mundy today delivered a narrative verdict saying that “had appropriate treatment been instigated on any of these three occasions it is likely Lewis would have survived”. She said she would write a Rule 43 letter with recommendations regarding the use of documentation at the walk in centre.

The inquest discovered procedural problems had impacted upon Lewis’ care.   Potentially serious symptoms recorded on a questionnaire completed by Lewis’ mother at the walk-in centre were not passed on to the GP who saw Lewis there.  He advised the Court, had he had the additional information he would have considered referring Lewis to hospital.  In addition, Lewis’ A&E notes from his first attendance at hospital were not made available to the paediatric staff who saw Lewis on his second visit to hospital.  Had the doctors that day been aware of the information in those notes it was likely Lewis would have been admitted. 

Expert evidence was heard from a consultant paediatrician who advised that Lewis’s fevers, rash and steady deterioration were highly unusual for uncomplicated chickenpox, and steps could and ought to have been taken to identify and treat his serious lung infection. Further, had Lewis been given appropriate antibiotics on any of the three occasions he presented to healthcare professionals, he would more than likely have survived. 

His parents, Jodie Conlay, 28, and Andrew Mullins, 32, who lived in Maltby, Rotherham at the time of Lewis’ death, are finding it hard to come to terms with losing their young son. 

Lewis’ mother Jodie said: “I still can’t believe that Lewis is no longer with us. He was such a content baby, a real happy chappie. We have pictures from his first birthday just days before he became ill. His big sister keeps telling me she misses her little brother.  It has hit both myself and Andrew very hard.

“Hearing that the treatment given to Lewis could have been different and could have saved his life was completely soul destroying. I just hope now that changes can be made, and more notice taken of parents’ concerns, to try and prevent others from having to go through the heartache that we have.”

Heather Kolar, a medical law specialist at Irwin Mitchell, said: “There were a number of occasions during Lewis’ treatment that medical staff could and should have done more to identify and treat his condition. He was just one year old and clearly very ill. Lewis needed the utmost care when he was at his most vulnerable but tragically, on this occasion the standard of care was not good enough.

“The medical evidence suggests that had Lewis been given appropriate antibiotics the outcome would have been different. Medical staff should have recognised that his illness was more serious and carried out simple blood tests and an x-ray to find out what else was wrong.

“No-one can possibly imagine what Jodie and Andrew have been through, losing their son just days after his first birthday. Nothing can ever bring Lewis back and they will never get over that. But the one thing they are determined to do is to get assurances from the hospital that they have improved their training to ensure that no other parent ever has to go through what they have.”

Although a vaccine to protect against chickenpox is available and is part of routine childhood immunisations in some countries, it is not routinely available here in the UK.  Lewis’ parents want to set up a campaign to get all children in the UK vaccinated against the virus.

Jodie said: “Being vaccinated against chickenpox is part of routine childhood immunisations in certain countries like the USA and Canada.  Here in the UK the vaccine is available, but is not routinely offered by the NHS.

“I want the Government to consider introducing the vaccine to all children in the UK.

“I also think parents need to be given more information as to the serious complications that can arise from chickenpox.  I expected Lewis to recover from chickenpox just as his big sister had.  But he started to get worse, not better.  I knew something was wrong, but the doctors kept reassuring me.”

Heather Kolar from Irwin Mitchell said: “We are supporting the family’s campaign and feel that parents need information about the dangers of childhood diseases, so they know when to seek medical assistance.  Jodie and Andrew sought assistance, but regrettably the doctors did not realise the seriousness of Lewis’ condition.  We also feel there should be a further investigation into the effectiveness of a chickenpox vaccine and whether it is suitable for use in the UK.”