Eye specialist accused over 'preventable' death of eight-year-old boy
The death of an eight-year-old boy could have been prevented if an eye specialist had "done her job properly", a court has heard.
Vincent Barker, known as Vinnie, died on July 13 2012 - around five months after he was taken to have a routine eye test at Boots the Opticians in Upper Brook Street in Ipswich, Suffolk.
The conduct of locum optometrist Honey Rose, 35, fell so far below the standards expected that it was "criminal", prosecutor Jonathan Rees QC said.
Rose, from Newham, east London, is charged with gross negligence manslaughter.
Mr Rees told Ipswich Crown Court: "The prosecution allege that Vinnie's death was preventable and would have been prevented had the defendant, Ms Rose, done her job properly."
Jurors heard that post-mortem examinations showed the cause of death was hydrocephalus - a build-up of fluid in the brain which led to an increase in pressure within his skull and, ultimately, his collapse and death.
They were told that Rose owed a duty of care to her patients and this included a duty to carry out a competent examination of the eye and a duty to make an urgent referral if any injury or disease was detected.
Mr Rees said: "At the heart of the prosecution case against the defendant is the allegation that the defendant's failure to detect the swollen optic discs and refer Vinnie on for further investigation was grossly negligent - key phrase in this case - on her part."
He added: "Given the risk of death involved, her conduct was so bad in all of the circumstances - it fell so far below the standards to be expected of a competent optometrist - that it was criminal."
Mr Rees said it is agreed that, at the time of Vinnie's examination on February 15 2012, there were "obvious abnormalities" in both of his eyes.
The jury heard that photographs taken by another member of staff of the back of his eyes shortly before he was examined by Ms Rose suggested he had bilateral papilloedema - the optic disc at the back of each eye was swollen because of the raised pressure within his skull.
Mr Rees told the court: "The prosecution say that the abnormalities in his optic discs would have been obvious to any competent optometrist who had examined them."
He said this would have led to him being "urgently referred for further investigation" because of swollen optic discs signifying that the patient may be suffering from papilloedema, "which is known to be a life-threatening condition".
Mr Rees said Rose failed to detect the swollen disc in either eye and as a consequence Vinnie was not urgently referred for further investigation "as he should have been", adding: "Indeed, it was the defendant's assessment that he needed no treatment whatsoever."
The prosecutor said had Vinnie been urgently referred, then the evidence establishes that his hydrocephalus would have been identified and successfully treated by a neurosurgeon using a surgical procedure which would have prevented the fluid from accumulating and the build-up of pressure.
"This procedure would have prevented him from dying on July 13 and in essence he would have continued to live his life as a normal young boy," Mr Rees said.
He told the jury that Rose's failure to detect the swelling of Vinnie's optic discs was a "significant contributory factor" to his death.
The jury heard that Rose was not a permanent member of staff at the branch but she was working there that day and had done so previously.
Mr Rees said it is agreed that Vinnie's death would have been prevented had he been the subject of an urgent referral following his eye test.
The court heard that on July 13 2012 Vinnie was sick in school and his mother was contacted about collecting him.
He was brought home but deteriorated during the afternoon and emergency services were called that night and he was taken to accident and emergency.
Paramedics and an emergency team tried to resuscitate Vinnie but he was formally pronounced dead at Ipswich Hospital.
As Mr Rees opened the trial on behalf of the Crown, Rose sat behind her legal team in the court room wearing a black outfit.
Mr Rees told the jury about the morning Vinnie's mother, Joanne Barker, took him and his younger sister for the routine eye tests.
At the start of the test, Mrs Barker recalls that she told Rose that Vinnie had suffered headaches over the previous Christmas, the court heard.
When it came to the examination itself, Mr Rees said Mrs Barker "recalls that Vinnie sat still and behaved perfectly, doing everything that he was asked".
He told the jury that Vinnie showed no signs of being sensitive to the light and "nothing was mentioned by the defendant about there being any problem whilst conducting the tests or examination".
Mr Rees said Mrs Barker cannot recall Rose making reference to the retinal photographs that had been taken or calling them up on the computer screen.
The jury was told that Rose was interviewed under caution by two police officers in March 2013.
Mr Rees said that, when she was shown the retinal images taken of Vinnie on February 15 2012, she said they were not the ones she had seen because they showed a "completely pathological problem" which would have caused her to make an emergency referral that day.
The court heard that she said it looked like the findings she recorded that day related to 2011 images of Vinnie's eyes, and she suggested that she had been shown those instead of the 2012 images.
The jury heard that Rose told the police officers she qualified as an optometrist in India in 2005, the same year she came to the UK.
She told the officers that in 2007 she did an optometry course at City University, the court heard.
Mr Rees said she told them that she passed her exams and registered as an optometrist with the General Optical Council in July 2010.
The court heard that she said she worked as a self-employed locum for companies such as Specsavers and Boots as and when they required her services.
Giving evidence to the trial, Vinnie's mother said that after the eye test she thought "that his eyes and the health of his eyes were perfectly normal".
She said she had "no idea" he had hydrocephalus when he died, and asked if she had any concerns about Vinnie growing up she said: "None at all."
She added: "He only ever had a blocked tear duct as a young child."
The only time he had ever visited hospital was in connection with the blocked tear duct, she said. Vinnie "loved football" and enjoyed school and the outdoors, Ms Barker told the court.
She said that because she had always worn glasses it was something she was aware of and that is why she had arranged eye tests for her children.
Talking about the day of the eye test, she recalled the children being told that they would "get great pictures that would make their eyes look like Mars".
She said "nothing" was said when Vinnie had his pictures taken.
Ms Barker said she thought getting the pictures taken was "something fun" for the children and "something exciting for them to tell nanny and daddy about".
Recalling how Vinnie went first, she said of her daughter Amber: "She always wanted to do everything her big brother done."