Decision report 201100635

Summary
At around six weeks old, Miss C's baby (Baby A) developed laboured breathing and was not sleeping or feeding well. She was referred to hospital by her GP who noted that was symptomatic of an upper respiratory tract infection (URTI). Baby A was triaged and seen by a junior doctor at Wishaw General Hospital. She was noted as having a four-week history of worsening wheezing, cough and intermittent fever. It was also noted that Miss C described Baby A as making a 'squeaking noise' when breathing.

The junior doctor diagnosed a URTI and this diagnosis was supported upon review by a paediatric registrar. Baby A was discharged home with arrangements put in place for follow-up review at home. Baby A was reviewed three days later. She was found to have a stridor (high-pitched breathing sound, normally associated with a blockage in the throat). Further examination by a consultant, and a chest x-ray, resulted in Baby A being transferred to Yorkhill Hospital, where she was diagnosed with a hemangioma (a benign tumour partially blocking her airway). Miss C complained that Baby A's condition had not changed during the time she was at the first hospital and that, therefore, the stridor had been missed and the hemangioma diagnosis delayed. She also complained about the attitude and actions of the junior doctor and the board's complaint handling.

Our investigation did not find that the hemangioma could have been diagnosed earlier. We found that the stridor would have been an indicator for the condition, but that none of the four medical staff who originally examined Baby A recorded this symptom, which is relatively simple to identify. We were satisfied that Baby A's symptoms were indicative of a URTI and established that the symptoms associated with hemangioma can be exacerbated by URTIs, indicating that her condition likely developed and worsened. We were unable to comment in specific detail on the actions of the junior doctor, but did not find any evidence that issues complained about had any impact on Baby A's treatment. We were also generally satisfied with the board's complaint handling.