TORONTO -- One of the doctors involved in treating an Ontario toddler who died in her sleep after being told she only had the flu will need to take formal education in the management of fever, dehydration and sepsis in children.
The College of Physicians and Surgeons of Ontario (CPSO) launched an investigation after Newmarket toddler Sophia Farah died suddenly in January.
The two-year-old became sick around Christmas last year, her mother Arzo Wahab told CTV News Toronto in September. Sophia developed a fever, was lethargic, throwing up, and had discoloured eyes.
When the fever spiked, Sophia's parents took her to The Hospital for Sick Children in Toronto. After waiting seven hours to see a doctor, they were told the wait would be another six hours, and left.
The next morning Wahab and her husband took Sophia to a walk-in clinic in Newmarket, where a doctor said she needed urgent medical attention. They then took her to the emergency department at Southlake Regional Health Centre.
Wahab said her daughter was seen by a resident doctor, who was told everything about Sophia's symptoms. She said she asked that they complete blood work or be prescribed antibiotics since Sophia had a fever for 10 days.
The resident doctor initially agreed to do tests, Wahab said, but then changed her mind when a supervising doctor said no. She said doctors told her they believed Sophia was suffering from a viral infection.
Medical documents from Southlake Regional Health Centre, provided by the family to CTV News Toronto, show that on Jan. 3 Sophia's heart rate was 164 beats per minute, she had a fever of 38.4 degrees, and was lethargic. According to the documents, Sophia was discharged less than 2 hours after arriving and was told to keep hydrated while taking Tylenol. The doctor's note says she was suffering from gastroenteritis.
Wahab said the supervising doctor, Dr. Jay Martin Silverstein, discharged Sophia without visually seeing her. The medical documents show that the family was told to return to the hospital in four days if Sophia's fever or other systems didn't improve.
She died in her sleep three nights later.
While the final report into Sophia's death has still not been released, Wahab said she was told by the coroner earlier this year that her daughter died from Strep A that turned septic, a bile infection and pneumonia.
The CPSO told CTV News Toronto that after investigating they determined that Dr. Silverstein must undergo training.
"In the case of Dr. Silverstein, the CPSO ICRC Committee determined that mandated formal education in supervising trainees and the assessment and management of fever, dehydration and sepsis in children was warranted," the CPSO said. "This was a tragic case and the CPSO offers its sincerest condolences to the Farah family."
Dr. Silverstein must complete the education courses within the next three months. Going forward, he must also inform the college of any additional medical facilities where he has an affiliation.
The CPSO was unable to release details about the resident doctor who actually saw Sophia at Southlake, saying the "course of action related to the resident is not public information."
The Chief of Staff at Southlake Regional Health Centre, Dr. Stephen Beatty, said in a statement to CTV News Toronto that they "acknowledge the educational requirements for Dr. Silverstein."
"We take the safety of all our patients very seriously and when there are concerns about physician care provided we work closely with College of Physicians and Surgeons of Ontario."
The Farah family declined to comment on the matter, citing an ongoing civil lawsuit.
Wahab said in September that she feels the health-care system failed her daughter, and that if doctors ran tests on Sophia in hospital, she would still be alive.
"I asked them so many times to do tests," she said. "I am just so angry with the health-care system. We kept being told by the doctors she was fine and we believed them."
Wahab said while it pained her to speak publicly about her daughter's death, she did it with the hope parents will feel more confident advocating for their children at hospitals.
"I just don't want any other families to have to go what we went through," she said.
"Even if this saves one kid's life – it’s worth it."
CTV News Toronto attempted to speak with Dr. Silverstein but he declined to comment.
