The death of a 15-year-old girl who died just hours after being informed that she had had an ear infection, was due to negligence, ruled a coroner.
Schoolgirl Rosie Umney – a Type 1 diabetic – was taken to see her GP on the evening of July 2, where she was controlled by Dr. Sadaf Mangi.
She was wrongly told that she had just had an ear infection and that she was provided with a prescription for antibiotics, as reported. KentLive.
Less than 10 hours later, a student from Herne Bay High School in Kent died of diabetic ketoacidosis after being transported to QEQM in Margate.
The investigation into Rosie's death was closed this week by the Canterbury Court of First Instance, where the coroner found the negligence.
Dr. Mangi should have or not started his own test to measure Rosie's ketone level, or at least a ketone test in her urine, and whether she should have sent her back to the hospital.
Assistant Coroner James Dillon said, "During the initial hearing, Dr. Mangi spent a lot of time answering questions about this specific issue, particularly two sets of NICE guidelines that would provide a roadmap for actions. which could have been followed. .
"Dr. Mangi was specifically referred to the NICE NICE guideline 18 (type 1 and type 2 diabetes in children and adolescents) and the NICE NICE guideline for sepsis.
"The evidence has persuaded me, on a balance of probabilities, that both sets of directions would have provided Dr. Mangi with a roadmap for immediately referring Rosie to the hospital and would have actually done in ambulance conditions of blue light.
"So I find that the two sets of guidelines suggesting the available observations would have required immediate hospitalization."
"I make a finding of negligence".
He concluded: "Rosie Jean Umney died on July 3, 2018 at the Queen Elizabeth Hospital Queen Mother Hospital in Margate, where she had been admitted by emergency ambulance in the early hours of the morning.
"It was established that she was in a state of advanced diabetic ketoacidosis. Her condition was not recoverable and she died at the hospital.
"There is evidence that she has not complied with the surveillance and treatment regime for her diabetes, particularly that her blood glucose meter could have been used a few days before July 2nd.
"Rosie attended her medical office in the afternoon of July 2.
"The GP did not send her to the hospital, the instructions, including those from NICE, would have sent her to Rosie to the hospital.
"The general practitioner has not made any independent measure of sugar in the blood or ketone in the urine.
"To the extent that, therefore, the general practitioner did not arrange immediate consultation at the hospital nor undertook independent measurement of blood glucose or ketone levels in the urine, I was not able to do so. concluded to negligence. "
"She had all her life in front of her"
A representative made a statement on behalf of the family at the end of the investigation.
She said, "We thank the coroner for conducting a thorough investigation and we are satisfied with the result.
"The coroner acknowledged that Rosie should have been sent directly to the hospital by her GP and not doing so was an act of negligence that contributed to her death.
"We hope the medical profession can learn from today's discoveries so that it never happens again in another family."
After the investigation, Rosie's mother, Georgina Umney, said, "She was kind, caring and beautiful.
"She had all her life in front of her. She wanted to drive, she wanted to go to university.
"She was just perfect."