A Melbourne mother who sought medical treatment for her toddler six times before the child died of septic shock has told an inquest that her pleas for antibiotics and further tests were ignored and that she was made to feel like an “overly concerned parent”.
The Victorian coroners court on Monday began an inquest into the death of Dio Kemp, three, who died after she was taken to Monash Medical Centre four times and to her GP twice over eight days in late 2019.
Her mother, Miranda Jowett, told the inquest that she first took her daughter to the emergency department on 21 November. Dio had been suffering from a fever and diarrhoea for several days and had developed a facial rash that spread from her eyelids across her forehead and cheek.
The inquest heard Dio, who had Down’s syndrome, was diagnosed with viral urticaria – or hives – and discharged from the hospital.
“They just said she has a virus … and they just told me to take her home and give her Panadol and Nurofen, keep her fluids up,” Jowett said.
The following day, Jowett took Dio to Monash’s rapid review clinic, where she was given the same advice. But as Dio’s face began to swell and her temperature soared to 40.5C, they returned to hospital in the evening.
Jowett said she told staff her daughter was “even worse” than the previous day and sought clarity about her condition.
“I just didn’t understand about the virus. I wanted to know what was going on, what’s wrong with her,” she told the inquest.
“I wanted blood tests and I did at some point ask for antibiotics. They told me it wasn’t necessary … it’s not effective for viruses.”
Dio was sent home, with a second appointment booked for the following day at the hospital clinic, where she was again recommended Panadol as well as allergy medication.
Three days later Jowett took Dio to her GP, as her fever was yet to break. The GP said if she was not better by the following day to return or go to the emergency department.
Jowett told the inquest that the GP did not offer to run further tests. Instead, he printed out information from the Royal children’s hospital about how to manage fever and gastroenteritis.
“These are things that I already knew as a mum,” she said.
On 28 November she returned to the GP as Dio’s hands felt swollen and hard.
“He said that was the urticarial rash just moving around in other parts of the body and he didn’t seem to be concerned,” she said.
Dio woke up crying at 2am the following morning, the inquest heard. Her forearms and hands were “totally rock-hard swollen”, Jowett said, and her heart was racing.
The infant was taken to hospital by ambulance but by the time she arrived at the emergency department she was in cardiac arrest. She could not be resuscitated and died of sepsis.
“They were doing chest compressions on her little body and I asked them to continue, to not stop, but of course it was too late and she passed away,” Jowett said.
Jowett told the court throughout her interactions with medical professionals, she was made to feel as if she was being an “overly concerned parent”. She said every time she asked about blood tests and antibiotics, she received resistance.
“I felt that each time I presented with Dio I kept asking that question [about antibiotics] to a different variety of doctors – it wasn’t just one doctor – and their continual answer to that was that it’s a virus, antibiotics is ineffective for a virus,” she said.
“I guess I agreed and accepted what I was told by professionals … and took her home. Deep down I felt that she really did need antibiotics. I knew there was something wrong.”
The inquest, led by coroner Paresa Spanos, will examine if Monash complied with guidelines requiring patients who were readmitted within 72 hours to be reviewed by an emergency department consultant – or if they were unavailable, two senior registrars. The guidelines also require readmitted patients to have their working diagnoses re-evaluated.
The guidelines were introduced in 2018 after two-year-old Lachlan Black died of septicaemia at the Monash’s emergency department in 2014. Lachlan’s death was also investigated by the coroners court.
Outside court, Jowett told reporters that Dio’s death had forever changed the lives of her and her son, Jayden, who was 12 when his sister died.
“The joy within our household is gone. I have missed out on the life I envisioned with her. It’s just not fair,” she said.
“No parent is ever prepared to lose a child like this. She is missed by us and so many. She was the most joyful and loving little girl with a vibrant little personality to match.”
