My brother Bernard was born with Downs Syndrome but apart from a slight speech impediment he led a full and active life. Bernard was always lively and outgoing and loved to socialize, he attended Oldham College and was an avid gardener. Bernard lived with our sister Pat and stayed with our family at weekends and in the holidays. We always looked forward to Bernard's visits, he was outgoing and full of fun and was much loved by all the family.

Bernard came to stay with us in May 1997 while Pat went into hospital. On the 28th May Bernard complained of pain in his groin and a headache, he also mentioned he had banged his head recently. He had no appetite, was very lethargic and was unsteady on his feet. I was very concerned and took Bernard to the Accident and Emergency Department at Hope Hospital, Salford. He was examined by a doctor who checked his eyes, took his temperature and tested his urine, which was clear. She then said Bernard had an infection and told us to take him home and give him paracetomol. I was still concerned and asked the doctor to check Bernard again, she repeated whatever was wrong with him was not serious and to take him home.

When I went to wake Bernard on the morning of May 30th he still wasn't feeling well and I left him in bed. I kept checking him throughout the morning and at about 1.30am he had a temperature of 38 degrees. I went to get him some water and paracetomol but when I returned I couldn't waken him. My daughter Joanne stayed with Bernard while I called an emergency ambulance. Again Joanne and I went with Bernard to the A&E department at Hope Hospital. On reaching the hospital Bernard was unconscious and was taken to the resuscitation area where he was attended by Registrar Dr Jundi and Consultant Mr Sammy. Bernard had a degree of neck stiffness and a marked weakness of the left side. Dr Jundi ordered blood tests and a CT scan. The CT scan was clear and Dr Jundi considered several possible diagnoses, including meningitis. Bernard was then started on an antibiotic drip of benzyl penicillin, the drug of choice for meningitis. Mr Sammy supported Dr Jundi's assessment but neither doctor recorded this in Bernard's notes. Dr Jundi then told us that they would be admitting Bernard for a Lumber Puncture and that the sister would tell us what ward he was going on. Both doctors later stated that at this stage Bernard appeared quite seriously ill and they assumed that he would be admitted to the hospital. Although we stayed with Bernard throughout both attendances at the hospital the staff never discussed their findings with us or mentioned the fact that they suspected meningitis.
All the family had had close contact with Bernard including my baby grandson of just three months old yet hospital staff offered us no antibiotics or protection against the disease and left all the family at risk.

Later a doctor tried unsuccessfully to catheterise Bernard, and as Bernard was so ill she said she would get someone more senior to attend him. She returned sometime later with Dr Elaine Smith. Dr Smith asked Bernard to lift his head, she then tilted his head forward as Bernard was now semi conscious and could not do it himself. Dr Smith then suggested that Bernard could have had a small fit made worse by his condition and we explained to her that Bernard did not suffer from fits. Dr Smith then told us we could take Bernard home. My brother and I were astonished as Bernard was still semi conscious, could not move properly and was obviously seriously ill. We argued that we couldn't possibly take Bernard home in that condition and she said "we should be grateful that all his tests had come back clear" and repeated that we should take Bernard home, she then walked out. Staff nurse McKenzie, who had attended Bernard earlier, came to ask us what the doctor had said. She was shocked that Bernard was being discharged and she went to speak to Dr Smith. She told the doctor that she was concerned that Bernard was still unable to move his left side and that we were unhappy with the decision to discharge him as he still couldn't communicate normally. Dr Smith repeated that she could find nothing wrong with Bernard and Nurse McKenzie returned to the resuscitation room telling both a senior nurse and second registrar that she "couldn't believe they were sending that man home". Bernard was still only semi conscious and it took the staff nurse, a nursing sister and myself to put him in the wheelchair. The following morning Bernard was still very ill and as we now had no confidence in Hope Hospital we took him to Royal Oldham Hospital where he was admitted immediately. Bernard was given a lumbar puncture and diagnosed with meningitis. This was the first time meningitis was mentioned to us and on the evening of Saturday 31st May, Royal Oldham Hospital rang us to say everyone who had had contact with Bernard must attend the hospital to start a course of antibiotics. Bernard was the transferred to Crumpsall Hospital to remove fluid from the brain and sadly died a week later on June 8th.

An Ombudsman investigation found that the majority of the staff at Hope Hospital had made errors and omissions in their records concerning Bernard. The Ombudsman went on to say that Bernard had to wait some hours before being seen by Dr Smith and this wait could not be justified. Dr Smith's notes referred to a rash, photophobia and neck movement indicating that she was looking for signs of meningitis. Bernard had been given the choice drug for meningitis and his neurological chart had shown that at 5.20am he was still confused and had persistent left-sided weakness. Even with all this evidence and despite the protests of both the staff nurse and ourselves, Dr Smith still insisted that we take Bernard home. The Ombudsman noted that where meningitis is suspected the accepted protocol is to prescribe Benzyl penicillin as an initial response. He was advised by his assessors that a registrar with Dr Smith's experience should have been aware of this and he criticised Dr Smith for her actions. The Ombudsman concluded by saying:

"My detailed findings in this case represent a disturbing account of system failure, poor recording and clinical judgement below that which a patient has a right reasonably to expect. The patient in this case was disabled and was badly let down by medical staff and by the procedures in force at the time. I am unable to say if matters had not taken the course they did; Mr Waugh might have survived".

We firmly believe that Dr Elaine Smith treated Bernard differently and did not take his condition seriously enough because he had Down's Syndrome. From the very beginning Dr Smith showed a complete lack of care or compassion for either Bernard or ourselves. She appeared abrupt and uncaring and spoke down to Bernard as if he were a child instead of a grown man using terms such as 'belly button' for his navel. At one stage she even suggested that Bernard might be ill because he was missing his carer, this is an insult. If Dr Smith attended someone who presented with signs of meningitis and was as seriously ill as Bernard obviously was, but who had no disability, I'm sure she would not suggest they were so ill because they missed someone.

We believe Bernard would have lived had he received the correct diagnoses and appropriate treatment from Dr Smith, we will never know for sure but at least we would know he was given the same chance as anyone else. Although the Ombudsman Inquiry found Dr Smith's decision to discharge Bernard was inappropriate she has not been disciplined and is still working as a doctor. We have lost a loving, caring, trusting brother and it is our opinion that Dr Smith discriminated against Bernard because he had Down's Syndrome. Bernard's death was unnecessary and Dr Elaine Smith should be struck off the medical register and not be allowed to carry on practising medicine.