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‘Doctor persisted with failure to be transparent over death of nine-year-old’

Dr Heather Steen is accused of trying to cover up the true circumstances of Claire Roberts’s death in 1996.

30 March 2022

A doctor failed to give a clear account of a child’s treatment up to a decade after her death, a tribunal has heard.

Dr Heather Steen is accused of trying to cover up the true circumstances of nine-year-old Claire Roberts’ death at the Royal Belfast Hospital for Sick Children in October 1996.

Claire’s parents, Alan and Jennifer, say they were told a viral infection had spread from her stomach to her brain, causing a build up of fluid, and that medics had done everything possible.

Mr Roberts contacted the hospital again in October 2004, the day after he watched a television documentary, UTV’s When Hospitals Kill, which focused on hyponatraemia – a condition which occurs when there is a shortage of sodium in the bloodstream.

Hyponatraemia inquiry findings published
Jennifer Roberts attends the publishing of findings of the hyponatraemia inquiry (PA)

The programme featured the deaths of three children and the build up of fluid in their brains, a Medical Practitioners Tribunal Service (MPTS) panel was told.

Consultant paediatrician Dr Steen was asked to review her notes of Claire’s treatment and a meeting was set up in December 2004 with the family and other hospital chiefs.

Tom Forster QC, representing the General Medical Council (GMC), said: “It is clear…the family wanted to know what led to Claire’s sudden deterioration. Was Claire’s condition misdiagnosed and what role, if any, did her sodium and fluid management play in her death?”

He said Dr Steen stuck with her explanation that a virus had entered her stomach and then her brain.

“What Dr Steen did not acknowledge is that things had been done wrongly at the time,” he said.

Hospital bosses went on to refer Claire’s death to the coroner, which led to Dr Steen providing a formal witness statement and giving oral evidence at an inquest in May 2006.

Mr Forster said: “It is the GMC’s case that she persisted with her failure to be open and transparent with the coroner.”

He said Dr Steen “did not disclose the failings in Claire’s treatment”.

In the wake of the documentary, a public inquiry was launched into a number of deaths, including Claire’s.

In 2018, it said she died from “negligent care” after an overdose of fluids and medication.

A fresh inquest in 2019 ruled her death was “caused by the treatment she received in hospital”.

The MPTS tribunal, sitting remotely, has heard Claire was sent home from school on October 21 1996 with a note from her teacher explaining she was pale and felt lethargic.

Claire went on to be sick two or three times at home before the family GP was called out and she was referred to hospital.

Mr and Mrs Roberts stayed with their daughter until she fell asleep at about 9pm and said they left with the impression she had a stomach bug, the tribunal was told.

Nursing staff went on to note that Claire’s sodium levels were outside the expected range as she vomited on several occasions throughout the night.

Her parents saw her again the next day and did not think she looked herself.

The hearing was told a repeat blood test was not ordered despite a decline in her levels of consciousness and, consequently, her fluid regime was not assessed.

Claire stopped breathing in the early hours of October 23 and later died in intensive care.

Mr Forster said Dr Steen knew Claire had suffered acute hyponatraemia, which had been a contributory factor to the swelling of her brain.

She should have told them the virus was an “unconfirmed working diagnosis” but instead omitted to mention hyponatraemia, he said.

Dr Steen went on to inappropriately complete a medical certificate of cause of death without reference to hyponatraemia and did not pass the death to the coroner in 1996, said Mr Forster.

The GMC alleges Dr Steen acted dishonestly and took part in a cover up to avoid scrutiny.

The doctor denies the allegations and, it is understood, will say she acted in good faith and to the best of her ability at all times.

The hearing is scheduled to last until the end of April.

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