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The mum of a 15-year-old girl who died after her blood sugar meter gave false readings did not know batches of the equipment used had been recalled, an inquest heard.
Herne Bay High School pupil Rosie Umney – a type 1 diabetic – went into cardiac arrest and died hours after she was told by Dr Sadaf Mangi she had an ear infection.
She was taken to the GP’s William Street surgery on Monday, July 2, last year after displaying some of the symptoms of ketoacidosis – vomiting, hyperventilating and struggling to walk.
The doctor had previously said that she initially thought Rosie could have had the illness after learning she was a type 1 diabetic. But she thought otherwise after Georgina Umney said her daughter’s blood sugar readings had been normal that day.
An ambulance was called to the schoolgirl’s home in South Road that night after Ms Umney was unable to wake Rosie.
A paramedic tested two samples of Rosie’s blood from her earlobe and finger. Her sugar levels were so high that his machine – and another he borrowed from a colleague – was unable to provide a reading.
The paramedic later used Rosie’s meter himself, which again returned a safe readings of 7.8 and 8.6 millimoles per litre.
In a statement read to the inquest into her daughter’s death, Ms Umney said she did not know the readings could be wrong.
“When the paramedics tested Rosie’s blood I did not know what it meant,” she said.
“I then found out thousands of strips had been recalled. Nobody had ever told us the results could be wrong.”
Dr Abigail Price, from the East Kent Hospitals Trust, told the inquest at Canterbury Coroners’ Court that Rosie had missed doctor’s appointments, with the last being one week before her death.
But Mrs Umney said: “On a couple of occasions appointments had to be rescheduled and so Rosie could not go.
“On other occasions, Rosie did not want to go because she was very studious [and did not want to miss school].”
Two months before her death, batches of the test strips similar to the ones Rosie was using were recalled by their manufacturer Roche Diabetes Care because it was thought they could provide inaccurate readings.
Dr Price had carried out tests, which were overseen by the police, on the 15-year-old’s meter in September. She said the checks had revealed the machine was “in working order”.
“I can only make an assumption that it might have been the strips,” the paediatrician added.
“I can’t think of any other explanation. It’s highly unusual – we haven’t come across that before.”
Quality control tests were not carried out on the strips because by this time they had passed their expiration date.
Also, none of the equipment was sent to Roche for it to carry out its own checks.
Dr Mangi had not followed two sets of guidelines – regarding diabetes and sepsis – published by the National Institute for Health and Care Excellence (Nice), a previous inquest heard. They state a patient should be referred to hospital if they display symptoms such as shortness of breath, sickness and high temperatures.
“If Rosie had gone to hospital at that point, could her life have been saved? It’s a possibility, however there’s a possibility the outcome might have been the same,” Dr Price said yesterday.
“She would have had treatment if Dr Mangi had sent her to hospital, but I can’t say that she would have survived.
“This is a very unusual situation for a person of this age to be this unwell.
“It made a more than a negligible difference to her chances not being at hospital at that time.”
Coroner James Dillon adjourned the inquest to decide if neglect contributed to Rosie’s death.
He said he expects to have it written and sent to Rosie’s family and Dr Mangi within the next seven days.
