Graham (A Child) v Altaf [2023] EWHC 156 (KB) (27 January 2023)

On Sunday 13 June 2010, Edward Graham, who was then aged 3 years and 4 months, fell ill. The following day, his parents took him to Orchard Surgery in Kegworth, to see the general practitioner. The doctor they saw was Dr Simone Altaf, who was a GP Registrar. Dr Altaf diagnosed tonsillitis and prescribed antibiotics for Edward. On 15 June 2010, Edward’s mother, Rebecca Graham, had a telephone consultation with Dr Altaf about Edward’s condition. By 16 June 2010, Edward’s condition had deteriorated significantly. Mrs Graham again spoke to Dr Altaf by telephone. Dr Altaf had Edward admitted to Queen’s Medical Centre in Nottingham. He had developed meningococcal meningitis. It is alleged that he has developed neuropsychological sequelae from his meningitis, in respect of which he now claims. [2]

…the Particulars of Claim contains the allegations about 15th June 2010 which have causative relevance. There are 16 allegations of negligence in this paragraph, but in my view, they amount in substance to three allegations, that:

(1) Edward’s condition had significantly deteriorated and consequently, Edward should have been seen in clinic as a matter of urgency and then referred to hospital. However Dr Altaf proceeded upon the basis that Edward was “slightly better today.”

(2) Dr Altaf paid insufficient heed to the fact that Edward had not taken the antibiotics that had been prescribed.

(3) Dr Altaf paid insufficient heed to the finding she made on 14th June that Edward’s capillary refill time exceeded 3 seconds. [4]

…My conclusions in relation to the alleged breaches are as follows:

(1) On 15 June, Dr Altaf was not told that Edward’s condition had significantly deteriorated; on the contrary, she was told that he was “slightly better, no worse”. Having regard to her previous diagnosis of tonsillitis and the absence of any evidence that Edward was worse or had some other pathology, Dr Altaf did not refer him for further assessment or investigation. Having regard to what she was told, Dr Altaf’s actions were consistent with the practice of a responsible body of general practitioners.

(2) Dr Altaf was given sufficient information to realise that Edward may not have taken all or any of the antibiotics that had been prescribed for him. Her actions following the giving of this information was consistent with the practice of a responsible body of general practitioners.

(3) On 14th June, Dr Altaf found Edward’s CRT gave no grounds for concern. Despite her misleading note of her examination, Dr Altaf had no reason to suppose that Edward’s capillary refill time should raise any alarm. [66]

There has been no causative breach of duty. The claim must therefore be dismissed. [67]