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NHS Service Failed Imperial Lecturer

Jun 17 2010 01:22
Lawrence Weetman
A coroner has said that the misdiagnosis of a blood infection by an out of hours service contributed to the death of Imperial scientist Dr Alastair Hosie in March.
Dr Hosie eventually called paramedics, who took him to The Whittington Hospital in Islington.

An inquest into the death of an Imperial College academic, neuroscientist Dr Alastair Hosie, has found that incorrect medical advice given by an out of hours phone service was a "contributing factor" to his death, according to the Islington Gazette and the Islington Tribune.

Failed by Camidoc: Dr Alastair Hosie.

Hosie died from a blood infection at The Whittington Hospital on March 1st this year after calling 999. Paramedics found him with no pulse.

It has transpired that Hosie called an out of hours service ran by a private not-for-profit firm called Camidoc on behalf of the NHS.

Camidoc employs a group of GPs who provide out of hours diagnostic services to patients of health trusts in Camden, Hackney, Harringey and Islington.

The Islington Gazette reports that Hosie had been suffering from flu-like symptoms for 10 days before his death, however during the later stage of this he developed a rash behind his knee.

The night that the rash appeared, Hosie had a telephone appointment with a Camidoc out-of-hours GP, Dr Tessa Katz, however this was cancelled as Katz believed Hosie had septic arthritis and requested to see him later that day.

At 8.30am Camidoc GP Dr Dhuha Jassim saw Hosie - whose rash had grown - in person and prescribed him with antibiotics, thinking that he had cellulitis.

I don't think it helped that the antibiotics were stopped and not replaced.
Dr Julie Andrews, Microbiologist at The Whittington Hospital

Later that evening, with the rash now covering much of his body, Hosie made a telephone appointment with yet another Camidoc GP, Dr Kirmang Dabagh.

Dabagh wrongly diagnosed the rash as an allergic reaction and instructed Hosie to stop taking the antibiotics prescribed to him earlier that day.

Coroner Andrew Reid, cross-examining Dabagh, asked how he could diagnose Hosie's condition accurately over the phone. Dabagh insisted that he offered Hosie a face-to-face appointment, which was refused, and told Hosie to see a doctor as soon as possible.

Reid, according to the Islington Tribune, said, "I find it incredible that he would not take your advice to go and see a doctor".

The fact that the advice was given to stop taking the antibiotics ... contributed to the cause of death.
Dr Andrew Reid, St Pancras Coroner

Camidoc guidelines state that all phone conversations with patients should be recorded. Dabagh had not recorded his conversation, claiming that he thought the conversation would be recorded automatically.

Giving evidence in court, specialist Dr Julie Andrews of The Whittington Hospital, said, "I don't think it helped that the antibiotics were stopped and not replaced". Andrews told the inquest that had Hosie been hospitalised the night before his death then the outcome would have been "favourable".

Closing the inquest with his verdict, Coroner Dr Reid said: "The fact that the advice was given to stop taking the antibiotics, and that for a period of time antibiotic treatment was started and then stopped, contributed to the cause of death".

Reid also said that it was up to involved parties as to whether civil action should be taken against Camidoc.

Similar Camidoc Case

This isn't the first time that Camidoc has been criticised for misdiagnosis. A previous Camidoc case prompted Gordon Brown to call for better GP cover out of hours.

Penny Campbell died in 2005 after being wrongly diagnosed eight times by Camidoc.

Back in 2005, 41-year-old journalist Penny Campbell died of septicaemia after consulting eight different Camidoc GPs about her illness. Two of these consultations were face-to-face.

All eight of the GPs failed to provide proper care for Ms Campbell, with the ensuing investigation finding that at least one of the doctors contacted did not explore her symptoms adequately.

A report published by the Islington Primary Care Trust, ruled that Camidoc's internal procedures were "not fit for purpose".

After the death of Dr Hosie, and despite the damning report from Islington's Primary Care Trust, Camidoc's NHS contract was renewed, to the dismay of Campbell's widower.

Tributes

When Hosie died in March, tributes flooded in from friends, family and colleagues.

Professor Nick Franks, a colleague of Dr Hosie, said: "Alastair joined the Biophysics Section of our Division in 2007, and rapidly established himself as a productive and well-liked member of staff.

Alastair contributed to all aspects of College life and will be greatly missed.
Professor Nick Franks, Colleague

"Alastair studied neuroscience at Edinburgh before doing a PhD in Cambridge with David Sattelle on insect GABAA receptors, work which led to more than a dozen publications. In 1998 he moved to UCL to work with Trevor Smart, where he worked on the modulation of GABAA receptors, which led to a landmark publication in Nature that identified the binding sites for neurosteroids.

"This achievement laid the foundations for his work at Imperial, where he was pursuing the idea that the intoxicating effects of alcohol might be mediated by neurosteroids; this was a novel and promising line of inquiry and Alastair rapidly won funding from both the MRC and the Royal Society.

[Alastair] rapidly established himself as a productive and well-liked member of staff.
Professor Nick Franks, Colleague

"Alastair Hosie was one of our most promising young investigators and his sudden death at the age of 39 has left his family, friends and colleagues devastated by the loss. As well as his achievements, Alastair was an individual of rare warmth and kindness. He invariably found time for undergraduates and project students, and turned nobody away. Alastair contributed to all aspects of College life and will be greatly missed. He is survived by his wife Emma and his daughter Phoebe".

Back in March, Dr Hosie's family also paid tribute, saying: "His death will be an enormous loss not just to the scientific world, in which he was a senior lecturer at Imperial College, but more importantly to his family - especially his wife Emma, his two-year-old daughter Phoebe whom he idolised, and the baby Emma is expecting in August".

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