A six-year-old girl died from meningitis after nearly a two-hour wait to see a doctor who then dismissed her rash as ‘just a bruise’.
Layla-Rose Ermenekli had what was later described as one of the ‘worst cases of meningitis’ doctors had ever seen.
She was rushed to A&E at the Royal Oldham Hospital by her mother Kirsty with a high temperature, headache and stomach ache.
When she finally was seen, a rash – a tell-tale sign of the deadly infection that can kill in hours – was spotted on her hip, but the doctor did not make a written note nor speak to her mother about it.
Layla-Rose was diagnosed with a ‘viral illness’ and Kirsty, from Oldham, Greater Manchester, was told her daughter was fit to go home.
Staff had a u-turn and she was kept in, but within 12 hours, her heart stopped beating and she passed away from meningococcal meningitis and septicaemia.
A damning internal report by the hospital has now revealed there were ‘missed opportunities’ to accurately diagnose her which lead to a fateful three-and-a-half-hour delay in treatment.
An internal investigation by Pennine Acute Hospitals NHS Trust found there were ‘missed opportunities’ to spot Layla-Rose Ermenekli had deadly meningitis and septicaemia
Kirsty brought her daughter to the hospital showing symptoms of the virus – including a tell-tale rash – but within 12 hours she had passed away
Delays to life-saving treatment
Kirsty brought her daughter to the hospital at around 8.30pm on February 3.
After a 25-minute wait to see a triage nurse, the youngster was assessed as needing to see a doctor within 10 minutes. But delays meant it was an hour and 50 minutes before that happened.
After the first doctor was prepared to send her home, a sister nurse in charge felt uncomfortable and she was instead transferred to the paediatrics ward.
After another wait, Layla-Rose was assessed by a junior doctor, who picked up on the rash on her hip, but was told by the previous doctor it was just a bruise and not a new symptom.
But 30 minutes later, another locum doctor noted the rash, inserted a cannula, took bloods and administered antibiotics for sepsis.
The rash on Layla-Rose’s body began to spread rapidly and she then went into cardiac arrest, before she was pronounced dead on the morning of February 4.
The internal report by carried out by the Pennine Acute Hospitals NHS Trust found doctors used an old document when assessing Layla-Rose. It also states the mother’s concerns were not listened to, while there were two missed opportunities to recognise the rash.
The report said: ‘The doctor who saw the patient initially did not recognise the rash, which was not documented at the time as being of a worrying nature, as a result the diagnosis of sepsis was missed for three-and-a-half hours, during which treatment opportunities were missed.
Layla-Rose was described as ‘a much loved, bright, beautiful daughter and sister’
‘A second opportunity to spot any rashes was missed when the rash was noted prior to transfer and escalated, false re-assurance was given that this was not a new finding so no action was taken.’
The report says there was ‘failure to identify the advanced nature of the sepsis and treat accordingly’ as well as ‘failure to recognise a ‘bruise’ as a purpuric rash and therefore as an indicator of meningococcal sepsis’.
She loved to dance
Kirsty, who was pregnant at the time of the incident, has been forced to give up her job as a beautician following the tragedy.
The family have raised more than £10,000 for charity Meningitis Now and are campaigning for all children under the age of 16 to receive inoculation for meningococcal D.
A statement from Kirsty and Layla-Rose’s father Ramazan Ermenekli said: ‘Layla-Rose was a much loved, bright, beautiful daughter and sister. She had many friends and loved to dance.
‘In addition to the fundraising and inoculation campaign the family hopes that the tragic events giving rise to Layla-Rose’s death will bring about patient safety at Royal Oldham.’
Family friend Hannah Morrey has previously described Layla-Rose as having ‘a cheeky, infectious laugh and beautiful smile’.
The six-year-old was a keen dancer with ‘a cheeky, infectious laugh and beautiful smile’
No other child should fall through the net
Solicitor Jacqueline White from Oldham law firm Pearsons Solicitors said: ‘This is a terribly sad case involving the loss of a much loved daughter and sister.
‘I sincerely hope that processes and pathways will now be put in place by the Trust to ensure that no other child falls through the net in the way that Layla-Rose did.
‘This is likely to require a comprehensive programme of training not least to ensure that a culture of team working is put in place so that all members of the clinical team are empowered, supported and confident promptly to escalate clinical concerns of sepsis to experienced senior doctors.’
The hospital is now recommending doctors have additional training to identify rashes, while staff have been sent a patient alert asking to consider sepsis when diagnosing unwell children.
Dr Jawad Husain, medical director at the Royal Oldham Hospital, said: ‘We would like to express our sincere condolences to all of Layla’s family and friends following her sad and tragic death on 4 February this year.
‘We have carried out a thorough investigation into the care and circumstances surrounding Layla’s death and have shared our findings with her parents.
‘We continue to be in contact with the family to provide feedback and support.’