Dr Heather Steen was alleged to have “acted dishonestly” according to Tom Forster QC, when he opened the court speaking on behalf of the General Medical Council (GMC), in trying to cover up the death of a nine-year-old girl, Claire Roberts, who was under her care in 1996
Image: Photopress Belfast)
A doctor “acted dishonestly” and tried to cover up the death of a nine-year-old girl to avoid facing blame for his failings, a court has heard.
Dr Heather Steen was said to have tried to conceal the circumstances surrounding the death of Claire Roberts, at the Royal Belfast Hospital for Sick Children, in October 1996.
At the time, Claire’s parents, Alan and Jennifer, were told a viral infection had spread from her stomach to her brain and that despite their efforts, medics were unable to save her.
However, an inquest found that her death was actually the result of “negligent care” from an overdose of fluids and medication.
Then, in the aftermath, Dr Steen allegedly tried to cover up her actions by incorrectly completing a medical certificate and on two later occasions.
A television documentary, UTV’s When Hospitals Kill which was broadcast in October 2004, raised questions about the treatment of a number of children who had died under similar circumstances.
They died from hyponatraemia, which occurs when there is a shortage of sodium in the bloodstream, the same way Claire died.
The same documentary also led to Claire’s dad to seek answers about his daughter’s care.
Tom Forster QC, opening the case for the General Medical Council (GMC), said a public inquiry into hyponatraemia-related deaths, including that of Claire, was subsequently announced.
In 1996, Dr Steen failed to pass on the death for coronial investigation.
Mr Forster said: “The GMC’s case is that various procedural steps were taken by her in response to Claire’s unexpected and problematic death in which she set out to conceal what she knew about Claire’s death and the clear possibility there were failings in her care.
“In other words, a cover-up was attempted by Dr Steen to avoid scrutiny.”
He said that she withheld information not just in the immediate aftermath of the youngster’s tragic death.
On March 24, Mr Forster said Dr Steen faces “a very serious allegation of dishonesty”.
The court has been asked to consider allegations, including that Dr Steen “knowingly and dishonestly carried out several actions to conceal the true circumstances” of Claire’s death, according to Mr Forster.
“The public interest can only be served if this tribunal… determines those allegations,” he added.
But also later at a hospital meeting in 2004 with Claire’s parents and again when she allegedly gave inaccurate evidence at an inquest into the youngster’s death in May 2006.
The Medical Practitioners Tribunal Service (MPTS) hearing, sitting remotely, heard Claire was sent home from school on October 21 1996 with a note from her teaching explaining she felt pale and lethargic.
Claire went on to be sick two or three times at home before the family GP was called out and later referred her to hospital.
The first doctor at hospital to see her noted her speech was “very slurred” and she was “hardly talking.”
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 court heard.
Nursing staff went on to note that her sodium levels were outside the expected range as Claire vomited on several occasions throughout the night.
Her parents saw her again the next day and did not think she looked herself.
From there, her condition continued to go downhill and she suffered a five-minute seizure at 3:10pm.
This was followed by a number of other “episodes” into the evening.
The hearing was told that a repeat blood test was not ordered earlier and consequently her fluid regimen was not being assessed.
Mr Forster said: “At some point between 9:15pm and 10:30pm, Mr and Mrs Roberts decided to go home. They did so because concerns about Claire’s condition was not communicated to them.
“They were wholly unaware that their daughter was seriously ill.”
Claire stopped breathing in the early hours of the next day and was ended up in intensive care at 3:25am.
At 4am, Dr Steen, the on-call consultant pediatrician, saw Claire for the first time.
Mr Forster said: “By 4am Claire was in reality already dead.
“Plainly this was devastating news to her parents. It must have also come as a great shock to her nurses and doctors.
“When Dr Steen came into the ICU she must have been asking how this possibly could have happened, whether there were matters to be investigated and whether or not Claire’s death raised questions about the care she received.”
He said all she knew at that stage was Claire had suffered acute hyponatraemia which had been a contributing factor to the swelling of her brain.
However, he said, later the same day she inappropriately completed a medical certificate of cause of death without reference to a confirmed diagnosis of the condition.
Mr Forster said Dr Steen had admitted in her evidence to the hyponatraemia public inquiry that she failed in her care and ought to have done things differently.
She argued though that recognition came with the benefit of hindsight and she did not actively try and cover up her actions.
The hearing continues.
The hyponatraemia public inquiry concluded in 2018 that Claire’s death was the result of “negligent care” from an overdose of fluids and medication.
A fresh inquiry in 2019 ruled her death was “caused by the treatment she received in hospital.”
George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.