Doctors thought a little girl who died from meningitis was suffering with just ‘bruises’ instead of a rash, a damning report has revealed.
Layla-Rose Ermenekli, six, was rushed to Royal Oldham Hospital on February 3 after she began to have a high temperature, headache and stomach ache.
But after spending eight hours in the hospital the youngster went into cardiac arrest and died in the early hours of the morning the following day.
An internal report carried out by the Pennine Acute Hospitals NHS Trust has now revealed medics failed to realise a rash on her hip were signs of Meningococcal meningitis and septicaemia.
The investigation found there were ‘missed opportunities to identify the severity’ of Layla-Rose’s illness by doctors at the hospital.
Layla-Rose’s mother, Kirsty, from Oldham, Greater Manchester, brought her daughter to the hospital at around 8.30pm and she was assessed by a triage nurse after a 25 minute wait. The little girl was identified as requiring a doctor within 10 minutes, but delays meant it was an hour and 50 minutes before she was seen by a doctor.
A rash was spotted on Layla-Rose’s body, but the doctor thought it was just a bruise and did not write this information down or speak about it with her mother.
The doctor diagnosed her with a ‘viral illness’ and later told Kirsty she was fit to go home as she was showing no new symptoms.
But a sister nurse in charge felt uncomfortable sending the girl home and she was instead transferred to the paediatrics ward.
After another wait Layla-Rose was assessed by a junior doctor, who picked up on the rash on her hip, but was told by the previous doctor it was just a bruise and not a new symptom.
But just 30 minutes later another locum doctor noted the rash, inserted a cannula, took bloods and administered antibiotics for sepsis.
The rash on Layla-Rose’s body began to spread rapidly and she then went into cardiac arrest, before she was pronounced dead by medics on the morning of February 4.
A list of missed opportunities in the internal report found doctors used an old document when assessing Layla-Rose, which failed to facilitate the early recognition of potential sepsis.
It also states Layla-Rose’s mother’s concerns were not listened to, while there were two missed opportunities to recognise the rash.
The report said: “The doctor who saw the patient initially did not recognise the rash, which was not documented at the time as being of a worrying nature, as a result the diagnosis of sepsis was missed for three and a half hours, during which treatment opportunities were missed.
“A second opportunity to spot any rashes was missed when the rash was noted prior to transfer and escalated, false re-assurance was given that this was not a new finding so no action was taken.”
The report says there was “failure to identify the advanced nature of the sepsis and treat accordingly” as well as “failure to recognise a ‘bruise’ as a purpuric rash and therefore as an indicator of meningococcal sepsis”.
The report recommends doctors require additional training to identify rashes, while staff have been sent a patient alert asking to consider sepsis when diagnosing unwell children.
Layla-Rose’s mother, who was pregnant at the time of the incident, has been forced to give up her job as a beautician following the tragic death of her daughter.
The family have raised more than £10,000 for charity Meningitis Now and are campaigning for all children under the age of 16 to receive inoculation for Meningococcal disease.
A statement from Kirsty and Ramazan Ermenekli said: “Layla-Rose was a much loved, bright, beautiful daughter and sister. She had many friends and loved to dance.”
They added: “In addition to the fundraising and inoculation campaign the family hopes that the tragic events giving rise to Layla-Rose’s death will bring about patient safety at Royal Oldham.”
Solicitor Jacqueline White from the clinical negligence department of the Oldham law firm Pearsons Solicitors said: “This is a terribly sad case involving the loss of a much loved daughter and sister.
"I sincerely hope that processes and pathways will now be put in place by the Trust to ensure that no other child falls through the net in the way that Layla-Rose did.
“This is likely to require a comprehensive programme of training not least to ensure that a culture of team working is put in place so that all members of the Clinical Team are empowered, supported and confident promptly to escalate clinical concerns of sepsis to experienced senior doctors.”
Dr Jawad Husain, medical director at The Royal Oldham Hospital, said: “We would like to express our sincere condolences to all of Layla’s family and friends following her sad and tragic death at The Royal Oldham Hospital on 4 February this year.
"We have carried out a thorough investigation into the care and circumstances surrounding Layla’s death and have shared our findings with her parents.
"We continue to be in contact with the family to provide feedback and support.”