The seven-week year old baby, referred to as ‘Baby A’ for the purposes of the investigation, was admitted to the Manchester Children’s Hospital with a hernia problem and constipation. It was discovered that her left ovary was protruding into her stomach and surgery was therefore required.
43 year-old Consultant Paediatrician, Miss Pierina Kapur, set out to remove the inguinal hernia, an operation which would normally take only 15 minutes. In this occasion, however, it took over an hour before the surgery was completed and the abdomen closed.
Baby A was returned to the ward and during the course of the evening, the baby’s mother became increasingly concerned about her progress. The patient developed a rash and a temperature, and numerous attempts to fit a catheter failed. After 35 hours, the child had still not passed any urine and therefore blood tests were taken which confirmed dangerously high levels of potassium. Baby A was immediately transferred to intensive care with acute renal failure.
Further lengthy surgery was undertaken and the Consultant Paediatric Urologist found that 90% of the child’s bladder had been removed and the inguinal hernia was still very much in place. Baby A would require further surgical procedures and a catheter for the rest of her life.
Miss Kapur has stood in front of the GMA fitness-to-practice panel in Manchester and admits that the treatment provided was inadequate but denies misconduct. However, according to the BBC (source 3), the barrister for the GMC, Miss Cundy, argued that “Miss Kapur had failed to recognise the anatomy or stop and take a step back from what she had found, therefore causing serious and irreparable damage to the bladder”. The expert witness also criticised Miss Kapur for failing to take appropriate steps to investigate the baby’s post-operative symptoms particularly as she had known that the surgery had been unexpectedly complicated as it had taken over an hour, rather than the usual 15 minutes. No blood tests or ultrasound was arranged by Miss Kapur.
Following the week long investigation, the GMC ruled that Miss Kapur had been guilty of gross misconduct during her treatment of Baby A. Miss Kapur had proved incapable of being able to recognise the muscle layers of the abdomen or even basic anatomy. During the operation she had had to stop twice to reorientate herself but failed to seek any assistance.
On being interviewed after the investigation, Baby A’s parents said that they had reported the incident to the GMC ‘to ensure that appropriate steps were taken to ensure public safety.’