Bleak life after misdiagnosis
WILLIAM BURTON’S parents trusted the young doctors who claimed their son’s sickness was not serious.
But within five days, the three-monthold Wellington baby was in intensive care, gripped by seizures that would nearly kill him. The disease, eventually diagnosed as bacterial meningitis, would leave him blind, deaf and severely braindamaged.
William is now 2, and requires constant care. He can swallow his food, make some noise and feel his parents’ touch, but not much else.
His future appears bleak, with doctors believing he will die of a respiratory illness before reaching adulthood.
In a decision to be made public today, the Health and Disability Commissioner has criticised Capital & Coast District Health Board for failures in William’s treatment in October 2013.
Among a litany of mistakes, a lack of senior oversight was the biggest, with junior doctors unfairly left to make big calls about William’s condition.
In a statement, DHB chief medical officer Geoff Robinson said the findings were fully accepted and the DHB ‘‘unreservedly apologises for the grief and distress suffered by the patient and their family as a result of this regrettable event’’.
William’s parents, Derek and Wendy Burton, want the tragedy to serve as a wake-up call for other parents, and doctors, to be on the alert for the deadly disease, which can kill within hours.
‘‘You just can’t necessarily rely on a doctor to pick them up. Even if your symptoms are reading like a checklist, somehow it can still slip through,’’ his father said.
On October 16, 2013, William’s parents took their sick son to the Karori Medical Centre. Their GP was concerned enough to refer them to Wellington Hospital’s emergency department.
There, a trainee junior doctor told them William probably had an unknown viral infection, sent them home and told them to come back if his condition did not improve. ‘‘While she was examining Will, she mentioned meningitis, thinking aloud to herself, and then dismissed it. She came really close to taking William in for overnight observation, but didn’t unfortunately.’’
The next day, they returned to the hospital and were met by another trainee junior doctor. This time, they were told William had a stomach bug and his fever could last days.
But William’s condition deteriorated. He could not sleep, was vomiting and running a high fever. When his mother took him back to hospital for the third time, five days after their first visit, emergency department doctors quickly diagnosed meningitis.
‘‘I was just angry and shattered, as soon as I heard meningitis,’’ his mother said. ‘‘And it wasn’t just meningitis, but it had been five days of it.’’
His father remembers walking in to see his tiny son full of tubes, surrounded by a huddle of worried hospital staff.
‘‘He was going into seizures and hooked up to different monitoring machine, things were beeping, I don’t know what they were but I knew things were beeping that shouldn’t be beeping.’’
The family was flown to Starship children’s hospital in Auckland early the next morning, where William had holes drilled in his head to release the pressure and fluid building around his damaged brain. The family stayed in Auckland for a month, waiting with dread as each scan showed William’s brain deteriorating further.
The last scan back at Wellington Hospital about six weeks later was the final blow. Most of William’s cerebral cortex was gone, killing the cells that allowed him to move his limbs, to see and to hear. ‘‘We couldn’t really have had much worse news. There was this anger at the hospital for the mistakes they had made, and an overwhelming sadness for our son.’’
Robinson said significant changes had been made at Wellington Hospital after the failures in William’s care. These included greater senior oversight of junior doctors, and training on bestpractice treatment for feverish children. Any child who turns up at hospital again within three days is automatically seen by a senior doctor.
‘‘Safety is our No 1 priority and we have taken several actions following this event to reduce the risk of it occurring again.’’
Meanwhile, William’s parents continue to struggle with the knowledge that his life has been irrevocably changed, and shortened.
In July, he spent three weeks in hospital on life support after another infection, the fifth such visit in the past 18 months. Next time, the doctors have said there will be no life support, as it would only prolong his suffering.
‘‘We not happy with it,’’ his mother said. ‘‘Big mistakes were made at the hospital, and now the hospital is saying, ‘We are not going to do all that we can’.’’
But they have learnt to take medical judgments about William with a grain of salt. Doctors said he would probably need to eat through a tube in his stomach, but that is not the case. He sometimes appears to react to sounds or follow faces with his eyes, despite tests confirming him as completely deaf and blind. Day by day, they work to improve his strength and expand his little world as much as they can. ‘‘He has this strong presence and we still enjoy spending our time with our boy.’’
‘There was this anger at the hospital for the mistakes they had made, and an overwhelming sadness for our son.’
Derek Burton