Child's Pain Exposed: Wrong Prescription Trauma

A five-year-old girl suffered significant physical and psychological distress due to multiple failures in her care, as revealed by a new report. She was incorrectly prescribed a vaginal pessary and cream by a physician associate at an East Midlands GP practice in March 2026, who suspected thrush.

Despite the mother's concerns about the treatment's appropriateness for a child, she administered it, leading to the girl experiencing bleeding and intense pain. The cream also caused skin burns. Subsequently, the child's reluctance to be examined during an out-of-hours appointment triggered safeguarding concerns for possible sexual abuse.

A consultant later determined the symptoms stemmed from the wrongly prescribed pessary and cream, not thrush. The ombudsman noted that the pessary was unsuitable for a child of that age and her symptoms were indicative of vulvovaginitis. Failures included a lack of appropriate supervision for the physician associate's prescription and no evidence of the pharmacy querying the unusual order.

The GP practice has since implemented an electronic alert for intravaginal pessary prescriptions for children and provided additional staff training. This case echoes concerns raised in a previous government report suggesting stricter oversight of physician associates, with some professional bodies recommending they do not see patients under 16.