Boy died after 'failed diagnosis'

The hearing is before the General Medical Council

A five-year-old boy died from a rare disease which had been missed by a hospital consultant, a disciplinary hearing was told.

Dr Robert Woodd-Walker, a paediatrician at Clacton Hospital in Essex, first saw Jake Smith in October 1996.

The boy died in May 1997 from Addison's disease, which affects only one in 40,000 people.

The illness attacks the adrenal gland, causing bouts of vomiting, diarrhoea, and abdominal pain.

It is normally treated with hormone replacement therapy.

However, Dr Woodd-Walker is accused of failing to attempt to complete a diagnosis of Addison's, to seek specialist advice or arrange any further tests.

When the paediatrician first saw Jake in October 1996, he was said to have lost a "dreadful amount of weight", but an examination proved inconclusive.

He was admitted to Colchester General Hospital as an emergency in December, but Addison's was discounted by doctors, despite tests showing signs of the disease.

'Nothing to worry about'

In January, Dr Woodd-Walker told Jake's mother, Carol Smith that "there was nothing to worry about", the GMC was told.

Again in February, Jake was admitted to hospital, but tonsilitis was diagnosed and antibiotics prescribed.

A test for Addison's was mentioned but not carried out.

He was seen again in March and April by Dr Woodd-Walker, and allergy tests carried out.

However, he was found dead in bed on May 1, 1997, and attempts to resuscitate him failed.

Dr Carlo Acerini, a consultant paediatrician at Cambridge University, told the hearing that Dr Woodd-Walker should have "seriously considered" the possibility of Addison's disease.

Dr Woodd-Walker told the hearing that in 25 years at the clinic, he and his colleagues had seen only three or four new cases of Addison's.

He said: "I though Addison's disease was on the cards but I did not think the test results were diagnostic.

"I thought that the results should be worse during an attack which was why I didn't arrnage for other tests.

"The fact that he had had so many attacks without treatment was reassuring in a way. None of us had that sense of urgency. We did not expect him to drop down dead at the next attack."