A doctor who sought to cover up the cause of death of a nine-year-old patient has been struck off the medical register.
The parents of Claire Roberts were told at the time a viral infection had spread from her stomach to her brain and that medics had done everything possible to save her.
But a television documentary, UTV’s When Hospitals Kill – broadcast in October 2004 – raised concerns about the treatment of a number of children who had died from hyponatraemia, which occurs when there is a shortage of sodium in the bloodstream.
Following the screening, a public inquiry was announced as Alan and Jennifer Roberts sought answers from the Royal Belfast Hospital for Sick Children about the care of their daughter, who died in October 1996.
On Friday, a Medical Practitioners Tribunal Service panel decided that the appropriate sanction for Dr Heather Steen was erasure after it earlier found her fitness to practise was impaired.
Fellow practitioners would consider Dr Steen’s behaviour in seeking to cover up the cause of Patient A’s death to be deplorable— Sean Ell
The tribunal accepted that Dr Steen, now retired, was “not attempting to conceal details of, or failings in, Patient A’s care in 1996/97, when she believed there was a viral cause of death”.
However, she persisted with her focus on a viral cause once fluid and electrolyte mismanagement became a “live issue” from 2004 and “continued to emphasise this aspect whilst seeking to downplay, qualify and minimise or ignore findings to the contrary”.
Tribunal chair Sean Ell said this “misrepresentation” continued through the consultant paediatrician’s involvement with Claire’s parents, at a coroner’s inquest – ordered after the documentary screening – and the public inquiry itself.
Mr Ell said: “Dr Steen had many opportunities to reconsider and be open and transparent, but chose to maintain her dishonesty over the course of events after 2004.
“Whilst the failings may not have changed the tragic outcome of Patient A’s death, her parents were seeking answers to what happened and were entitled to full transparency.”
He later added: “The tribunal determined that public confidence would be undermined if, knowing all of the circumstances of this case, a finding of impairment was not made.
“Fellow practitioners would consider Dr Steen’s behaviour in seeking to cover up the cause of Patient A’s death to be deplorable.
“Honesty and integrity are key to public confidence in the medical profession and the tribunal determined that a finding of current impairment was necessary in order to maintain public confidence in the profession and to uphold proper standards of conduct and behaviour in the profession.”
The tribunal also found Dr Steen’s failure to report the sudden and unexpected death of a child in hospital to the coroner “fell seriously below the standard expected”.
It judged that her inappropriate completion of Claire’s death certificate also amounted to serious misconduct.
Dr Steen denied the allegations but did not give evidence.
The tribunal noted that Dr Steen accepted at the public inquiry that there had been mistakes in Claire’s care and had apologised to her family.
It also noted “numerous positive testimonials provided on behalf of Dr Steen that spoke both to her skills as a clinician and the manner in which she dealt with patients and parents, in often difficult circumstances.”
But Mr Ell said: “The tribunal considered that it had insufficient evidence to fully assess Dr Steen’s insight and so, notwithstanding the passage of time and positive testimonials, it could not therefore rule out the risk of repetition.
“It was satisfied that Dr Steen, through her dishonesty, had failed to maintain the high standards expected within the profession, and her conduct is incompatible with continued registration as a doctor.”
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 inquest in 2019 ruled her death was “caused by the treatment she received in hospital”.
