September 20, 2019

How meningitis can be missed by GPs – a case example

One very sad case occurred in recent years (2014). A woman was seen by her GP after she had felt extremely unwell over the previous week, and reported a sensation of pressure in her head, as well as a rash over her hands, arms and midriff. Because of this, she asked her GP whether she might have meningitis. Astonishingly, her GP diagnosed a respiratory infection, and told her to rest up, failing to do any further investigations.

Several hours afterwards, this very unfortunate woman was found at her home in a coma. She was taken to hospital, where bacterial meningitis was diagnosed. Unfortunately, by this time a great deal of damage had been done, and she suffered total blindness and a significant degree of hearing loss. The woman brought a case against her GP, alleging that they had negligently failed to consider the possibility that she was suffering from meningitis, even though this had been mentioned to her.

The case was fiercely contested by the woman's solicitors and the defendants so eventually went to trial. Experts from a number of disciplines, including neurology and general practice, were called to give evidence. It was common ground amongst the experts that, if meningitis should reasonably have been suspected (or, importantly, could not reasonably have been ruled out), then the GP had a duty to administer penicillin immediately, and arrange for her patient to be taken to hospital. A failure to do either of these things would be a breach of duty of care.

There was a considerable dispute about what symptoms had been apparent, and in particular the type of rash. However, the fact that the patient herself had raised the possibility of meningitis as a diagnosis was thought to be significant.

With one exception, the experts agreed that prompt administration of antibiotics would have made a difference to outcome, and the medical literature that the experts quoted from strongly supported this view. It was agreed that the GP had misinterpreted the rash with which her patient had presented. The court therefore found that both blindness and hearing loss would have been avoided with prompt treatment.

This case offers a stark reminder of the potential consequences of leaving meningitis untreated even for a period of hours. If someone with such an alarming set of symptoms were to attend their GP practice, they are entitled to expect rapid treatment (especially if they are a young adult or child). Sadly, this prompt care was not forthcoming in this case, with devastating consequences.

Because meningitis cases typically arise after suffering devastating injuries as a result of the infection, they tend to be very hard-fought, with many settling at or shortly before trial (this is relatively unusual in clinical negligence cases that do not relate to birth injury). This may reflect the complexity of the issues, and also the fact that many such cases involve GPs. GPs will usually be insured privately, and may be less inclined to admit fault for a variety of reasons.

If you have been affected by this issue and are seeking legal help, it would be my strong advice that you instruct a firm of solicitors with experience in this field and a dedicated clinical negligence department.

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