10/24/2016 - Death of 10 year old girl with viral infection: Expert witness says doctors acted appropriately.

A child who died from complications arising from an undiagnosed herpes infection was suffering from an unusual case and all medical practitioners who assessed her acted "appropriately", a doctor has told an inquest into the girl's death.

Briony Caitlin Klingberg, 10, died from organ failure in January 2015 after contracting a herpes infection.

The Coroners Court has heard Briony was very poorly for almost a week before her death, was vomiting and had sores on her throat.

It heard that despite multiple doctor and hospital visits, the herpes virus was not diagnosed and she was repeatedly sent home.

The inquest previously heard one doctor thought she may have had glandular feve while another, who saw her later, thought she had a cold.

Dr Peter Joyner, who was called as an expert witness, has told the inquest it was a rare case.

"In retrospect it's always easy to see things better. I think each person who has come across the situation has handled it appropriately within the context of the situation they were presented with," he said.

"A normal healthy person, in the experience of all doctors, with an infection would deal with it, and the body gets it out and it subsides and goes away."

He said after reviewing the medical notes he formed the opinion the GPs who saw her had made a "very good, comprehensive" examination.

"I think unfortunately Briony had a very difficult, unusual situation which was so different to normal that really, if you look at it openly, no particular doctor at any one time would have handled it differently when faced with the situation," he said from outside the court building.

Dr Joyner also answered questions raised during the inquest about whether the use of steroids to treat the child may have exacerbated or accelerated her condition.

"The use of steroids is very frequent and this is the only case I know that has been reported and yet steroids are used hundreds if not millions of times a year," he said.

"HSV [herpes simplex virus] is the commonest virus infection we all have and the coincidence of this happening in this way I think shows us it was an unusual, unique event.

"We don't know why but I don't think you can link one with another, the same as if you said was the Panadol a cause. Well no, Panadol is used millions of times."

Dr Joyner said the case reinforced the need for medical practitioners to investigate a child's illness further if that child kept presenting for multiple visits.

"The one factor that stands out is when a child appears unwell and they need to see several doctors frequently," he said.

"It may not have helped Briony. By the time it would've been achieved towards the end of the last week of her life, I think the die had already been cast unfortunately.

"But that's perhaps the one learning that we can have - is to say always be careful when a child is presenting for another opinion and they have already seen other doctors because there may be something very unusual going on."



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