Inquest hears delay in giving drug to baby

30 Oct 2012, 7:33 pm   -   Source: AAP

An inquest has heard that a doctor involved in the treatment of a baby who died after being shuffled between hospitals stressed the need for antibiotics.

A paediatric registrar who treated Elijah Slavkovic the night he fell ill with meningitis has told an inquest she warned another doctor he urgently needed antibiotics, hours before he finally got them.

Helen Doyle, now an anatomical pathologist, said the experience drove her to quit clinical medicine.

Medical staff who treated Elijah at two hospitals gave conflicting evidence on Tuesday to the inquest at Parramatta Coroner's Court.

The three-month-old was on a family holiday on the NSW south coast when he developed bacterial meningitis.

It was seven hours from the time Elijah first visited Pambula Hospital on April 24, 2009, before potentially life-saving antibiotics were administered, the inquest heard.

From Pambula he was taken to hospitals in Bega, Canberra and Sydney, before finally being airlifted to Melbourne's Royal Children's Hospital, where he died six weeks later.

Dr Erika Jaensch, the on-call medical officer in Bega District Hospital that night, said when Elijah was admitted to that hospital he was described as "floppy", feverish and lethargic.

Under questioning from counsel assisting the inquest, Peggy Dwyer, Dr Jaensch agreed Elijah's symptoms were very dangerous for a child so young.

"I would have collected what (blood and urine samples) I could and then administered antibiotics," Dr Jaensch said.

She never examined the child personally, she said, adding that she "specifically asked" Dr Tin Myint - the only doctor present at Bega District Hospital that night - if she should attend the hospital, but was told she was not needed.

She said she told Dr Myint to administer antibiotics quickly and suggested he speak to the paediatric registrar in Canberra.

But Dr Myint told the court Dr Jaensch never offered to attend the hospital, and that the two had discussed whether the baby should be sent to Canberra Hospital for treatment.

Dr Myint said he had not been expecting Elijah when the baby arrived at his four-bed emergency room about 11.40pm on April 24.

Dr Doyle, the overnight Canberra paediatric registrar, said she spoke to Dr Myint by phone shortly after 1am and agreed to accept the baby in Canberra.

She said she expected to see Elijah within two or three hours, and checked the paediatric ward several times to see if he had arrived.

Yet it took until about 2.30am or 3am for a nurse in Bega to give Elijah intravenous antibiotics, the court heard, and the baby did not arrive at Canberra until after 6am on April 25.

Dr Myint originally said in a statement that Dr Doyle "didn't even mention antibiotics", but in court agreed that she had.

Dr Doyle said it was not yet clear the baby had bacterial meningitis, but from her conversation with Dr Myint she identified sepsis as a possibility and told him to treat accordingly.

"I was very clear and loud on the phone that this child needed antibiotics and specialist care," she said.

Dr Doyle became emotional as she told the court Elijah was one of her last patients.

"It's quite unpleasant to know that your best efforts aren't sufficient," she said.

The inquest continues on Wednesday before Deputy State Coroner Carmel Forbes.

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