Martha's Rule: A mother's battle, a young daughter's death, and a change that could save your child

LONDON, UNITED KINGDOM: The parents of a girl who died after doctors failed to admit her to critical care are demanding to implement 'Martha's Rule' to make it simpler to seek a second opinion.

Martha Mills, who would have been 16 on Monday, died after contracting sepsis while in the care of King's College Hospital NHS Foundation Trust in south London.

Doctors failed to recognize warning symptoms

A coroner decided last year that the 13-year-old might have lived if doctors had recognized the warning symptoms and sent her to critical care sooner.

Martha was being treated at King's after suffering a pancreatic injury while on a family vacation in Wales. King's is a specialized national referral center for children with pancreatic disorders, as reported by Independent.

There were multiple opportunities to refer Martha to critical care, like when she began to bleed profusely through a tube implanted into her upper arm and a drainage tube at one point. But this did not occur.

Since then, the trust has apologized for any errors in Martha's care.

Merope Mills, an editor at the Guardian, has alleged that she and her husband, Paul Laity, raised concerns about Martha's declining health several times but that nothing was done and doctors ignored them.

Mills advocates for parents like her ignored by doctors

Mills told the PA news agency, "At King's College Hospital, there were no consultants present after the ward round during the weekend when Martha deteriorated, and so when I had doubts about Martha's care I had no-one senior to turn to."

Mills added, "I mentioned my concerns to a junior doctor when he misdiagnosed her rash, but he ignored me; questioning him further would have involved a confrontation. I talked to a nurse, but she said to trust the doctors. I didn't have the language or knowledge to request a critical care review."

Ms Mills further added, "I had been 'managed', I hadn't been listened to and I felt powerless. A national expert on sepsis worked just down the corridor in paediatric ICU (intensive care); had he seen her following a review, we know her treatment would have been utterly different."

Mills added, "If a patient and family escalation system such as Martha's Rule had existed – and had been clearly advertised around the hospital with posters and stickers – I'm sure I would have used it and it could well have saved Martha's life."

"Where such systems exist they are used appropriately and effectively – which is why we'd like to see Martha's Rule introduced across the NHS."

Demos, a think tank, has written an accompanying study urging NHS England to implement the regulation as soon as possible.

What is Martha's Rule?

According to the Demos research, "Martha's Rule" is based on the Call 4 Concern system, which has been adopted by a number of institutions in the UK and, to a lesser extent, "Ryan's Rule" in Australia, and provides patients with a direct access to an expert second opinion.

According to the study, Martha's Rule should be publicized to families and staffed by an independent clinical review team, which many hospitals currently have.

'Martha's Rule would help to shift power'

Polly Curtis, CEO of Demos and co-author of the paper, stated that too many reviews "highlighted a refusal to take families seriously with a 'doctor knows best' attitude."

She added, "Martha's rule would help to shift power, encouraging patients to challenge in the most difficult of circumstances and clinicians to listen to them. In other countries, it has been proven to save lives."