Meningitis – the effect of deadly sepsis
The Guardian reported last week the tragic death of 18 year old Ellie Penrose, a Team GB triathlete who died of meningitis in August 2015.
The Inquest into her death heard how she was “inappropriately discharged” following an attendance at A&E at Hull Royal infirmary in August last year. She was examined by a newly qualified junior doctor at 3am on the 12 August who diagnosed gastroenteritis and dehydration and sent her home with painkillers.
Following her discharge, her parents found her seriously ill in bed, complaining of pins and needles in her face, neck and back. An ambulance took her back to A&E where she was seen at 11.30am but was not given antibiotics until 1pm. At about the same time a scan revealed her body was shutting down and she died a short time later from “overwhelming sepsis” caused by meningococcal septicaemia.
The newly qualified doctor was asked at the inquest by the coroner whether he had considered meningitis. He replied “I did. When I examined her there was no rash. There was blotching on her face. I felt it was more viral”. When questioned by the family’s lawyer he admitted that he did not treat it as meningitis because he felt it didn’t fit with the general picture.
The junior doctor admitted that he was not 100% sure of the cause of her illness and as no Consultant was on duty, he consulted with a fellow trainee before discharging her.
Following Ellie’s death a serious incident report was written by Hull and East Yorkshire Hospitals NHS Trust which admitted that there had been a “failure in care”. Dr Mark Simpson who wrote the report said that Ellie would have had the best chance of survival had antibiotics been administered at 3am but he could not determine if she would have lived.
Unfortunately although the presence of a rash can be an indicator of meningitis, it is not always present and when dealing with admissions of acutely unwell patients, it is important that this potential diagnosis remains under consideration even where there is no rash in the patient. This enables treatment to be started as early as possible.
The Meningitis Research Foundation state on their website:
“Septicaemia can occur with or without meningitis. Not everyone gets all the symptoms and they can appear in any order.”
The coroner was unable to reach a verdict in this case as to the cause of death and the matter was adjourned so that further expert opinion could be provided as to whether the delay in diagnosis and treatment led to the infection becoming untreatable or whether the infection whenever treated would inevitably have led to death.
If you or your family have been affected by any issues regarding meningitis, please do not hesitate to contact our specialist clinical negligence team on 0800 316 8892 who will be able to advise you further.