Apology after misdiagnosis led to child's death at Fife hospital

NHS Fife says it has accepted the findings of the Scottish Public Service Ombudsman (SPSO) after the child's bereaved parent complained about the standard of care.

The youngster, named in public reports as 'A', had been taken to Kirkcaldy's Victoria Hospital feeling unwell.

A nurse practitioner diagnosed the child with gastroenteritis, or inflammation of the stomach, and sent them home.

Days later, the child suffered a seizure and was admitted to another hospital where it was discovered they had pneumococcal meningitis - a life-threatening condition that inflames the membranes surrounding the spinal cord and brain. They later died in hospital.

The child's parent, anonymised in documents as 'C', complained to NHS Fife, arguing that their child should have been seen by a doctor before being discharged from the hospital, and that the original diagnosis had been unreasonable.

NHS Fife carried out a significant adverse event review (SAER) that found faults in how the case had been handled.

However, the parent then referred the case to the SPSO, dissatisfied with its findings.

After taking independent advice, the Ombudsman concluded in November that the original diagnosis had been "unreasonable".

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"We found some additional failings in record-keeping, and highlighted that we would have expected the misdiagnosis to have been identified when the nurse practitioner discussed A’s case with a doctor before discharge.

"We also considered there had been failings in the handling of C’s subsequent complaints," it said in a written report on the case.

NHS Fife has been told to apologise for its failure to provide reasonable treatment and diagnosis, failing to keep reasonable records and failing to communicate reasonable with A's parents.

The Ombudsman has also issued the health board with recommendations on how to improve its practice and complaint handling in the future.

Helen Buchanan, NHS Fife's director of nursing, said: “Our aim is always to provide the best possible care for all of those who need our services.

"However, we accept that was not the case in this instance and we want to offer our most sincere apologies to the family involved.

“We accept the findings of the Ombudsman and we are in the process of implementing their recommendations in full.”

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