Doctor's 32% Error Rate 'Not Unusual' Says Inquiry

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Doctor's 32% Error Rate 'Not Unusual' Says Inquiry

By Jeremy Laurance

Health Editor

The Independent - UK

 

 

A consultant paediatrician who mistakenly diagnosed almost one third

of his patients as having epilepsy had an error rate that was " not

unusual " , an inquiry has concluded.

 

The high error rate, revealed by a review of almost 2,000 children

diagnosed with epilepsy at Leicester Royal Infirmary over an 11-year

period, could be similar at other hospitals, the author of the

inquiry said yesterday.

 

Between 1990 and 2001, Dr Andrew Holton, a consultant paediatrician

at the Royal Infirmary, diagnosed 1,948 children with epilepsy of

whom 618 (32 per cent) had their diagnoses changed or recategorised

as a result of the inquiry, the report said. All the misdiagnosed

children were over-treated or given the wrong treatment and many

suffered side-effects from powerful cocktails of drugs. The families

of 308 children are suing the University Hospitals NHS Trust, which

runs the infirmary, for compensation.

 

Richard Newton, the president of the British Paediatric Neurology

Association who led the inquiry, said: " I always worry this might be

repeated elsewhere. There is the potential for that. "

 

Epilepsy affects one in 200 children but is difficult to diagnose

because children can suffer fits for many reasons, including

fainting, migraine and fever, not related to epilepsy. In most

hospitals, cases are diagnosed by a general paediatrician, but

specialist expertise in paediatric neurology is necessary to make an

accurate diagnosis.

 

Only two known studies have been conducted of epilepsy diagnosed by

general paediatricians, one in Copenhagen which found a 39 per cent

error rate and one in Sarajevo where the error rate was 38 per cent.

 

Dr Newton said Britain faced a severe shortage of paediatric

neurologists. " Over the last 30 years there have been about 50

reviews of epilepsy whose findings have been published, filed and

forgotten. I am anxious that shouldn't happen again, " Dr Newton

said. The inquiry report, published yesterday, confirmed the

findings of an interim investigation in November 2001, which found

Dr Holton had diagnosed epilepsy in children who had suffered any

kind of recurrent episode including behavioural outbursts, headaches

or abnormal movements. He frequently ignored " normal " EEG reports

(measuring electrical activity in the brain) and prescribed

excessive doses of drugs.

 

The parents of Annabelle Appleyard, six, from Market Harborough,

said her condition had dramatically improved since she came off

drugs prescribed by Dr Holton. Her mother, Rosalind, said: " We like

her better now she is not on medication.She is far more lively and

has got more personality. I am not saying it is easier but it is

more of the child we like to see. "

 

A separate review of Dr Holton's behaviour towards parents found he

had adopted the " wrong approach " , in some cases misleading them, or

causing unnecessary anxiety.

 

Peter Reading, chief executive of Leicester Royal Infirmary, said Dr

Holton, who has been suspended since May 2001, would face a

disciplinary tribunal. However, because he had been working alone

with inadequate resources and a high case load, he would not be

sacked. The trust is supporting his request to retrain in another

specialty outside Leicester.

 

http://news.independent.co.uk/uk/health/story.jsp?story=375685