Boy (14) was so ill I thought he was going to die in front of me - GP tells inquest
A Derry GP feared her 14-year-old patient was so gravely unwell he was going to die in front of her before he could be transferred to Altnagelvin Hospital, an inquest has heard.
Dr Karen Connolly was giving evidence at the inquest into the death of Orin McBride, from Strabane Old Road in the Waterside area of Derry.
Orin, who had a complex medical history of hydrocephalus, epilepsy and global developmental delay, died at the Royal Belfast Hospital for Sick Children (RBHSC) on June 28, 2015, from pancreatitis.
Dr Connolly told the inquest sitting in Strabane that she was contacted on June 16 by Orin's mother, Majella McBride, who told her Orin was unwell and was having difficulty breathing.
Dr Connolly advised Ms McBride to call an ambulance and get her son transported to Altnagelvin.
However, Ms McBride said she wanted her son taken to Belfast where the medical team who had been providing long-term care for Orin was based.
Dr Connolly said Ms McBride ended the phone call rather abruptly, which left her feeling uneasy, so she decided to visit the family home and see Orin, and was "very alarmed at his appearance".
Dr Connolly was asked by counsel for the Coroner, Patrick McGurgan, if she thought Orin could have survived the journey to Belfast, which was in line with his mother's wishes and in accordance with a care plan put in place when the boy had been discharged from RBHSC a month earlier.
Dr Connolly said "definitely not" and added: "He (Orin) needed urgent medical care. I took a medical decision based on his best interest and went against her (Ms McBride) wishes.
"I felt I needed to get him to the nearest hospital for stabilisation. I didn't think he would survive a journey to Belfast.
"I feared he may not make it to Altnagelvin because he was so gravely unwell. I thought he mightn't survive while I was in the house."
Orin remained in Altnagelvin hospital for three days until a bed in a medical ward at RBHSC became available.
Orin's condition continued to deteriorate after he was admitted to the paediatric Intensive Care Unit at RBHSC until June 28, when a decision was made to withdraw life support.
Earlier in the inquest, Ms McBride gave evidence that she did not consent to this decision and denied saying that Orin had "fought long enough, just make him comfortable".
Dr Sharon Christie, who was one of two doctors in the room with Ms McBride when the 'end of life' discussion took place, told the inquest it had been made clear throughout the day to Ms McBride how unwell her son was.
Dr Christie said she felt it had been communicated to his mother "that there was nothing else we could do and that on this occasion we were at the point of no return".
She said the decision was made to "not actively intervene" and "not actively resuscitate" Orin and that Ms McBride understood and consented to this.
She told the court she was a fairly direct person, and had said: "Your son isn't going to pull through."
Mr McGurgan asked Dr Christie if she was sure Ms McBride knew it was end of life and she was seeking her consent, as that issue was being disputed by Ms McBride.
Dr Christie there was another doctor and two nurses present at the time and she had asked Ms McBride if she understood, if she had any questions, and then arranged for a priest to come.
Dr Christie told the court she wrote her notes on the meeting as soon as Ms McBride left the room to go and be with her son, so she was clear in what had been said by Ms McBride.
Dr Christie also said the ventilator would not have been removed from Orin, as Ms McBride had said in her evidence, because that wasn't part of the process of withdrawing life support.
The inquest continues.