Risk manager denies withholding critical report

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By Ruth O’Reilly

THE woman tasked with gathering statements from hospital staff about the death of a child from fluid overload in their care today denied having any involvement in a decision to withhold an expert report, which blamed the hospital, from the coroner examining the case.

Therese Brown, the head of risk management at the Western Trust said she believed the report would have been handed over to the coroner who conducted an inquest into the death of nine year-old Raychel Ferguson in Altnagelvin Hospital in June 2001.

A public inquiry which is examining the death of Raychel and other children from maladministration of fluid in hospitals in Northern Ireland, is currently focusing on the corporate handling of Raychel’s death including the various legal processes surrounding it.

In the course of Mrs Brown’s evidence, the hearing looked at the sequence of events which led the trust’s legal advisers in the HSCB’s Directorate of Legal Services (DLS) to adopt a position in written correspondence with both the Coroner and Raychel’s family, when they sued, of denying that Raychel had appeared particularly ill on the ward before she collapsed, never to recover.

Ahead of Raychel’s inquest in 2003, a report commissioned by the Coroner from a paediatric anaesthetist based in London had concluded that post-operative vomiting by Raychel in the hours leading up to her collapse had been “severe and prolonged” – a critical point, as such a high level of sickness would have made her more susceptible to the devastating effects of excess fluid she was receiving from a drip at the same time.

The trust had sought the views of a senior Northern Ireland Paediatrician, Dr John Jenkins, on the subject and also a Dublin-based paediatric anaesthetist, Dr Declan Warde.

Dr Jenkins initially reported back that he needed more information while Dr Warde’s report strongly suggested that the hospital was at fault, referring to “severe and protracted” vomiting. The inquiry heard that Dr Warde’s report was subsequently shown to Dr Jenkins who reported back to the trust and its legal representatives on it.

Dr Jenkins then produced a third report – the only one of the three he had written which was give the coroner – which concluded that he believed doctors and nurses had acted according to established custom and practice at the time.

A hand-written note among the DLS documents, however, shows that a phone call had been made to Dr Warde’s home and his wife asked to tell him he would not be needed to give evidence at Raychel’s inquest. Dr Warde’s report was also not given to the coroner – a move the DLS has pointed out is within its rights under rules governing privilege and inquests.

Meanwhile a document surfaced at the inquiry which showed that another child received the wrong fluid in the same ward as Raychel on June 4 2001, three days before Raychel was admitted there with suspected appendicitis. There was no further discussion on the incident at the hearing, which continues tomorrow.

© The Detail 2013