GP denies lying over letter

Robert Powell died of Addison's disease in 1990

A GP has denied dictating a letter of referral after a schoolboy patient died of a treatable illness which was missed by doctors, an inquest has heard.

Robbie Powell, 10, of Ystradgynlais, south Wales, died of the glandular condition Addison's disease in 1990.

Michael Williams, his GP, denied dictating a hospital referral letter after Robbie had died but agreed with a lawyer for the Powell family that there were inconsistencies with medical notes.

The inquest at Swansea Crown Court was adjourned until Wednesday.

Four months before his death, the schoolboy had been admitted to Morriston Hospital, Swansea, where a consultant ordered a test for the condition.

But he was later diagnosed as having gastroenteritis and discharged after his condition improved, the test having never been carried out.

Disease found

He collapsed at home on 17 April, 1990, and was rushed to hospital by his parents, where he suffered two heart attacks.

He died hours after arriving.

A post-mortem examination established that he died from Addison's disease, which affects the adrenal gland.

Previously, an inquest jury at Swansea Crown Court has been told that Robbie was seen seven times by five separate GPs in the two weeks before he died.

His parents William and Dianne Powell have criticised the level of care he received in the weeks before his death.

Robbie was admitted to Morriston Hospital in December 1989

Ystradgynlais GP Mr Williams gave evidence on Tuesday about a consultation he had with Robbie and his parents on 11 April.

Mr and Mrs Powell said the GP was so concerned about their son's condition that he said he would urgently refer him back to the hospital.

But Robbie died before any new referral was made.

Dr Williams disagreed with the parents' version of events on Tuesday, saying the letter of referral had been dictated the next day because it was non-urgent.

He was cross-examined about the medical notes he made about the consultation.

Michael Powers QC, for Mrs Powell, highlighted inconsistencies between his medical notes and the information in the referral letter he later dictated.

'Inconsistency'

The letter stated Robbie suffered no vomiting or diarrhoea as a result of his condition - vomiting is a symptom of Addison's disease.

However, the medical notes do not record the absence of either symptom in its brief summary of the consultation.

Dr Williams agreed that that was an "inconsistency" between the notes and the letter itself.

Mr Powers asked: "Is it not the case that the letter was not dictated on the 12th but after his death in the light of knowledge of Robbie's death?"

Dr Williams replied: "No."

Dr Williams said the date on the referral letter was not normally an accurate guide to when the letter had been dictated.

Due to a backlog of letters at the surgery it could take more than a week for official correspondence to be sent out.

Letters sent out would be dated the day they were typed up.

But Dr Williams insisted that the referral letter was dictated following the visit by Robbie and his parents.

At that time, he said he was not aware that the schoolboy was suspected of having Addison's disease.

He was also unaware that the test ordered by the hospital was specifically to check for that condition.

The inquest continues.