A doctor dismissed a ten-month old baby’s symptoms as a stomach bug just hours before she died of septicaemia caused by meningitis, an inquest heard.
Lily Teale was rushed to a doctor’s surgery after suffering a high fever, bouts of vomiting and diarrhoea on November 22, 2017.
A GP diagnosed her with gastroenteritis – a common stomach infection – and advised her mother Rebakah Watson to continue administering Calpol, the Doncaster inquest heard.
But just hours later, Lily was rushed to hospital after her lips turned blue and she became unresponsive. She tragically died at Doncaster Royal Infirmary that night.
Post-mortem examinations revealed she had meningococcal meningitis W which caused septicaemia, her official cause of death.
Ms Watson has since called for the age at which the MenACWY vaccine – which protects against the type of meningitis Lily had – is given to be lowered to prevent similar deaths.
Lily Teale was rushed to a doctor’s surgery after suffering a high fever, bouts of vomiting and diarrhoea on November 22, 2017
An inquest into her death today heard Lily had suffered from tonsillitis a month before her death but had generally been fit and well.
Ms Watson told Doncaster Civic Chamber that on November 21, after seeming ‘completely fine’ all day, Lily woke up screaming and she recorded a temperature of around 39.4.
Ms Watson said: ‘I first became aware something was wrong in the early hours of the morning, she woke me up screaming.’
Asked by the coroner if this was unusual for Lily, Ms Watson said yes.
She added: ‘She felt boiling hot. She vomited in the spare bedroom after I got her out of the cot.
‘I rang 111 and explained what happened and how high her temperature was. They advised she needed to be seen within 12 hours by a GP.
‘Lily was shaking, her body was vibrating. I had not seen her like that before.
‘It was like she was hot but freezing, like when you’re cold and you’re shaking, but she was red hot. I could see her shaking, her lip was trembling.
‘I was trying to keep her awake and she was falling asleep.’
Ms Watson told the inquest she did not see any lumps, bumps or rashes on Lily’s body at this point and was advised to make a GP appointment the next day.
She told the coroner that she couldn’t get an appointment with her GP so instead rang a same-day health centre in Doncaster and managed to get Lily seen by a doctor there.
A GP diagnosed the her with gastroenteritis – a common stomach infection – and advised her mother Rebakah Watson (pictured with her daughter) to continue administering Calpol
The doctor diagnosed her with gastroenteritis and advised Ms Watson to continue giving Calpol to her daughter.
WHAT IS MENINGITIS?
Meningitis is inflammation of the membranes that surround and protect the brain and spinal cord.
Anyone can be affected but at-risk people include those aged under five, 15-to-24 and above the age of 45.
People exposed to passive smoking or with suppressed immune systems, such as patients undergoing chemotherapy, are also more at risk.
The most common forms of meningitis are bacterial and viral.
Symptoms for both include:
- Pale, blotchy skin with a rash that does not fade when compressed with a glass
- Stiff neck
- Dislike of bright lights
- Fever, and cold hands and feet
- Severe headache
Bacterial meningitis requires urgent treatment at hospital with antibiotics.
Some 10 percent of bacterial cases are fatal.
Of those who survive, one in three suffer complications, including brain damage and hearing loss.
Limb amputation is a potential side effect if septicaemia (blood poisoning) occurs.
Vaccines are available against certain strains of bacteria that cause meningitis, such as tuberculosis.
Meningococcal meningitis is a type of bacterial meningitis caused by specific bacterium Neisseria meningitidis.
Viral is rarely life-threatening but can cause long-lasting effects, such as headaches, fatigue and memory problems.
Thousands of people suffer from viral meningitis every year in the UK.
Treatment focuses on hydration, painkillers and rest.
Although ineffective, antibiotics may be given when patients arrive at hospital just in case they are suffering from the bacterial form of the disease.
Ms Watson added: ‘She was very, very clingy. She was attached to me.
‘As soon as she woke up, she was screaming, I had to have her with me at all times.
‘She was warm but her temperature had come down a bit.
‘I was told by the GPs there were no appointments and I should ring the same-day health centre.
‘I got off the phone and got in the car and pretty much got there straight away.
‘Lily started vomiting while we were in the waiting area. She was hot, but she was spaced out.’
Ms Watson said she explained Lily’s symptoms to the doctor and said the girl ‘wasn’t herself’.
She told the inquest: ‘He took her temperature and listened to her chest. I told him she’d had tonsillitis and asked him to check her throat. I wasn’t in very long.
‘I thought the tonsillitis had come back. I explained her dad had been poorly and that me and her sister had been poorly.
‘I was told she had gastroenteritis and told to give her Calpol but not Ibropofen.’
Ms Watson told coroner Louise Slater she was not given any more advice on what changes to Lily to look out for.
She said later that day, Lily fell asleep on the sofa and her lips turned blue.
It was only then that Ms Watson noticed a rash on Lily’s body under her nappy when she went to change her.
She added: ‘It was just under the top of her nappy. I could see it growing.’
The inquest heard Dr Ben Saward – the GP who assessed Lily – had not recorded a respiratory rate test in his notes of the consultation.
He told the coroner he came to the conclusion that Lily had most likely had gastroenteritis as her temperature and heart rate were ‘in the normal zone’.
He said: ‘My personal opinion was she had gastroenteritis and my advice was to drink fluids and monitor the number of wet nappies Lily produced to keep an eye on her hydration levels.’
Sufiyan Rana, representing the family, asked Dr Saward if he had checked under Lily’s nappy for a rash.
He said there was no reason to check for a rash as there were no obvious symptoms of septicaemia.
But expert witness Dr Alan Middleton – a GP since 1977 – said he would have checked under Lily’s nappy if he were examining her.
He told the inquest: ‘My procedure is to undo the nappy and look.’
Asked by the coroner if there were any exceptions to this, he replied: ‘No, I can’t think of any. It’s a very simple measure.’
He told the inquest he could only recall a handful of instances in which he had seen a young child presented with red flag meningitis symptoms.
He added: ‘From what I have heard today and what has been written, the most likely diagnosis was gastroenteritis.
‘Lily was alert, she’d had diarrhoea and vomiting, these symptoms are very common and GPs will see many children with these symptoms.
‘From what I have seen, gastroenteritis would have been the top of my list for diagnosis. A GP has to go off what they think the most likely illness is.
‘But I would be critical of some things.
‘A more full examination should have been performed and a rash should have been looked for under the baby’s nappy.’
He added Dr Saward’s record-keeping had ‘inadequacies’ and it was not clear from his notes if he had checked for a respiratory rate or just not recorded the results.
The inquest heard Lily was rushed to hospital at 4.10pm on November 22 and suffered six cardiac arrests within the space of a couple of hours.
Despite the best efforts of medics, she was tragically pronounced dead at 10pm on the same day.
But just hours later, Lily was rushed to hospital after her lips turned blue and she became unresponsive. She tragically died at Doncaster Royal Infirmary (pictured) that night
The inquest heard medics described her skin as being ‘extremely mottled’ and she had shown signs of severe sepsis.
Ms Watson is campaigning for a meningitis vaccine, that could have saved Lily, to be given to babies.
The MenACWY vaccine is routinely offered to teenagers in school Years 9 and 10, aged between 13 and 15.
She launched a petition in 2018 urging the government to lower the age of the meningitis vaccination to three months.
According to the charity Meningitis Now, meningococcal meningitis W is historically the rarest strain of the disease.
Families wanting younger children to be protected have to pay for the vaccine privately.
Ms Watson previously said she felt the vaccine could have protected her daughter if it was available to her.
The inquest, expected to last three days, continues.
Ms Watson has launched a fundraising page in Lily’s honour after her death.
To donate, click here.
The inquest, expected to last three days, continues.