Professor tells inquest he has changed mind about cause of girl's hospital death in 1996
A child at the centre of the Hyponatraemia Inquiry did not die as a result of a brain virus, a medical expert has told her inquest.
In a dramatic U-turn from evidence given to the inquiry seven years ago, Professor Keith Cartwright has said he no longer agrees with his earlier conclusion that viral encephalitis played a role in the death of Claire Roberts.
Speaking in court yesterday, the consultant microbiologist said: "It did not cause her death."
Claire was just nine years old when she died at the Royal Belfast Hospital for Sick Children in 1996, two days after she was admitted with symptoms of drowsiness and vomiting.
The Hyponatraemia Inquiry, headed by John O'Hara QC, examined the management of fluids of five children who subsequently died after treatment in hospitals here.
Hyponatraemia occurs when there is a shortage of sodium in the bloodstream and can happen as a result of receiving excess fluid.
Mr O'Hara ruled that Claire's death was preventable and he also concluded that medical professionals were involved in a cover-up following the tragedy.
The Attorney General subsequently ordered a fresh inquest into Claire's death and it opened in Belfast yesterday.
Appearing in court, Professor Cartwright said he had changed his mind about the cause of Claire's death after reviewing evidence from the Hyponatraemia Inquiry in preparation for the inquest.
He said he had only carried out this exercise in the past couple of weeks.
He explained that he had read a report by Professor Brian Harding, an expert neuropathologist, who said that it was "unlikely that encephalitis could cause death without causing any change to the brain histology".
He continued: "This caused me to think again - was I right in attributing her death to encephalitis when he was so firm in his conclusion?"
He said he was further persuaded to change his opinion after discussing the case with Professor Sebastian Lucas prior to giving evidence.
Pressed on the matter by coroner Joe McCrisken, Professor Cartwright said he understood the gravity of his comments. Mr McCrisken said: "At no stage between 2011 and last week did you reconsider the view given to Mr John O'Hara?
Professor Cartwright answered: "That's correct."
Mr McCrisken continued: "Only in the last nine or so days has it come into focus?"
Professor Cartwright replied: "Yes."
The coroner continued: "This inquest is happening because the independent inquiry didn't properly arrive at a cause of death for Claire Roberts. "This inquest is required to give a cause of death.
"Had the Hyponatraemia Inquiry decided to establish a cause of death it would have been based upon an incorrect piece of expert evidence."
Professor Cartwright said: "In retrospect, that's right."
Earlier Professor Cartwright told the inquest he accepted there was no histological change to Claire's brain to show she had suffered from viral encephalitis prior to her death.
The inquest heard she was suffering from diminished consciousness and drowsiness when she was admitted to hospital.
Professor Cartwright said the onset of these symptoms, which suggested she was suffering from some kind of infection, must have been acute, as she was well enough to attend school earlier in the day.
However, the court also heard evidence that Claire had been in contact with someone who had a gastric infection in the days leading up to her hospital admission.
Professor Cartwright was at yesterday's hearing as he was one of a number of medical experts to provide reports to the Hyponatraemia Inquiry.
Professor Lucas, a consultant histopathologist, also appeared in court yesterday to discuss the evidence he gave to the Hyponatraemia Inquiry in November 2012.
He said: "There was no significant inflammation in Claire's brain at the time of death.
"There is no question that she was admitted to hospital with an infection of some sort, probably gastroenteric.
"By the time she died, if she was going to die of it (encephalitis), there would have been pathology there."
Professor Lucas suggested that her death certificate should state she died as a result of a cerebral oedema, caused by hyponatraemia, as a result of fluid therapy and a hormonal imbalance, following on from a viral infection.
The opening of yesterday's inquest was the latest emotional step in a 22-year fight by Claire's parents Alan and Jennifer for the truth about their daughter's death.
Her original death certificate gave the cause of death as cerebral oedema and status epilepticus.