A five-year-old girl who said her tummy ‘felt like it was on fire’ was misdiagnosed as having a stomach bug but died from appendicitis – minutes after telling her father she loved him, an inquest heard.
Elspeth Moore had told doctors from Southampton Children’s Hospital of a burning pain in her stomach but this was written off as a common infection.
Her parents took her home without being given advice on how to monitor her symptoms and she tragically died in her bed several days later as her worried father lay next to her.
In a heartbreaking account of the night his daughter died last July, Elspeth’s devastated father recalled how, ten minutes after she said ‘I love you daddy’, he watched her eyes roll up and her head flop back.
Elspeth Moore, five, was diagnosed with a common tummy bug but was instead suffering with appendicitis which developed into fatal strands of peritonitis and sepsis
Steven Moore said: ‘I stayed up, went into Elspeth’s room every half hour to check on her. At about 11pm I went in and she was still awake.
‘I said “I’m going to stay in here with you”, and lay down on the floor next to her. I said “love you” and she said “love you daddy”.
‘It can only have been five or ten minutes later, I heard her making a weird noise, like something was catching in her throat.
‘I said “what’s that noise all about Elspeth, that doesn’t sound right.” She didn’t respond.
‘I said “do you want to sit up darling.” I sat her up, at which point her head just flopped back and her eyes rolled up.’
The inquest was told that despite being diagnosed as having viral gastroenteritis, Elspeth was actually suffering from appendicitis which developed into peritonitis and sepsis.
Although the coroner found that the misdiagnosis was reasonable in the circumstances, he did say the hospital should have advised her parents better when they allowed them to take her home.
The inquest heard Elspeth had been sent home from school on July 2 last year, following a bout of diarrhoea, and her parents rushed her to hospital after her GP said she was dehydrated and should be put on an IV drip.
Minutes before her heartbroken father watched her eyes roll back, Elspeth told him ‘love you daddy’
Doctors at Southampton Children’s Hospital, Hants, did not put her on a drip, but instead took her observations, finding she had a fever of 38.3C and an increased heart rate.
They set up a ‘fluid challenge’ whereby her parents gave her 5ml of water every five minutes for two hours to see if she could ‘keep it down’.
Because Elspeth’s parents asked to leave the hospital and continue the fluid challenge at home, a second set of observations were not done.
Elspeth’s parents, who said they were not aware of a need for second observations that would rule out sepsis and appendicitis, asked to take the little girl home to continue the fluid challenge as it was past her bed time.
The inquest heard they were allowed to leave without a discharge letter, and were only given verbal advice by the doctor, with nothing in writing to tell them what symptoms to look out for and when to come back to the hospital.
Doctors at Southampton Children’s Hospital (pictured) did not put her on a drip, but instead took her observations, finding she had a fever of 38.3C and an increased heart rate
Tragically, the little girl died in her bed just days later, as her high fever and diarrhoea gave way to vomiting on July 5, last year.
Speaking at Winchester Coroner’s Court, Hants, Steven Moore, a systems analyst from Lymington, Hants, described their time in the hospital.
He said: ‘We understood Elspeth had viral Gastroenteritis and there weren’t any antibiotics to be given as it was a virus and it would be something we would have to see out.’
WHAT IS APPENDICITIS?
Appendicitis is a swelling of the appendix, a two to four-inch-long organ connected to the large intestine.
Appendicitis can cause severe pain and it’s important for it to be treated swiftly in case the appendix bursts, which can cause life-threatening illness.
In most cases surgeons will remove the appendix in an appendectomy – scientists aren’t sure why people need an appendix but removing it does not harm people.
The causes of appendicitis aren’t clear but it is thought to be caused by something blocking the entrance to the organ.
Symptoms include pain in the stomach which later travels to your lower right-hand-side and becomes severe.
Pressing on this area, coughing, or walking can all make the pain worse, and other symptoms can be nausea, vomiting, loss of appetite, diarrhoea and a fever.
Mr Moore said that after asking if it would be alright to continue giving her fluid at home, he was told staff were ‘happy’ for her to be discharged.
‘Given that when we arrived we were freaking out, and then to be told actually your daughter’s got viral gastroenteritis that will work its way out, I actually felt quite relieved.
‘We weren’t given specific advice on when to come back or things to look out for.’
Back at home, Elspeth seemed a little better the next day, eating more food than she had done previously, but by July 5, she was worse again, and was vomiting.
Mr and Mrs Moore called an ambulance, but their daughter was pronounced dead just after her arrival at A&E in Southampton General Hospital at 12.05am on July 6.
Giving evidence, consultant Dr Faye Hawkins said there was no reason that Elspeth’s parents couldn’t continue with the fluid challenge at home.
Nicola Trevelyan, an A&E doctor, who was on call the night of Elspeth’s death, and head of nursing Louisa Green said lessons had been learned from the death.
They said changes were made to ensure paperwork and leaflets be made available to parents taking their children out of hospital, with a new text-messaging system in place to link parents to online advice.
Recording a death by natural causes, Central Hampshire coroner Grahame Short said that gastro enteritis was not an ‘unreasonable diagnosis’ as Elspeth had an unusually positioned appendix.
However, he said doctors could have advised the parents better.
‘I find however there was insufficient advice given on how to look after Elspeth at home and most importantly what to look out for.
‘Although Dr Hawkins gave general advice it was not clear to them.’