Anaesthetist fined $12,000 over girl's death from meningitis

A former Whangarei anaesthetist has been fined $12,000 for professional misconduct after failing to diagnose meningitis in a 14-year-old girl who later died.

Annesley Perera had denied the charge brought against him by the Medical Practitioners Disciplinary Tribunal in June last year, in relation to his care of 14-year-old Paree Nicholas, who died on July 17, 1999.

Paree was taken to Whangarei Hospital's emergency department about 1.40am on July 17, after vomiting and complaining of a sore head.

It was feared she may have had delayed concussion after a weights barbell fell on her nose during a physical education lesson at school earlier that week.

A CT scan was organised to check for head injury and Dr Perera was called at this point to anaesthetise her for the scan, which came back clear.

The tribunal found Dr Perera failed to adequately investigate her symptoms at any time following the CT scan.

Dr Perera also failed to act upon suspected meningococcal disease by starting the administration of antibiotics.

The patient's mother said that on arrival at the Intensive Care Unit, the nursing staff were ready with all necessary emergency equipment but Dr Perera said that the patient's oxygen levels were fine and there was no need for an arterial line.

She said he told her that the patient was fine and that she would be woken in the morning.

The nurse put in charge of the girl said Dr Perera left within 20 minutes without talking to him about the patient's condition or giving him a management plan.

He did not feel that Dr Perera had completed things and he was not really sure what he was supposed to be doing.

The girl's condition continued to deteriorate and Dr Perera was recalled to the hospital.

A paediatrician took over the case at 6.15am and diagnosed meningitis after a nurse pointed out a rash on her thigh.

Antibiotics were administered by it was too late.

The girl was resuscitated four times between 6.15am and 7am and was finally declared dead at 10.50.

During the hearing, Dr Perera's lawyer Harry Waalkens said the case highlighted "systemic inadequacies and resource issues at the hospital".

While lack of clear procedures for making referrals was among "mitigating factors, the tribunal found these issues did not affect Dr Perera's culpability in this particular case.

Dr Perera is no longer practising in New Zealand.

The tribunal ordered that if Dr Perera should ever apply for a New Zealand Practising Certificate, he must work under supervision before completing a competence review.

He was also ordered to pay 25 per cent ($19,122.44) of the costs and expenses of the investigation, prosecution and hearing of the case.

- NZPA