Hospital inquiry told of 'unsafe' practice

to have a patient's case notes with them during ward rounds.

Mr Philip Myerscough told the inquiry into the death of 14-year-old

Lorraine McGalliard that in all the hospitals he had worked in the case

notes were readily at hand.

Advocate Adam Ardrey, representing Greater Glasgow Health Board, said:

''I would suggest to you that is not the practice across the medical

profession in Scotland, but you suggest there is an equally good

practice which involves having the notes in the ward although not always

in a doctor's hands.''

Mr Myerscough: ''I would completely reject that, and call it a shoddy

and unsafe practice.''

The inquiry at Glasgow Sheriff Court has heard earlier that a

consultant surgeon, Mr Robert Darling, did not read the medical notes on

Lorraine during morning ward rounds on Sunday, September 12, last year.

Lorraine, of Waverley Crescent, Kirkintilloch, died next day at

Stobhill Hospital, Glasgow, from septic shock and multi-organ failure

after an ovarian cyst twisted and turned.

Another Stobhill consultant surgeon, Mr Matthew Calvert, also said

earlier that he had failed to see vital information on the girl's case

notes when he examined her on ward rounds the previous Friday. He failed

to notice a grossly abnormal high white blood cell count and said he

could not explain how he missed seeing it.

Mr Myerscough, 70, formerly of Edinburgh's Royal Infirmary, who is

retired but who still lectures on gynaecology, was asked by Mr Ardrey if

it was not proper for a consultant to go on ward rounds without

patients' notes and to rely on information from a junior doctor.

Mr Myerscough replied: ''In all the hospitals in which I have worked

in the last 10 to 15 years the ward case notes were kept on a trolley so

they could readily be conducted round the ward so I would find that

suggestion contrary to my experience.''

Mr Ardrey: ''Am I to understand that you are saying that on each

occasion a consultant on ward rounds will take out the case notes

relative to each patient?''

Mr Myerscough: ''Normally and personally he would not take them, but

it would be the duty of the house doctor with him so to do.''

The inquiry was told that Lorraine was sent home twice from the

hospital in the six days before her death only to be re-admitted a third

time.

Family doctors could find no trace of a urinary infection and there

was evidence that the hospital continued to believe she had one and

ignored a junior doctor's request for an ultrasonic scan which would

have revealed the problem with the cyst.

Mr Ardrey asked, given the nature of Lorraine's case and the

diagnosis, whether a gynaecologist or a surgeon would make the decision

about surgery.

Mr Myerscough: ''The problem is that no diagnosis had been reached,

and on that basis it is impossible to assign anybody.''

Asked if surgery always depended on a diagnosis, Mr Myerscough said

that there could be circumstances where a patient was very ill and the

dianosis still uncertain when haste was of the essence.

Mr Myerscough then disagreed that in Lorraine's case she was not

''apparently ill'' and that there appeared to be no need for hasty

surgery. He said there was an urgency because of the girl's high white

cell count, the persistence of pain, and an an unusally low urine

output.

The inquiry continues.