An out-of-hours phone GP service made “serious failings” which partly led to the death of a teenager with type 1 diabetes, a coroner has ruled.
Two phone calls were made in February 2012 about Sammy-Jo Boyce’s health as she was in bed feeling drowsy, drinking lots of water, vomiting and breathing rapidly.
The 19-year-old from Swansea, who was diagnosed with type 1 diabetes in 2010, had also been ill with a chest infection the previous week.
Dr Nitin Gupta and Dr Tity Tiju, who took the calls, failed to spot the signs of diabetic ketoacidosis (DKA), a potentially life-threatening condition caused by a lack of insulin in the body.
Ms Boyce passed away the next day at Morriston Hospital.
Evidence was given during the inquest which said both doctors had carried out proper examinations, but independent expert, Dr Stephen Hicks, said: “In my view out of hours services should ensure that doctors and nurses have some training in telephone consultations; you have to ask more questions because you can’t see them face to face.”
Dr James Ahlquist, an Endocrinology in Southend-on-Sea, Essex, told the inquest it was his belief that had Ms Boyce been referred to hospital sooner, it was “likely that DKA would have been diagnosed and it is my opinion that she would probably have made a full recovery”.
Swansea’s acting senior coroner, Colin Phillips, said: “This terribly sad case highlights the need for GPs to be adequately trained in telephone consultations and specifically in recognising the warning signs of diabetic ketoacidosis in type 1 diabetics and also for the family of such patients to be made aware of the warning signs and required action.”
Vomiting, rapid or deep breathing, dehydration and an unusual smell on the breath are some of the primary symptoms of DKA; a serious medical emergency that requires immediate treatment.

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