A consultant paediatrician accepted the blame for Victoria Climbie being discharged from hospital when the girl was an "obvious" victim of abuse and neglect.
Dr Mary Rossiter said "any shortcomings" in the way North Middlesex Hospital handled the case were her responsibility. Neil Garnham QC, counsel for the inquiry into the death of the eight-year-old, asked Dr Rossiter if she was "entirely content" with her actions during Victoria's 13-day stay at the hospital in the summer of 1999, Dr Rossiter replied "No."
The fears of doctors and nurses that Victoria's injuries were deliberate were not clearly recorded on forms to social services, she said, and no case conference was held. "I failed to realise the inadequacies of the documentation. I failed to realise that what seemed very obvious to us in hospital as a clear-cut case of child abuse had not been comprehended by my colleagues in social services."
She added: "I have looked at the notes and thought about Victoria on a daily basis, with mounting horror actually, and I feel very distressed that I did not keep up to my own standards."
Dr Rossiter, who is in charge of child protection at the hospital, wrote on Victoria's medical notes, "able to discharge", despite noting the girl exhibited signs of abuse and neglect.
Victoria was admitted to the hospital on 24 July 1999, with a scalded head and face, which staff immediately suspected as non-accidental. Photographs also showed the "appearance of chastisement with a belt". But after treatment for burns, Victoria was allowed to return to the home of her great-aunt, Marie Therese Kouao, and her partner, Carl Manning, who have been jailed for life for murder.
In Dr Rossiter's statement to the inquiry, she said her addition to the medical notes of "able to discharge" had referred only to the girl's physical condition. "I do not believe anyone thought I meant I wanted her to go home. The plan was to discuss her with the social workers."
She was asked if there was a risk in leaving follow-ups of such cases like to other agencies. Dr Rossiter said: "It has been a concern of mine for quite some time that it has been difficult to find out what has happened to children whom we have referred to social services. I am not necessarily talking about big cases like Victoria's but I'm talking about the 300 cases a year that we deal with at present."
Dr Rossiter told the inquiry that she had "great concerns about what might happen" after she signed Victoria's discharge sheet on 13 August 1999. But she believed social workers and police would follow up the case.
In February the next year, Victoria was readmitted to hospital and died of horrendous physical injuries and neglect.
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