Death of Katie Wilkins prompts call to address national shortage of haematologists
A coroner has written to Health Secretary Sajid Javid to ask him to take action to address a national shortage of haematologists following the death of 14-year-old Katie Wilkins.
Posted on 31 May 2022
Katie, of Warrington, died following a catastrophic bleed on the brain at Alder Hey Hospital in Liverpool, after she was not given the blood clotting product fibrinogen concentrate prescribed by a haematologist as part of a treatment plan. Katie had recently been diagnosed with a rare form of leukaemia called Acute Promyelocytic Leukaemia (APML), which put her at a serious risk of bleeding and her blood levels required regular monitoring.
However, despite APML being a haematological emergency, Katie’s lead consultant was an oncologist, who, an inquest heard last week, did not have the knowledge or experience of the management of the early stages of APML. Failures in handover and communication between the haematology and oncology teams meant that she was not given the fibrinogen concentrate when her fibrinogen levels fell below 1. When she complained of a headache on her second day at Alder Hey Hospital on 29 July 2020, it was not recognised as a symptom of a haemorrhage. Shortly afterwards Katie collapsed and was found to have suffered a bleed on the brain. Urgent surgery failed to help and she had to be put on life support. She died two days later.
In her prevention of future deaths report, to which Mr Javid has until 21 July to respond, assistant coroner Kate Ainge says.
The inquest has highlighted an ongoing concern that oncology consultants will continue to be the lead consultants for care of APML patients at Alder Hey Trust.
The most significant risk of death in such patients is due to the risk of serious bleeding due to the associated and significant coagulopathy.
Coagulopathy management should be led by a haematologist to prevent future deaths due to this issue, that was recognised by a consultant haematologist who gave evidence to the inquest as an expert witness and was supported by a leading Haematologist at the Trust.
There is nationally a shortage of haematologists which leaves Alder Hey Trust without resources available to them to address this matter of concern or to recruit.
The care of APML patients at Alder Hey is managed as part of a cross-over system between haematology and oncology specialities. At Katie’s inquest, expert witness Dr Cathy Farrelly said it was almost unheard of for an oncologist to manage APML patients. Alder Hey haematologist Dr Keenan said he had raised his own similar concerns to the Trust after Katie died. However, the coroner heard that due to national issues in recruiting haematologists, Alder Hey Trust decided to keep the same arrangements in place.
Following the publication of the prevention of future deaths report, Katie’s parents Jeanette Whitfield and Jonathan Wilkins said:
“It has been incredibly difficult to come to terms with Katie’s death over the past two years. The evidence that we have listened to in court from the specialist consultants stating that the care of our daughter should have been under the care of a haematologist, and that our beloved daughter would be here today if she had received that care is devastating. As parents we are incredibly angry and will continue to raise this issue so that future families will not have to go what we have.”
Leigh Day solicitor Julie Struthers, who represents the family, said:
“It is worrying that nearly two years after Katie died, there is still an ongoing concern that children with APML may not receive care from the correct speciality of doctor. I am pleased that the coroner has recognised this, and that it will be addressed at a national level to ensure that this tragedy will not happen to another child and their family.”
Julie Struthers is an associate solicitor in the medical negligence department.
Coroner rules death of 14-year-old Katie Wilkins was contributed to by hospitals’ neglect
The inquest into the death of 14-year-old Katie Wilkins, from Warrington, has ruled that neglect by Warrington General Hospital and Alder Hey Children’s Hospital contributed to her death. Assistant Coroner Katy Ainge has also issued a Prevention of Future Deaths report addressed to the Secretary of State for Health expressing her concerns about the national lack of funding for paediatric haematology specialists.