ERROR RG P4 15.10.1999 In the reporting of the Mia Warren inquest in yesterday's edition of The Royal Gazette , the actions of internal medicine specialist Dr. Wilbert Warner should have been made clearer.

Dr. Warner came into the case five days after Ms Warren had been admitted to hospital. He was not the physician in charge but a doctor who was called upon during its final stages. It was in fact Dr. Warner's tests that allowed a diagnosis of meningitis to be made at all.

A nurse yesterday gave damning evidence against doctors during an inquest into the death of American visitor Mia Warren.

Registered nurse at King Edward VII Memorial Hospital Anita Lewry told a four-man, four-woman jury doctors refused to treat or even examine Ms Warren while she was disoriented and held down by restraints.

The 21-year-old waitress, who travelled to the Island for her aunt's wedding, was admitted to the hospital in the early hours of May 28, having complained of back pain.

An autopsy later revealed that Ms Warren's death, on June 4, was caused by staphylococcal meningitis, a condition brought on by bacterial infection of the outer portion of the brain.

In this case, the infection was caused by the rupture of a spinal abscess that had formed around one of two metal Harrington Rods, inserted to help support Ms Warren's back after a road accident in her hometown of Memphis, Tennessee in June, 1995.

Yesterday in her statement and in answering questions from the Warren family's lawyer Michael Smith, Ms Lewry said: "When I consulted with the doctor he simply asked me if I had any bright ideas.'' Ms Lewry described how she decided to call St. Brendan's so that a psychiatrist could come and examine Ms Warren himself.

"When Dr. (Gareth) Smith arrived in the patient's room he immediately said he could smell the illness in the room and `this is not a psychiatric case','' she said. "When I tried to get Dr. (Stephen) Trott to do something he refused to see the patient. I wouldn't let him off the phone until he agreed to get someone to see her though.'' "All of us nurses were extremely concerned.

"Dr. Smith could tell there was something seriously wrong medically and we couldn't get any doctors to come and see her.'' Specialist in internal medicine at the hospital, Wilbert Warner, also gave evidence yesterday.

After being called by Police Coroner's Officer Sgt. Phil Taylor, Dr. Warner admitted that C.A.T. scans revealing the abscess had not been performed until several days after Ms Warren had been admitted.

And he also revealed that vital blood tests showing her high white blood cell count were not performed until that point either.

Apparently such high white blood cell levels are usually considered as "danger signals'' or "red flags''.

Prompted by questions from Mr. Smith, Dr. Warner stated: "If tests had been done sooner, it is possible that the infection would have been revealed.'' The specialist said meningitis is curable if discovered early enough.

In this case, however, detection came too late and the intravenous antibiotics Dr. Warner treated Ms Warren with were not enough to save her life.

In the hospital's defence, lawyer Jai Pachai pointed to the fact that the back pain Ms Warren complained of at first was not enough to warrant examinations that would have revealed the infection.

"Most people complaining of back pain don't have abscesses do they?'' he asked.

Mr. Pachai bolstered his argument by saying that events look completely different in retrospect than to when they are actually unfolding.

But Dr. Warner said having any type of foreign objects, such as metal rods, in the body makes the risk of infection much higher.

Other testimonies from several witnesses who examined, treated, or came into contact with Ms Warren during her final days in King Edward hospital in June 1997 were read by the Police officer in charge of the case, P.c. Volney Welsh.

The witnesses included registered nurse Michelle Windsor, who, along with Nurse Lewry, was responsible for Dr. Smith's intervention, Intensive Care Unit nurse Susan Ingle, who cared for Ms Warren when she was at her most critical condition and medical social worker Nicole Saunders, who attempted to arrange an airlift of Ms Warren to a hospital in the US.

The inquest continues today in Magistrates' Court with Coroner Will Francis presiding.

Complained of back pain: American visitor Mia Warren, who died in hsopital here.