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Doctor 'failed to spot meningitis'

29/ 1/2001

A SALFORD GP only made a "cursory examination" of a five-year-old girl hours before she died from meningitis, a General Medical Council hearing was told.

Margarita Darker, from Worsley, died in hospital in December 1999, 10 hours after Dr Ramachandran Subramanian diagnosed only a fever. He had told her mother that her fears of meningitis were just "parental anxiety".

Dr Subramanian, appeared before the GMC's professional conduct committee in London yesterday, accused of serious professional misconduct. It is alleged he did not carry out an appropriate examination of Margarita, told her mother to drive the youngster to the hospital herself and failed to co-operate in the investigation surrounding the resulting complaint.

The hearing heard how Fanoula Darker took her daughter to a surgery in Pendleton on 28 December 1999, because her usual surgery was closed. The five-year-old had become sick and drowsy while staying at an aunt's house. Mrs Darker became increasingly anxious in the surgery waiting room when she spotted a purple rash on the girl's neck.

The hearing was told that Dr Subramanian made only a cursory examination of the youngster, taking her temperature, examining her ears and eyes and listening to her breathing, but did not examine the rash or make further examinations.

The GMC heard, according to Mrs Darker, that the doctor agreed that Margarita should be taken to hospital immediately and sent a referral note suggesting viral fever, but he refused the mother's request for an ambulance and told Mrs Darker to take her daughter to the hospital in her own car.

Mrs Darker said she had no choice but to drive her daughter, who she calls Margaret, to the hospital and got lost on the way taking 25 minutes to go seven miles. The youngster was admitted to a high dependency unit within an hour of reaching the Royal Manchester Children's Hospital. A diagnosis of meningococcal septicaemia was made but Margarita died during the early hours of the following day.

During the subsequent investigation, Dr Subramanian is accused of not responding sufficiently to requests from Salford Health Authority for a written report into his actions.

Dr Subramanian denies not putting himself in an adequate position to assess the youngster's condition and treatment needs. He also denies not making an adequate examination or being told about the rash and drowsiness. The doctor admits not providing the reports as soon as they were requested but denies failing to co-operate with the investigation.

If found guilty by the committee he could be struck off the medical register.

The hearing continues