Confidential enquiry into postneonatal deaths, 1964-1966.

  • Great Britain. Department of Health and Social Security.
Date:
1970
Catalogue details

Licence: Public Domain Mark

Credit: Confidential enquiry into postneonatal deaths, 1964-1966. Source: Wellcome Collection.

    29/76 (page 21)
    be taken into account in considering the proper management of the infant who is ill. TABLE 4.4 Avoidable factors attributed to parents in 187 deaths Parental factor No. | % of total factors* Mental subnormality, instability or notable low intelligence 18 it Neglect 1] 1] = Incompetence or inadequacy 29 28 Failure to summon medical aid 26 23 Failure to appreciate seriousness of the situation 17 16 Wilful neglect 3 8) Avoidable factors attributed ot general practitioners Of the 187 deaths in which there was deemed to be some avoidable factor, general practitioners were involved in 38 instances, either solely or in association with other factors. It is well appreciated that the general practitioner is at greater risk in this matter than those in other services. As the family doctor he is the point of first medical contact with most sick children, whether mildly or severely afflicted and with overt or hidden manifestations of disease. The total demands of his practice may make it difficult for him to provide the frequent visits for effec- tive oversight which he may desire to make and he may have no direct support to help him in his task. The details in Table 4.5 and the subsequent narrative dealing with specific situations must be read with this background in mind. Again the first three of the categories in the table shade into each other; taken together these factors, which depend upon a clinical appreciation of the situation, account for 78 per cent of the avoidable factors attributed to general practitioners. The term “‘slowness in reference to hospital’? has been used where the general practitioner was seeing the sick infant over an appreciable period of time. In two of these instances the child died of broncho-pneumonia. One case had been under the care of the general practitioner on account of respiratory infection of a fluctuating and relapsing character over several weeks. In the other the child had been visited daily by the family doctor for two weeks before being sent to hospital; in this case there were other concomitant respiratory infections in the crowded household and it seems likely that benefit would have accrued from