‘Trust your gut’, bereaved Cork parents warn after inquiry

The parents of a Cork schoolgirl who suffered “a horrendous death” from an invasive strep A infection have expressed a fervent hope that doctors will learn from the failure of a GP to recognise the urgency of their daughters’ condition.

Vivienne Murphy, 10, from Millstreet, died at CHI at Temple St, Dublin, on March 1, 2019, eight days after her parents took the decision to rush her to Cork University Hospital (CUH) after being dissatisfied with the diagnoses provided during four visits to doctors in the previous six days.

An inquiry by a fitness-to-practise committee of the Medical Council this week made findings of poor professional performance against one of the GPs, Dr Joyce Leader, in relation to her phone consultation with Vivienne’s parents, Lilly and Dermot Murphy, on February 19, 2019, while providing an out-of-hours clinic with SouthDoc in Kanturk.

Speaking after the conclusion of a two-day inquiry yesterday, the couple said they wanted to warn the public how untreated strep A can be fatal. They also want to raise awareness that it is curable with antibiotics and early diagnosis.

“Vivienne was not given antibiotics early enough and the chance to live,” they said.

“We are here to warn families: If you bring your child to a GP three times with deteriorating symptoms, then trust your gut and push to be seen for further investigation.”

Fighting back tears at remembering how her daughter had “a radiating smile and a mischievous laugh”, Ms Murphy said they had heard their desperate phonecalls to SouthDoc being played at the inquiry in which their daughter’s suffering could be heard.

“You fought so hard from your first breath of life to your last and we, your family, will fight until our last breath to make sure no family has to endure this devastating torture that has befallen this family. Nothing will bring back Vivienne, and we have had a harrowing experience that will affect our mental health forever,” said Ms Murphy.

The inquiry heard that Dr Leader had been informed by the couple that Vivienne was in too much pain to be brought by car to her surgery in Kanturk.

The GP accepted that she had failed to refer the patient immediately to an emergency department of a hospital in order to rule out a diagnosis of septic arthritis that she had considered as a possible diagnosis.

She further admitted that she had failed to express sufficient urgency to Vivienne’s parents about the need to bring her directly to the emergency department at CUH.

MISADVENTURE

An inquest into Vivienne’s death at Dublin District Coroner’s Court in March 2023 recorded a verdict of death due to medical misadventure. Medical records showed she had died from group A streptococcal septicaemia and necrotising fasciitis (known colloquially as “flesh-eating disease”).

Earlier, an apology by Dr Leader to the Murphy family was read out by the GP’s barrister, Rónán Dolan, at the inquiry.

Mr Dolan said the GP wished to apologise unreservedly for her management of a 15 to 20-minute phone consultation with Vivienne’s parents.

“I should have emphasised the need to transfer Vivienne to hospital immediately or to call an ambulance when it became clear that it was not possible for them to bring Vivienne to Kanturk,” said Dr Leader.

SUBMISSION

In a submission to the committee, counsel for the Medical Council, Neasa Bird BL, said patient harm is a factor that should be considered in deciding what sanction should be imposed, after three separate findings of poor professional performance against the doctor

Ms Bird noted that the harm in Vivienne’s case was “the most severe possible”.

Ms Bird called for the GP to be censured “at a minimum”, as well as recommending that conditions should be attached to her registration which should require her to undergo further education in relation to strep A and sepsis, as well as her specific failings.

In a plea of mitigation, Mr Dolan said Dr Leader had made full admissions and had shown “contrition and insight.”

He suggested that the GP could be admonished, but accepted that the case “may warrant censure”.

At the conclusion of the hearing, the inquiry chairperson, Jill Long, said the committee would forward its recommendation on sanction to the Medical Council.

Any ruling on sanction has to be determined by the full Medical Council, with more severe sanctions needing to be ratified by the High Court.