GP acknowledges failures in assessing toddler at Medical Council hearing

A Dublin-based GP who failed to properly examine a toddler with a serious blood disorder has been found guilty at a Medical Council hearing of five counts of poor professional performance.

Dr Fadzilah Abdul-Aziz had admitted a series of allegations relating to her consultation with the child and his mother in 2017 at the fitness to practise hearing.

Sarah Savage had brought her son Bobby to see Dr Abdul-Aziz at Primehealth Medical Centre in Swords, north Dublin, on December 20th.

Ms Savage had noticed Bobby had blood spotting on his abdomen and that bruises he had previously sustained had turned dark.

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Despite her concerns, Dr Abdul-Aziz diagnosed eczema and prescribed a common skin ointment, Betnovate, to treat it.

The next day, Bobby’s symptoms had worsened and his mother took him to Temple Street children’s hospital. There, doctors found his blood platelet count was one, when a normal count is 150-250, and diagnosed ITP, a blood disorder.

He was discharged the same day as it was close to Christmas and prescribed steroids. This resolved the issue and he made a full recovery.

In correspondence, Dr Abdul-Aziz has told the Medical Council the two-year-old was alert and active when she examined him and his temperature was normal. She said she felt eczema was “the most likely” diagnosis.

She said it was never her intention to dismiss Ms Savage’s concerns and apologised if she had given this impression. She has since undertaken further training.

Giving evidence, Ms Savage said she had been “quite fond” of Dr Abdul-Aziz as her GP and had had “nothing bad to say about her”. But she said she “knew” the diagnosis of eczema was not correct and resolved immediately after the consultation to take him to hospital the following morning.

Expert witness Dr Eamonn O’Shea told the hearing there was “no way” a GP could be certain the symptoms involved were ITP but Bobby should have been seen immediately by a specialist. He described the eczema diagnosis as “very unlikely”.

Dr Abdul-Aziz admitted failing to take an appropriate history from Ms Savage at the consultation. She also admitted failing to conduct a full or adequate physical examination of Bobby, and failed to identify he had bruising on his lower limbs and a “petechial” rash.

She admitted failing to appreciate that the child’s symptoms may have suggested “a sinister pathology”; failing to record Ms Savage’s concerns about her son’s blood spots and bruising; and failing to refer him for further clinical review “when she ought to have known that this was required”.

Character references read out at the hearing described Dr Abdul-Aziz, who trained in Dublin and Malaysia, as a hardworking and competent doctor.

The Medical Council will decide at a later date what sanction, if any, to impose on her.