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Man with type 1 diabetes died on holiday without a correct diagnosis

DCUK NewsBot

DCUK NewsBot

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A man who was newly diagnosed with diabetes and died while on holiday was not warned about how serious his condition was, an inquest has heard. Shaun Dobinson, from Washington, Tyne and Wear, was aged 21 when he died in New York in 2016. He suffered two cardiac arrests caused by complications of his condition. A post-mortem examination found he died due to diabetic ketoacidosis (DKA), a condition that develops when the body starts to run out of insulin. Prior to this, the former engineer had visited his GP, Dr Nandu Bhatt, as he suspected something was not right. He had been experiencing an unquenchable thirst and frequently needed the toilet; two significant symptoms of diabetes. He already knew of type 2 diabetes because both his mother and grandmother had been receiving treatment for the condition. A blood test at the doctors confirmed Mr Dobinson had diabetes, but a urine test was not carried out to determine whether he had type 1 diabetes or type 2 diabetes. When asked why a urine test was not conducted, Dr Batt, of Victoria Road Health Centre in Tyne and Wear, said: "I realise now it was a mistake. It was important but somehow it slipped my mind at the time." Mr Dobinson had been given metformin, usually prescribed to lower blood glucose levels in type 2 diabetes, and referred to a diabetes clinic. His sister, Kirsty - who claims she was with her brother at the time - told Sunderland Coroner's Court that he asked the doctor if he could still travel to the US to celebrate his birthday. Dr Batt told the hearing he was never made aware of Shaun's travel plans and if he had been told, he would have advised him to postpone it. Mr Dobinson's sister added that the doctor appointment was one of her final memories of her brother and she was certain he had told Dr Bhatt about the holiday because he was so excited and there was "no-one he had met that didn't know". The hearing continues.

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This young man's age should have been a red flag for T1. I know that the age of people being diagnosed with T2 is falling but further tests tests should have been ordered and a urine test can be done within minutes at the Practice. This is medical negligence and the doctor in question has no defence.
This lad hadn't even begun to experience adult life yet and the doctor should shoulder full responsibility for his death.
 
I'm not sure how the urine test would diagnose type 1 or 2 unless they mean testing it for ketones? I am surprised this hasn't happened more often because for most people they seem to hazard a guess at best when seeing a person with symptoms of diabetes for the first time. It mostly seems to depend on your age and how fat you are. I would love to know more about what he was told to do or not do whilst he was 'waiting' for the result. There does seem to be at least a weeks gap between first seeing the Dr and then getting some actual tests, that week is crucial to any type 1 (or sometimes type 2s) who may slip into DKA without any idea of what it actually is. Such a sad story and so pointless and unnecessary.
 
KK123 said:
I'm not sure how the urine test would diagnose type 1 or 2 unless they mean testing it for ketones? I am surprised this hasn't happened more often because for most people they seem to hazard a guess at best when seeing a person with symptoms of diabetes for the first time. It mostly seems to depend on your age and how fat you are. I would love to know more about what he was told to do or not do whilst he was 'waiting' for the result. There does seem to be at least a weeks gap between first seeing the Dr and then getting some actual tests, that week is crucial to any type 1 (or sometimes type 2s) who may slip into DKA without any idea of what it actually is. Such a sad story and so pointless and unnecessary.
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Is was a great tragedy, as a young person'r life was put in danger by a medical professional who should of done the basic checks and tests, so therefore the young man lost his life. It does make me sad and angry too.
 
KK123 said:
I'm not sure how the urine test would diagnose type 1 or 2 unless they mean testing it for ketones?
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I would say that was exactly what it was for - it was used on my diagnosis to determine ketones were present before sending me off to A&E.

I agree it's a very sad story for the sake of an extra test which could have gotten this young man the correct treatment.
 
Guzzler said:
This young man's age should have been a red flag for T1. I know that the age of people being diagnosed with T2 is falling but further tests tests should have been ordered and a urine test can be done within minutes at the Practice. This is medical negligence and the doctor in question has no defence.
This lad hadn't even begun to experience adult life yet and the doctor should shoulder full responsibility for his death.
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I would add that as people are infallible checks should be put into place that PROMPTS the doctor to call for all tests that should be carried out. Having to actually check a box to say a urine test has been requested/completed would totally avoid the possibility of "forgot".
 
db89 said:
I would say that was exactly what it was for - it was used on my diagnosis to determine ketones were present before sending me off to A&E.

I agree it's a very sad story for the sake of an extra test which could have gotten this young man the correct treatment.
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Although of course keytones do not prove type 1. Type 2 can also have DKA. I went to A&E with keytones of 8 in my urine that I tested at home then thought "um, I better get help!". However I am type 2 not type 1. Some did wonder if I was T1 instead but as the glimepiride is working, and wouldnt if I was T1 - I am pretty confident in my diagnoses.

Regardless of diagnoses however a urine test would have been one more thing to check - and the presence of keytones in any large amount should ALWAYS be looked at. For me, they kept watching me for 4 hours in A&E taking readings several times before they eventually sent me home. It's impossible to say that a urine test would have saved this guys life - but there is a very good chance it would have.
 
timgil said:
I would add that as people are infallible checks should be put into place that PROMPTS the doctor to call for all tests that should be carried out. Having to actually check a box to say a urine test has been requested/completed would totally avoid the possibility of "forgot".
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I think you mean fallible.
 
OMG!
His poor family.
A young man enjoying his life and now gone.

RIP

He died in 2016 so I'm hoping it has had a thorough investigation.
So sad. :(
 
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