Sandipan Dhar: GP referral to Joondalup Health Campus requested blood test, hospital staff to be reinterviewed

Joondalup Health Campus doctors and nurses involved in the treatment of Sandipan Dhar will be re-interviewed after the infant’s parents rejected a range of findings in an interim report into the tragic case. Ramsay Health Care — which operates the public hospital — has also conceded Sandipan’s parents arrived at the facility two days before the 21-month-old died bearing a GP referral that specifically requested a blood test. Sandipan died of acute lymphoblastic leukaemia — a common and highly curable form of blood cancer — on March 24, two days after presenting at JHC for the first time. In the weeks before Sandipan’s death, parents Sanjoy and Saraswati insist they repeatedly sought blood tests to diagnose a long-running fever, first from Key Largo Medical Centre and then at JHC. Ramsay has launched an investigation into JHC’s role in the potentially preventable death. Hospital representatives — including Ramsay state manager Shane Kelly — met Mr Dhar and the family’s advocate, Suresh Rajan, to talk through a timeline of events on Monday. The timeline begins with Sandipan arriving at JHC shortly after 2pm on March 22, having driven to the hospital directly from Key Largo after obtaining a GP referral. Mr Dhar said that the referral requested a blood test – a fact he said Ramsay confirmed at Monday’s meeting. That was despite Dr Kelly on Friday saying medicos who saw Sandipan the Friday before he died claimed not to recall his parents ever requesting a blood test. “They acknowledged that on the referral the GP requested a blood test but said the duty doctor overruled the request based on observations of Sanidpan over a couple of hours in the waiting room,” Mr Dhar said. The timeline provide to the Dhar family indicates Sandipan was checked by a nurse on arrival – when he had a temperature of 38.4C – and provided paracetamol. Still in the waiting room, he was checked again an hour later at 3pm, when his temperature had nudged up to 38.9C. He was not assessed by a doctor until around 4.20 pm, who noted Sandipan was “crying during assessment”, had an “occasional wet cough” and was warm and pale. However, the doctor formed the view Sandipan had viral tonsillitis — the same condition diagnosed by a GP two days earlier, and for which he was already on a course of antibiotics. No blood test was ordered and the family was advised to “re-present on Wednesday, March 27th if symptoms persist”. The timeline notes the family remained at the hospital a further two and a half hours – a fact Mr Dhar said supported his version of events that they remained concerned and continued to push for a blood test. The timeline notes a consultant doctor checked Sandipan sometime between 5pm and 6pm but the full details of the examination were not documented. A nurse who checked Sandipan at 6.25pm wrote he had “settled”, his observations had “improved dramatically” and that he was “feeding well”. Discharge is recorded as shortly after 7pm, although it was “unclear who was aware of the family leaving ED and what discharge advice was given” with “no documentation of the discharge”. The timeline says both the resident medical officer – a junior doctor – and the primary nurse involved in his care were tied up with other patients at the time Sandipan allegedly left the hospital. The consultant doctor was on a break and only informed Sandipan had left when they returned. Mr Dhar said it was suggested to him the family had simply walked out of the hospital without telling anyone – which he strongly rejected. “I said very clearly to them that was a very wrong and false statement,” he said. “We had been waiting for six hours and didn’t feel like we were listened to properly. Why would we leave the hospital without telling them?” Mr Dhar has previously said the consultant doctor had to assure his wife on three separate occasions that Sandipan was fine and the family should go home before they finally left. Sandipan’s second presentation to JHC – on the evening he died – is also documented in the timeline, revealing staff confronted with his rapid deterioration initially believed he had sepsis. The little boy arrived at the hospital shortly after 8pm on March 24 and rapidly declined. His time of death – a mystery to his parents for more than 9 weeks – was recorded as 10.38pm. Mr Dhar said Monday’s meeting was an opportunity for his family to provide input into Ramsay’s ongoing investigation, which to that point was solely on the recollections of medical staff. “They said some of the doctors and nurses may have forgotten (certain events) and they are now going to re-interview some of the doctors and nurses who were on duty,” Mr Dhar said. He said the family were told Ramsay did not intend to report any of the health workers involved to the Australian Health Practitioner Regulation Agency, which is responsible for oversighting the conduct of individual clinicians. The Dhar family is considering lodging those reports itself, both against staff at JHC and GPs who saw Sandipan in the days and weeks before his death at Key Largo Medical Centre.