Girl, 5, traumatized after physician associate wrongly prescribed vaginal pessary, report finds
10 reported
A five-year-old girl was left traumatized, bleeding, and in severe pain after a physician associate (PA) at a GP practice in the East Midlands wrongly prescribed her a vaginal pessary, according to a report by the parliamentary and health service ombudsman. The ombudsman found “multiple failures” in the girl’s care. The PA suspected thrush and recommended the pessary and cream after the girl complained of itching and vaginal discharge. The mother, who believed her daughter was being seen by a GP, questioned the treatment but was reassured it was appropriate. The ombudsman found no discussion between the PA and the GP before the GP authorized the prescription, even though vaginal pessaries are not suitable for prepubescent children and the girl’s symptoms were consistent with vulvovaginitis, not thrush. After inserting the pessary, the girl began to bleed and scream in pain, and the cream burned her skin. The mother took her to an out-of-hours doctor, but the girl was so distressed she asked not to be examined internally, leading the GP to raise concerns about possible sexual abuse and contact safeguarding services. It was later established the symptoms were caused by the pessary and cream, not abuse. The ombudsman recommended the GP pay the mother £1,000 and the pharmacy pay £500, and that both organizations take action to prevent recurrence. The incident occurred in 2023, before a government-commissioned report recommended PAs be banned from diagnosing patients not seen by a doctor.
What’s reported
A five-year-old girl was left traumatized, bleeding, and in severe pain after a physician associate wrongly prescribed a vaginal pessary.
The ombudsman found “multiple failures” in the girl’s care at a GP practice in the East Midlands.
The PA suspected thrush and recommended a vaginal pessary and cream after the girl complained of itching and vaginal discharge.
The mother believed her daughter was being seen by a GP and questioned the treatment but was reassured.
PAs do not have prescribing rights and must be supervised by a doctor; the ombudsman found no discussion between the PA and GP before the GP authorized the prescription.
Vaginal pessaries are not suitable for prepubescent children, and the girl’s symptoms were consistent with vulvovaginitis, not thrush.
After insertion, the girl bled and screamed in pain; the cream burned her skin.
The out-of-hours GP raised concerns about possible sexual abuse and contacted safeguarding services; it was later established the symptoms were caused by the pessary and cream.
The ombudsman recommended the GP pay the mother £1,000 and the pharmacy pay £500.
The incident occurred in 2023, before a government-commissioned report recommended PAs be banned from diagnosing patients not seen by a doctor.
Key figures
Rebecca Hilsenrath, chief executive of the parliamentary and health service ombudsman
Dr Emma Runswick, deputy chair of BMA council
Prof Gillian Leng, president of the Royal Society of Medicine
A Department of Health and Social Care spokesperson
Sources: The Guardian
