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Hospital accused of cover-up after death of teenager

Tuesday, 10th September, 2019

Chief Executive Stephen Rodwell Chief Executive Stephen Rodwell

By Craig Brealey

A report last night into the death of a fit, young man at the Broken Hill Hospital alleged that hospital management tried to cover up its negligence.

Alex Braes (18) died from a bacterial infection that went undiagnosed in the emergency department until his fourth visit in little more than the space of a day in September, 2017.

Mr Braes had his father take him to the hospital on September 20 after waking up in agony in the early hours of the morning. No standard medical tests were done and he was told to go home, according to the ABC’s Four Corners program. 

He died in hospital in Sydney on September 22 but the categorisation of his death was downgraded by the Broken Hill Hospital’s management, Four Corners said.

This resulted in it not being referred immediately for investigation, as it should have been under the NSW Health Administration Act.

The tragedy has again raised very serious questions about how the hospital has been managed and whether it and other outback hospitals have been neglected by the NSW Government.

Serious governance problems at the hospital and allegations of a decline in medical care have been the subject of investigation and review over the last four years.

On August 30 this year, the Chief Executive of the Far West Local Health District, Stephen Rodwell, tendered his resignation after, Four Corners said, it interviewed the Health Minister, Brad Hazzard, about the case of Mr Braes.

Mr Rodwell became the acting chief executive in July 2017. His appointment to the job was announced on September 21.

A spokesman for NSW Health told the BDT yesterday that he had resigned for “purely personal reasons”.

Four Corners described Mr Braes’ death as a “harrowing account of failure” in the nation’s country hospitals “where resources are stretched and staff are under constant pressure.”

The facts were brought to light only after a group of doctors and nurses at the hospital went over management’s head and “repeatedly lobbied” the Health Ministry and the Minister himself.

It then took a year for the investigation to finally be done, Four Corners said.

Last night’s report said that when Mr Braes first arrived in emergency at 3.18am complaining of a sore knee, staff assumed he had a sports injury. Standard observations such as blood pressure, pulse, temperature and blood samples were not done.

He was told to go home and come back for an ultrasound at 8am. The emergency department was busy and again no observations were carried out.

Mr Braes and his father returned at 6pm. The ultrasound showed a possible torn tendon and he was told to go home and put ice on his leg. No observations were made.

On Thursday at 10am he was in so much pain he could not walk so he called his father home from work. An ambulance was called but none was available. His father drove him to hospital where it took 25 minutes to get a wheelchair to carry him from the car.

This time observations were done but soon afterwards he started to lose consciousness and a rapid response team was called. The cause of his illness was found to be an infected toenail but Mr Braes had now fallen into toxic shock from the sepsis and his kidneys were failing. 

The hospital tried to get him into the Royal Adelaide but it had no beds available. The Flying Doctor could not fly him to Sydney because the only pilot available had reached his maxiumum hours, under rules applied by the Civil Aviation Authority.

A bed was found at the Royal Prince Alfred Hospital in Sydney but an air ambulance had to be sent from Sydney to collect him - a five-hour round trip.

By the time Mr Braes arrived in Sydney, on Friday at 12.50am, it was too late. He went into cardiac arrest and was pronounced dead at 2am.

The BDT sought comment from Mr Rodwell about the Four Corners report and he was also asked if he could give an assurance that the problems that led to Mr Braes’ death had been rectified. 

He was also asked if he was satisfied that the hospital was properly funded and resourced by the NSW Government.

A spokesperson from NSW Health replied that under NSW Health Policy, “all serious clinical incidents or near misses involving patients” had to be investigated.

An analysis of the hospital’s response to Mr Braes’ treatment was conducted and the hospital reminded of “the importance of a full set of vital sign observations for patients attending emergency departments...” 

Improvements were also recommended, including “stringent consultation with NSW Ambulance and the Royal Flying Doctor Service to provide best practice patient care.”

The spokesperson said NSW Health had conducted reviews of clinical incidents and clinical governance at Broken Hill and “made improvements with South Australia Health regarding escalation and transfer for patients in Broken Hill.” 

Mr Rodwell will leave his role on November 29, the spokesperson said.

“His retirement followed a long period of consultation with his family and his decision is purely based upon personal reasons.” 

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