Girl dies of sepsis after doctor uses ‘judgment’ instead of doing tests
A TWO-year-old girl died of sepsis after a doctor used her ‘own judgment’ to assess the toddler instead of screening tests, an inquest heard.
Marcie Tadman was taken to hospital by her father James with a temperature and ‘rattly’ breathing.
A nurse reassured the family she had a simple chest infection which could easily be treated with antibiotics.
But Mr Tadman claimed staff at the hospital ‘did not seem very urgent’ and antibiotics were not given straight away.
Marcie collapsed and died 24 hours later after looking her father in the eye and saying ‘OK, daddy’.
A doctor who examined the toddler shortly after she was admitted to Bath’s Royal United Hospital told the inquest she did not screen her for sepsis.
Dr Claire Verey said she instead used her ‘judgment’ to assess the child. She told a coroner: ‘My diagnosis was based purely on the Marcie I saw in front of me.
‘I reconciled all the observations I had in front of me with bacterial pneumonia. This is my only explanation for not doing all the sepsis tests. I cannot fully explain why sepsis didn’t pop up in my head. I genuinely felt that all the signs pointed to pneumonia. Rather than using the screening tool I used my own judgment looking at Marcie. I apologise wholeheartedly for what happened to Marcie.’
Dr Verey told the inquest that, had the girl been screened for sepsis, she would have been given intravenous antibiotics sooner, as guidelines dictate.
She added: ‘It can be very difficult to decide whether or not someone has sepsis. Sepsis is still quite rare in children.’
The Daily Mail’s End the Sepsis Scandal campaign has battled to prevent needless deaths from the condition, which is notoriously difficult to diagnose.
The inquest heard Mr Tadman, 40, from Bath, had initially raised concerns about his daughter with an out-of-hours GP on Saturday, December 2, 2017.
He said Marcie had a temperature of 39C and a ‘rattly’ cough. He was told she had a viral infection and was advised to give her paracetamol and ibuprofen.
But her condition worsened over the weekend and he took her to A&E in the early hours of Monday. Marcie was taken to the children’s ward and eventually given antibiotics.
That evening, a worried Mr Tadman questioned whether his daughter was getting sicker but was reassured the antibiotics would help. He said he fell asleep in the room with Marcie but woke at 2am the next day to find she had been vomiting.
He added: ‘ Marcie was still talking to me and was generally responsive but she looked worse and very unwell.’ A consultant then arrived and ordered a transfer to intensive care. Mr Tadman said: ‘I explained to Marcie that everything was OK and they were going to go to another room. She looked at me and said “OK, daddy”. ‘When the nurse finished giving the fluids Marcie looked at me, took one big breath and she looked straight into my eyes. ‘I had hold of her hand and was stroking it, telling her she was going to be OK. She just seemed to turn off when she exhaled and went limp. I really didn’t know what was going on.
‘I looked at the nurse and she had a look of horror on her face and shouted “crash”. I couldn’t believe this was happening. They were attempting resuscitation and that hour and a half was definitely the worst of my life.’
A doctor then came to see him to tell him they were going to stop resuscitation. At 5.59am Marcie was pronounced dead. A post-mortem found she died of ‘streptococcal infections including sepsis and pneumonia’.
Mr Tadman said: ‘I just couldn’t get my head around how we had got to this point when they had been telling me all day she was going to be fine.’
The inquest at Avon Coroner’s Court in Bristol continues.