Parents' fury as teenage daughter dies just days after doctors sent her home and 'told her to take paracetamol'
By Mail Online Reporter
21st July 2010
A schoolgirl suffered multiple organ failure and four heart attacks just days after doctors sent her home with paracetamol and told her to take 'plenty of rest', an inquest heard.
Amy Carter, 15, begged doctors not to discharge her, telling them 'I'm dying' but medics assured her she would be fine.
She developed septicaemia after being released by doctors who had diagnosed her with glandular fever.
Two days later on Christmas Eve, Amy - who had not been able to eat for 19 days and weighed just six stone - was taken to hospital and died hours later.
She developed septicaemia after being released by doctors who had diagnosed her with glandular fever, an inquest heard.
A post-mortem examination revealed Amy, from Stourport-on-Severn, Worcestershire, died from glandular fever and streptococcal toxic shock syndrome - a lethal combination of conditions never before seen in a patient.
But despite the hospital's evidence that Amy was treated in the correct manner being accepted, her parents Richard, 43, and Jacqueline, 48, are still demanding answers.
Mrs Carter told the inquest: 'I can't express myself properly to emphasise how poorly she was. She wasn't well enough to go home.
'I had to reassure her she was going to be alright. She even asked if she was going to die because she was that frightened.
'If they [the doctors] had stood there and watched her properly they would have told she was poorly but no one spent any time with her.
'Is a child who has not eaten for weeks well enough to go home?'
Amy was discharged by the Worcestershire Royal Hospital before results of blood tests and a throat swab were known - the swab later revealed bacteria that entered her bloodstream and triggered septicaemia.
Despite the inquest hearing the infection was not associated with the condition, her parents believe the treatment of their daughter was 'inadequate'.
Speaking after an inquest, Mr Carter said: 'We weren't allowed to ask the questions we wanted to ask. We don't feel they did everything they could to give Amy the best chance of surviving.'
He added: 'The doctors said she was going to be really poorly but was going to be ok. I thought we were being a pain by phoning up the doctors.
'On the 24th I got up to go to work, gave her a kiss, said goodbye then never saw her alive again. My daughter died and I think her care was inadequate and more could have been done.'
Amy fell ill at the beginning of last December suffering flu-like symptoms.
Her parents, who both run pet shops, took her to an out-of-hours medical unit at Worcestershire Royal Hospital.
An on-call doctor diagnosed sinusitis and prescribed a one-week course of antibiotics and sent Amy home.
Days later her face swelled up so much that she couldn't open her left eye and Amy was taken to her local GP who gave her antihistamines.
But over the next few days her health deteriorated.
On December 19 she was taken to hospital after collapsing at home and doctors diagnosed glandular fever, which was backed up by blood tests.
Three days later on December 22 she was discharged from hospital and told to take paracetamol and take plenty of rest.
But on Christmas Eve she was rushed to Worcestershire Royal Hospital.
Doctors desperately tried to revive her using adrenaline injections after she suffered four cardiac arrests but she died at 3.14pm.
Dr Mary Hanlon, the consultant paediatrician responsible for patients on the ward when Amy - who also had pneumonia - was discharged, said the bacteria entered the bloodstream and caused septicaemia but it was not 'medical practice' to treat it when it was first detected.
She said: "We wouldn't have waited for the results of the swab before sending her home. We had a diagnosis of glandular fever.
'Every person who gets glandular fever from now on, should they get a throat swab and then treat it in case they get septicaemia? That is not current medical practice.'
Margaret Barnard, deputy coroner for Worcestershire, asked: 'Do you think this should change?' 'No, I don't,' Dr Hanlon replied. 'We do not give people with glandular fever anti-biotics to stop them getting septicaemia.
'It's just very unfortunate that Amy got this other infection on top of having glandular fever. Once the septicaemia gets into your bloodstream it is rampant.'
Dr Andrew Short, clinical director for paediatrics at Worcestershire Royal Hospital, carried out an investigation into Amy's death to see if any lessons could have been learned.
He admitted nurses failed to correctly mark up the overall scores on her early warning chart but retrospectively said the correct information would still have resulted in her being discharged.
Dr Short added the medical cause of Amy's death was streptococcus toxic shock syndrome - a condition which has never previously been linked to glandular fever - after results from a swab revealed streptococcus was present in her throat.
He added this is present in the throats of 30 per cent of the population and it is not medical practice to treat it when someone is diagnosed with glandular fever.
'Of all the cases of children with streptococcus toxic shock syndrome over the past two years not one was associated with glandular fever,' said Dr Short. 'This case was unique.
'This tragic outcome could not have been foreseen.'
Deputy coroner for Worcestershire Margaret Barnard recorded a verdict of natural causes and accepted the evidence from doctors who decided not to treat the bacteria with anti-biotics as it had potential side-effects.
She said: 'Miss Carter suffered an infection in her throat which spread to her windpipe and into her blood.
'There is no medical record or literature of anyone suffering glandular fever and streptococcal toxic shock and that made Miss Carter unique.'
After the inquest Amy's parents - who have another daughter Sam, 17, and son, Ben, 24 - said they were considering taking legal action against Worcestershire Acute Hospitals NHS Trust.
Mr Carter said: 'We don't feel they did everything they could to give Amy the best chance of surviving.'
The Trust's chief executive John Rostill, however, insisted the care Amy received was appropriate.
He said: 'Following Amy's death a full investigation was carried out by the Trust which found that at all stages of her hospital stay, Amy received appropriate care.'
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