Doctor dismissed fear over infected baby

When nine-month-old Venice Kowalczyk was admitted to the Royal Children's Hospital, there were significant warning signs to indicate she had a serious bacterial infection, a court has heard.

Infectious diseases expert Associate Professor Peter Stanley told the Supreme Court that Venice should have been immediately admitted to the hospital for observation on July 23, 2004, and blood tests carried out, but instead she was given painkillers and sent home.

Venice's father, Danny, had earlier asked hospital registrar Dr Tanya Moyle to test his daughter for meningococcal disease, but Dr Moyle replied, "I don't think it's that serious", the court has heard.

Mr Kowalczyk and his wife, Nadia, later rushed their seriously ill daughter back to the hospital, where she was diagnosed with the deadly meningococcal septicaemia.

Venice spent five days in the intensive care unit as doctors fought to save her life and later had to have her feet, left hand and the tips of three fingers on her right hand amputated.

The Kowalczyks are suing the hospital for negligence, claiming it failed to treat her promptly and effectively when she was first admitted.

Dr Stanley told the jury in the civil damages trial on Tuesday that he was critical of Dr Moyle's clinical notes for when Venice was first admitted, saying the notes had "major deficiencies".

Dr Moyle had noted that Venice was "miserable" at 5.35am but "much better" at 7am after she had been given painkillers.

Dr Stanley said there was no real information in the registrar's notes on the child's appearance or behaviour.

He said in his opinion Venice fitted the "child looks unwell" category because she had an elevated heart rate and a high temperature, and was moaning and refusing to take fluids.

It was important for doctors to listen to parents' concerns about their children and not dismiss them too easily, he said.

A blood test was never taken and Venice's parents were told to go home and give their child another dose of painkillers after four hours if she had not settled.

They took Venice back to the hospital about 4pm after she had had diarrhoea, her temperature had risen to 39.8 and Mrs Kowalczyk had noticed a small rash on her baby's right hand and stomach.

A trained nurse, Mrs Kowalczyk was aware of the symptoms of meningococcal disease and remembered watching something about it on television.

The Kowalczyks were with Venice in a cubicle waiting for a doctor when she started gasping for air, threw her arms back and stopped breathing.

When cross-examining Mrs Kowalczyk on Monday, barrister Jeremy Ruskin, QC, representing the hospital, said Dr Moyle would give evidence that she thought Venice had the early signs of a viral infection but it had yet to show itself.

Dr Moyle would claim she told Mrs Kowalczyk if she had any concerns about Venice's condition to come straight back to the hospital.

The Kowalczyks barrister, David Curtain, QC, said the hospital had failed its own medical guidelines by not immediately admitting Venice.

"You will hear that any child with a fever who appears seriously unwell should be investigated and admitted irrespective of fever and this was not done," he said.

Mr Curtain said Venice had been left "grossly disabled".

"In addition to this she has understandable psychological reaction to her condition. She is now nine and a half years old and attending school but has special needs.

"She walks with prosthetic legs and cannot do many of the things her classmates can. In a few years she will reach puberty and then become a teenager. She will see her friends socialise and interact with boys and engage in sport and other active past times and she will be able to do nothing more than look on.

"It does not take much imagination to understand that this will be a grievous loss for her, and that her circle of friends is likely to narrow as they move on from childhood."

Dr Stanley said he believed Venice would have recovered if she had been treated immediately.

An emotional Mr Kowalczyk broke down this afternoon when telling the jury how Dr Moyle had ignored him when he suggested she check Venice for meningococcal disease.

He said Dr Moyle looked over her shoulder and told him Venice’s condition was not that serious.

Hospital staff had also never told the family why blood tests were not carried out on Venice.

Mr Kowalczyk was far from happy when Venice was discharged from hospital.

‘‘I felt like she was quite sick and nothing was really done,’’ he said.

The hospital and doctors had never apologised to the family for what had happened to Venice.

The trial continues.

This article is courtesy of The Age.