Sent home to die with paracetamol: GP 'failed to examine baby with heart condition then lied to inquest', GMC hears



14:08 GMT, 2 May 2012

A family doctor let a baby die from a heart condition 24 hours after he failed to examine him at his surgery and advised his parents to give him paracetomol, a medical tribunal heard today.

GP Renjith Nair, 36, was shown Calum Smith by his mother and told he had breathing problems and was cold and sweating yet he did not even get out of his chair to look at him, it was said.

Lianne Sabin and Mark Smith outside the General Medical Council in Manchester

Wanting answers: Lianne Sabin and Mark Smith outside the General Medical Council in Manchester

Instead he reassured Lianne Sabin, 24, and Calum’s father Mark Smith, 27, that their 18-day-old baby was fine.

He then checked the computer in his consultation room and prescribed him with paracetomol – even though hospital doctors had earlier issued advice to the parents saying the baby should not be administered the drug.

Calum returned home after his visit to Dr Nair but was taken later that day to hospital, where he died early the next day. A post-mortem found he died of myocarditis, an inflammation of the heart muscle.

When an inquest was held into the youngster’s death, it was claimed Nair lied on oath and misled the coroner by falsely claiming he had examined the child.

Today Nair, from Preston, Lancashire, appeared at the General Medical Council facing misconduct charges over the death of the baby and his treatment of another patient.

Calum Smith died from an inflammation of the heart muscle

Calum Smith died from an inflammation of the heart muscle

The Manchester hearing was told Calum was born on February 9 2009 but in his short life was re admitted to hospital on a number of occasions.

At the age of three days he developed a scab across his nose and at the age of six days he started making “grunting noises” when he was breathing.

He was admitted to Ward 8 of the Royal Preston Hospital but blood tests came back normal and there was no sign of infection.

He stayed in hospital for four days but his temperature fluctuated and was given antibiotics. A midwife came to visit and expressed concerns about the boy’s breathing but he was discharged from hospital and sent home.

On February 23, the health visitor visited Calum at home and was so concerned about the boy’s legs being “floppy” he was seen again by the hospital the next day. Yet the baby was then sent home with the reassurance of the doctor that he was perfectly well.

Two days later the midwife was still concerned about Calum’s breathing and rang the neo natal unit at hospital and left a message asking if they would take the youngster back.

During the evening at home, Calum developed a cold sweat and did not take feed for 15 hours so the following morning his parents took him to see Dr Nair at the Docklands Medical Centre in Ashton, Preston.

Lianne told the hearing: 'Mark held Calum in his arms, we went in and sat down and I spoke to Dr Nair, explained to him that he had been in the hospital the day before and that he had been in and out of hospital, that we had seen Dr Lee, and had been discharged.

'We were in because of his breathing and that since last night he had not been breathing properly and was cold but was sweating.

'I explained that we had been given a prescription for antibiotics. He had Calum’s records up on the computer so I can recall that he knew about it, but I did clearly state that had been in hospital regarding his breathing.

'He sat in his chair, he did not carry out an examination. He said Calum would have been cold and sweaty because of the antibiotics and he would not be feeding because of the thrush he had and told us to give him paracetemol. But the hospital had said not to give paracetemol at all.

'I said the symptoms had worsened overnight. My nanna had said that if babies stopped feeding there was something wrong. It ended with me asking for re-assurance that he would be alright because I explained about the feeding and he said he would be.

'He was not right, he did not look right but I wanted to believe a doctor. The consultation lasted ten minutes tops. Not once did he get out of his chair, Calum wasn’t touched he was still in the arms of Mark with his coat on.

'I asked him to re-assure me and he re-assured me that he would be fine. He sat at his desk, he did not move out of his chair at any time during the consultation. Calum was not touched during the consultation. Dr Nair never examined him.'

Calum’s condition worsened and he and was taken back to hospital where he died on February 27.

Lianne added: 'A a few weeks after Calum had died we were all very angry. Mark took it upon himself to question the doctor, I went with him. We wanted to question why he had not examined him and the doctor said ‘I did examine him’.

'I did not want Mark to go but he was very angry that he had not checked our son when he should have. We knew ourselves there should have been an examination.'

The panel heard that when they got to the surgery, Mark walked past the front desk and into Nair’s room.

Lianne said: 'Mark said ‘why did you not check him’ or something along those lines. I told Mark to calm down and the doctor said ‘I did examine him’ to which Mark said ‘I will see you in court’. We wanted to go about it the right way.'

An inquest in September 2009 recorded a narrative verdict but police were called in after Callum’s parents complained that the GP had lied by saying he had carried out an examination of the baby.

The couple were invited to a reconciliation meeting with the doctor and hospital trust officials the following December and they decided to tape it.

The recording is expected to be played at the GMC hearing

Lianne said: 'I just saw it as an opportunity to meet with the doctor face-to-face to get the truth.

'I didn’t realise it was just kept in that room. We decided to record the meeting ourselves because in the inquest the doctor had lied so we wanted to get it so that people knew what had happened to our son. We were sick of people thinking things which were not true.'

They put the tape recorder in Mark’s pocket and a transcript was prepared for the couple for the meeting.

Lianne added: 'We put all our concerns to him, the main ones like why did he not check Calum, why did he enter false information into the computer and why did he lie at the inquest.

'They then went into a separate room with Dr Nair. They returned and said that Dr Nair agreed with everything we’d said, however he couldn’t recall everything. I do not know what I understood that to mean.'

Counsel for the GMC Mr Russell Davies said: 'If the factual basis of the GMC case is proved on the balance of probability, the conduct of Dr Nair was very seriously below that expected of a medical practitioner.'

'Dr Nair did write to the coroner who conducted the inquest and stated that he examined baby Calum. The GMC case is that that was was a lie.'