The High Court has dismissed a clinical negligence claim brought by Maria Afolabi against SouthDoc Services Limited and GP Dr Rachel Finnegan over the treatment she received before suffering a perforated appendix.
Afolabi was 11 when she attended SouthDoc on December 13, 2017 after developing abdominal pain, vomiting and later diarrhoea. Dr Finnegan examined her, recorded a soft abdomen with mild general tenderness but no rebound tenderness or guarding, and made a working diagnosis of likely gastroenteritis.
Afolabi and her mother later alleged that appendicitis had been dismissed and that she should have been sent immediately to hospital. Dr Finnegan disputed that account. Her contemporaneous referral letter recorded “Cave appendicitis”, meaning appendicitis remained a possible diagnosis, and her notes stated that red-flag advice had been given together with a referral letter for use if the child's condition deteriorated.
The plaintiff's condition did worsen over the following days. She was taken to Cork University Hospital on December 16 and later underwent surgery for a perforated appendix. Complications included infection, a prolonged hospital stay and permanent abdominal scarring.
Ms Justice Leonie Reynolds preferred Dr Finnegan's contemporaneous records on the disputed issues. The court found that the initial gastroenteritis diagnosis was reasonable and accepted expert evidence that GPs are entitled to use careful “watchful waiting” rather than automatically referring every patient where appendicitis cannot be completely excluded.
The judge also accepted that appropriate safety-netting advice had been provided and found that the plaintiff's mother did not act on it when the child's condition deteriorated.
The ruling also addressed causation. The court found that, even if Afolabi had attended an emergency department on December 13, she would probably have been investigated and discharged with similar advice. On the balance of probabilities, presentation on December 14 or 15 would have avoided the later laparotomy and its consequences.
The negligence claim was dismissed, with costs awarded to the defendants.