Nurse gave 'safe clinical' advice

Annie Gray was in court to give evidence

An NHS 24 nurse, who advised a teenager who later died from meningitis, has told an inquiry she believes that she gave "clinically safe" information.

Annie Gray was giving evidence on the third day of the fatal accident inquiry in Aberdeen into Shomi Miah's death.

Ms Gray, a nurse with more than 15 years' experience, told Shomi to take paracetamol and did not call an ambulance.

Shomi, 17, died in hospital 25 hours after the phone call.

The nurse adviser said she had listened back to a recording of the call on 25 October last year. Meningitis was difficult to diagnose, even for a doctor, she told the inquiry at Aberdeen Sheriff Court.

General pain, headache and sleepiness did not necessarily mean a person was suffering from meningitis.

The view may be expressed that if a doctor is given those general symptoms on the phone they would call out someone to see the patient Sandy Kemp Solicitor

Ms Gray became visibly upset when it was put to her that evidence might be given which stated that in circumstances when a patient had a high temperature, a headache and neck pain, a doctor would be called out.

Solicitor Sandy Kemp, representing the Miah family, said: "The view may be expressed that if a doctor is given those general symptoms on the phone they would call out someone to see the patient."

Ms Gray said she knew meningitis could affect someone very quickly.

"That was one disease that was always in my mind," she said.

The inquiry also heard from the doctor on duty with the out-of-hours GP service who later examined Shomi at her home.

Meningitis symptoms

Dr Derek Mathieson said her condition was deteriorating but he felt there were no signs of meningitis at the time. He said his aim was to get her to hospital as quickly as possible.

Earlier Ms Gray had said that, during the call to Shomi, she did not tick boxes displaying two of the main symptoms of meningitis which could have led to her being given more rapid medical attention.

She confirmed that her computer screen included four boxes, two of which could be ticked to indicate that a patient had neck stiffness and a severe headache - both symptoms of meningitis.

Ms Gray said she checked for meningitis signs, asking Shomi if she could touch her chest with her chin. She said Shomi said she could but it was sore.

Shomi Miah died in hospital a day after ringing NHS 24

"I was expected her to be completely unable to do that if she had meningitis," she added.

When asked how she knew whether Shomi's headache was severe or not she replied: "I believe someone with meningitis would tell you if they had a severe headache because it is one of the main symptoms someone presenting with meningitis would complain of."

The inquiry also heard that Ms Gray, who started as a nurse adviser with NHS 24 in March 2004, had undergone "comprehensive" training with the service.

This included a nine-week induction course and a training session from the Public Health Department at Aberdeen Royal Infirmary.

The inquiry is also looking into the death of 30-year-old Steven Wiseman, from Laurencekirk in Aberdeenshire. Evidence in his case is unlikely to be heard for several days.