Doctors failed to diagnose four-year-old girl with ruptured appendix

20170315110000, Jenny Maganran Goh
Five-year-old Karis Cochrane suffered from a ruptured appendix which doctors failed to identify in her earlier visits. Photo credit: Daily Record/Mirrorpix
The stomach cramps of a four-year-old girl were dismissed by doctors as constipation until an ultrasound showed a burst appendix that left her with less than an hour for the life-saving operation.

When Karis Cochrane had complained of stomach pains, her mother gave her paracetamol, thinking that it could be the junk food she had eaten at a party. However, the pains did not subside.

Karis’ mother Demi Bane said, “But the next day she had really bad stomach cramps, sickness and diarrhoea and she had a fever.

“It got worse throughout the day and she was crying really hard.”

Doctors advised to continue with laxatives and painkillers

Her father, William Cochrane phoned NHS 24 and was told to take her to Gartnavel Hospital where they were directed to the A&E at Glasgow’s Royal Hospital for Children, as the nurse at Gartnavel Hospital had said that Karis would need a scan.

“They felt her tummy and took her temperature and then came back and told her dad that Karis was constipated. They sent her away with laxatives,” said Demi.

The following day, her condition did not improve so Demi rang up the out-of-hours service again but was advised to give the medication more time to work.

Seeing that Karis was not getting better, Demi tried to fix an appointment with her own doctor, but none was available until later in the day, when she was advised to take Karis back to hospital.

Demi said, “We did that. They took her temperature but they didn’t examine her tummy and said she was dehydrated. But I knew she wasn’t. They said to continue with the laxatives and painkillers.”

Surgeon said they needed to operate within 45 minutes

Two days later, Karis’s condition progressed and Demi took her to the GP, who advised a scan and blood tests at the hospital. By then, Karis was in excruciating pain and this time, Demi was determined not to take Karis home till they did other tests.

The distraught mother said, “They were really rude to my wee girl. They were asking her where her tummy was sore and a nurse said she had told them somewhere different the last time.”

Karis was admitted but it was only on the next day that the staff took a blood test, and when they found an infection, carried out an ultrasound.

“The surgeon came in and said he was not happy and that they needed to operate within 45 minutes. He was not sure what it was but whatever was in her tummy had spread throughout her tummy,” said Karis’ mother.

During the operation, the surgeon discovered that her appendix had ruptured and caused a massive abscess behind her pelvis and uterus.

Evidently, the doctors’ oversight had Karis landing at death’s doors, and Demi said, “They neglected my daughter by sending her away. I had to beg them and push for answers. It was disgusting.”

Doctors are still working on her infection and she is on her fourth course of antibiotics.

Difficult to diagnose appendicitis in children at first attendance

“Appendicitis in young children can be difficult to diagnose,” said NHS Greater Glasgow and Clyde. 

The health board explained that for some children, it might not be possible to diagnose on their first consultation, and this involves a number of presentations for assessment, depending on how symptoms and signs develop.

“For children with abdominal pain who are not admitted, the advice always given is to return to the emergency department if things are not improving, or getting worse.”

The board added that they would be happy to meet the family and discuss their concerns.

Apparently, this was not the first time a late diagnosis of a burst appendix has occurred in Glasgow’s Royal Hospital. In June 2015, five-year-old Zach Perkins was reportedly suffered from peritonitis after his appendix burst, spreading the infection in his abdomen. MIMS

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Sources:
http://www.dailyrecord.co.uk/news/scottish-news/child-burst-appendix-just-45-9978788
https://www.thesun.co.uk/news/3031735/four-year-old-girl-in-agonising-pain-was-turned-away-from-hospital-twice-with-burst-appendix/
http://www.mirror.co.uk/news/uk-news/girl-4-suffered-burst-appendix-9979615
http://www.dailyrecord.co.uk/news/scottish-news/second-family-hit-out-after-10005074