Alastair Hosie, 39, died after out-of-hours GP advice

Published: 11 June, 2010
by JOSIE HINTON

MEDICAL advice given by an out-of-hours GP directly contributed to the death of a 39-year-old man, a coroner has ruled.

Alastair Hosie died on March 1 from a rapidly spreading bacterial infection less than 24 hours after being told by a locum doctor to stop taking antibiotics.

Mr Hosie, of St Thomas’s Road, Finsbury Park, received the advice after calling Camidoc the previous day when he became concerned he may be suffering an allergic reaction to medication he had been prescribed for a rash.

At an inquest into his death on Tuesday, coroner Dr Andrew Reid recorded a verdict of natural causes “to which the fact of stopping antibiotics contributed”.

“It’s up to the properly interested persons whether this will go further in the civil courts,” said Dr Reid.

St Pancras Coroner’s Court was told that Dr Kirmang Dabagh, an on-call doctor for Camidoc, agreed with Mr Hosie’s diagnosis of an allergic reaction and told him over the phone to stop taking the tablets. But the GP failed to prescribe alternative medication. Critically, Mr Hosie was not ­suffering from an allergic reaction, but a rapidly worsening infection and required antibiotics. He continued to deteriorate and died the following day.

The inquest heard how Mr Hosie, a senior lecturer at Imperial College London, had been mildly unwell for around 10 days, but had become concerned when a painful red rash appeared behind his right thigh while he took his two-year-old daughter swimming on February 27. He was prescribed antibiotics for cellulitis, a skin inflammation, the following morning but believed he must be allergic to them when he started to feel very unwell.

His wife Emma Dunne told the court: “He looked awful. His face was bright red and extremely puffy so I couldn’t really see his eyes. It was February but he was just wearing boxer shorts and a T-shirt and complained of being very hot. His trunk was covered in a very pink rash and he was very worried about his breathing.” 

Dr Reid challenged Dr Dabagh over how he could make a confident diagnosis over the phone and demanded to know why, if the GP believed there was an allergic reaction, he did not prescribe another antibiotic.

Dr Dabagh said he had advised Mr Hosie to see a doctor immediately and offered him an appoint­ment, which he refused. Dr Dabagh added: “To have a delay in anti­biotics is quite common if one type doesn’t work and you have to start someone on another. I thought it could be delayed until the next morning at least.”

Dr Reid said: “I find it incredible that he would not take your advice to go and see a doctor. But you’re saying that is your recollection?”

“Yes,” replied Dr Dabagh.

The inquest heard it is Camidoc’s policy for doctors to record all telephone consultations, but this was not done as Dr Dabagh believed it would be taped automatically. Mr Hosie was taken to hospital around 12 hours later. Paramedics found him with no pulse.

Giving evidence to the court, Dr Julie Andrews, a specialist on infectious diseases at the Whittington Hospital, said if Mr Hosie had been hospitalised on Sunday night, the likely outcome would have been “favourable”.