1. ITV Report

Doctors manslaughter trial: actions 'extremely' below standards of care

A medical expert with more than 40 years experience as a GP has told a court that the actions of two doctors fell “extremely” below standards of care.

Ryan Morse died suddenly at his home in Abertillery Credit: Family photo

Two doctors are on trial for manslaughter through gross negligence.

Twelve-year-old Ryan Morse from Abertillery died suddenly at his home in 2012 after suffering from an Addision’s disease crisis.

Dr Joanne Rudling and Dr Lindsey Thomas are not accused of failing to diagnose the condition. However, the prosecution argue they should have personally examined Ryan at home or called for an ambulance the day before he died.

They both deny the charges against them.

Dr Leonard Peter said: "Any reasonably competent practitioner would have spotted red flags or warning signs from Ryan’s symptoms that indicated he was seriously ill”

He told the court he would not have expected the doctors to diagnose Ryan with Addison’s disease. However he said their first reaction on hearing Ryan’s symptoms should have been to visit him at home and personally examine him. And if this was not possible, then they should have advised an ambulance to take him to hospital.

Dr Peter told the jury “Any reasonably competent GP should have considered the child might be at risk of death if left untreated”

Earlier this morning, Professor Ieuan Hughes was also giving evidence at Cardiff Crown court.

Professor Hughes told the jury that if Ryan Morse had been admitted as an emergency case to a hospital on the day before his death and received specialist treatment, he would have survived.

He explained to the court that Addision’s disease is very rare, with 10-15 people per 100,000 affected by it and it’s even more rare in children. If diagnosed, the condition is easily treatable and patients are capable of living a normal life. However, if it’s left untreated, it can be fatal.

Describing the condition he said “the symptoms of Addison’s disease are non specific but can include tiredness, feeling weak, weight loss, nausea and vomiting over a lengthy period of time. Alongside that, the skin can also become pigmented”

Eventually it leads towards a condition called an Adrenal crisis. By that stage all the symptoms have become far more severe. The patient will be dehydrated from vomiting and diarrhoea and the blood pressure falls as well. Without treatment, the heart will stop because it has gone into a shock state. The blood will have low levels of sodium and high levels of potassium which has an adverse affect and eventually the heart will stop beating.

– Professor Ieuan Hughes

When asked what can be done for patients in this condition, Professor Hughes answered, “On examination, a doctor would see the patient would have a low blood pressure, they would be dehydrated, pale, thin and wasted. Doctors would give the patient fluids, oxygen and drugs. ”

Referring specifically to Ryan’s case he said “If Ryan had been given the appropriate treatment he would have survived.”

During the trial the court heard how Ryan’s mother spoke to both doctors at Abernant surgery over the phone, describing her son's severe symptoms on 7th December.

The prosecution argue that if the doctors had done what they should, Ryan would still be alive today.

However, he died the following day on 8th December 2012.

Dr Thomas, of Tredegar and Dr Rudling, of Cardiff, both deny manslaughter through gross negligence.

Dr Rudling has also pleaded not guilty to attempting to pervert the course of justice with an entry in Ryan's medical notes.

The trial continues.

Watch Alexandra Lodge's report here:

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