The High Court has dismissed a woman’s claim of negligence against a GP for allegedly failing to identify acute appendicitis which she claimed caused a three-day delay in diagnosis, resulting in a perforated appendix.
Judge Leonie Reynolds found that Dr Rachel Finnegan, a doctor qualified for 20 years, and with out-of-hours services experience, made a reasonable diagnosis of gastroenteritis on then 11-year-old Maria Afolabi on December 13th, 2017.
Afolabi, now an adult and a full-time student, sued Finnegan and SouthDoc out-of-hours co-op service where the GP worked.
She alleged that Finnegan was negligent in failing to identify that she met several diagnostic criteria for acute appendicitis and in failing to refer her to hospital that evening.
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It was common case between the parties that she suffered serious medical complications due to the perforation of her appendix, including a prolonged hospital stay and surgical intervention complicated by severe wound infection.
She also had a long midline surgical incision, resulting in permanent disfiguring scarring and the risk of further adverse consequences as outlined in medical reports presented to court.
There was a full defence and it was asserted that Finnegan’s diagnosis of gastroenteritis was reasonable in the clinical circumstances, and that she managed the patient appropriately in providing general and “red flag” advice together with a hospital referral letter.
It was claimed that, to the extent that Maria Afolabi’s condition deteriorated, that her mother, Gladys Afolabi, failed to follow the advice provided by Finnegan and/or to use the referral letter as advised.
The court heard the child had been feeling unwell since the previous day.
When there was no improvement in her condition, her mother made an appointment with SouthDoc in circumstances where their own GP surgery had closed early that day.
At that consultation Finnegan took a history of symptoms. Maria was examined and a diagnosis of likely gastroenteritis was made.
The doctor made a note that the mother was particularly worried about the possibility of appendicitis and voiced her concerns. The mother insisted on a referral letter for the hospital for use should her daughter’s condition deteriorate, and it was provided in a sealed envelope.
By December 16th, Maria’s pain was worse and Gladys, a healthcare support worker, said her daughter was very weak and dehydrated. She took Maria to the emergency department at Cork University Hospital. Maria was immediately admitted and subsequently underwent surgery for a perforated appendix.
Dismissing the action, the judge concluded that the primary diagnosis of gastroenteritis by Finnegan was reasonable.
She was further satisfied that Finnegan’s management and advice to Maria and her mother was in accordance with the standard expected of a GP acting with ordinary care.
“In circumstances where there was no clinical negligence on the part of either Dr Finnegan or SouthDoc, I must dismiss the plaintiff’s claim,” she said.
The judge also awarded costs against Maria Afolabi.
