The inquest heard that a mandatory investigation into the cause of Alexs death was not carried out by Far West Local Health District for a year after he died. "No-one deserves to lose a child, no one deserves to go through this, and I can't begin to imagine what this is like for you.". Deputy Coroner Ryan's findings also noted that whilethere were deficiencies in the care given to Mr Braes, theydid not cause or contribute to his death. Experts remain divided whether Alex had the type of GAS known as necrotising fasciitis, a flesh-eating bacteria which results in the rapid death of the bodys soft tissue. His wife was left sitting on the tarmac of Broken Hill Airport for hours waiting for a plane to come from Sydney to retrieve their 18-year-old dying son. Did you find what you were looking for? 00:00. Dr. Piazza - Injury and Thrombosis. She noted that there was no realistic possibility that his specific infection could have been identified and successfully treated on September 20, 2017. It took 25 minutes for a wheelchair to be brought out so Alex could be taken from the car into the hospital. Alex Murdaugh, a once prominent Hampton-based attorney from a well-known politically . A nurse in her first month at the hospital was assigned to take a full set of his vitals but was called away to prepare another patients antibiotics before she could finish. Please confirm you want to block this member. Alex Braes died at Sydney's Royal Prince Alfred Hospital after going to another hospital four times. A medical student struggled to insert the cannula. All NSW magistrates are coroners by virtue of their status: s 16. "She must have hoped beyond hope that he would survive.". "This was a perverseoutcome whichdemanded examination at the inquest.". I think it could easily happen I have a great fear it could happen, she said. "You need to move that patient as soon as you possibly can to an organisation that has the facilities, the staff to manage the patient as best as possible," she said. The death of a healthy 18-year-old man who first attended a hospital with moderate knee pain is almost incomprehensible, she said. Dr Greenberg told the inquest thathe first saw Mr Braesabout2:00pm on September 21, 2017, and from that moment on "I was the team leader". Like that day, she said the nurses were still often very busy and under an awful lot of pressure. My first thought was I havent finished obs for him, I havent done anything for him, have I missed something? she told the inquest. Findings are published on this website when an inquest was held or a coroner otherwise orders they be published in the public interest. Sign up and stay up to date with our daily newsletter. Ms Anderson said 'yes' and that the rule was notin place at the hospital any longer. This service may include material from Agence France-Presse (AFP), APTN, Reuters, AAP, CNN and the BBC World Service which is copyright and cannot be reproduced. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. The pathologist creates a written record of the autopsy findings, including the microscopic and laboratory tests. This would have left the state's Far West region without a pilot or plane, according to the retrieval specialist. The inquest also heard the Broken Hill hospital is prevented from transferring patients to Adelaide, despite the SA capital being closer than Sydney. Mr Palmbach testified that the findings in the autopsy report about Paul's wounds - that the head wound was an exit wound - were "inconsistent" with the evidence which he testified shows . Annual training is also provided for coroners' officers. The day's hearing also heard from DrDevinda Arangala, who reviewed Alex during the early hours of September 20, 2017, when the teenager first presented to the hospital with a sore knee. Alex and his father arrived back at the emergency department. "But the source of that infection was never confirmed, as I understandbecause an autopsy was not performed. "There was no system whereby a New South Wales clinician could insistthat acritically-ill, Broken Hill patient be accepted for treatment in South Australia," she said. One nurse is responsible for two jobs at the Broken Hill hospital, the inquest into the death of Alex Braes has heard. Alex Braes presented to Broken Hill Hospital four times over a more than 30 hour period in September 2017 (Noah Schultz-Byard) The second day of hearings heard from Dr David Hooper, who reviewed Alex during his third presentation to the local hospital on September 20, 2017. She recommended NSW and SA health departments urgently agree to cross-border transfers of critically ill patients from Broken Hill. She noticed he was sweaty and unwell and moved him into a bed in the emergency department. By the fourth visit Alex was in excruciating pain and the leg was turning a dark purple colour. Broken Hill hadn't been able to get a GP that week to staff the fast-track clinic which saw less-serious patients, so that put enormous pressure on the emergency department. "I've worked in 13 different locum hospitals since I've retired and I've never seen anything like Broken Hill in my entire career," he said. ': Teen searched internet before dying of suspected toenail infection, inquest hears, Doctor tells inquest why he can't celebrate his birthday since teenager's death, Inquest begins into teen's death from infected toenail, The death of Alex Braes still haunts doctors who didn't even know him, Outside her tent, next to a popular city walking track, homeless Tasha is past caring what people think. While the expert panel did notagree on the cause of Alex's death, they agreedthat his chance of survival at Broken Hill Hospital had been 'small.'. It recently handed down 44 recommendations to boost the rural medical workforce and improve the standard of care. All Rights Reserved. the death prevention role of the coroner family privacy sensitivity of the findings possible harm from making an investigation publically available In general, authorised findings for publication will include: all public inquest findings motor vehicle crashes long-term missing persons cases homicides after the criminal process has been completed The inquest heard hospital staff did not check Braes full vital signs including temperature, pulse and blood pressure when he presented to the emergency department with severe leg pain on the morning of 20 September. In the small hours of a Wednesday in an outback town, a teenager struggled to sleep. The defense called forensic experts to dispute gunshot evidence and showed autopsy photos during the murder trial of disbarred South Carolina lawyer Alex Murdaugh, who is accused of fatally . The spokesperson said the changes included strengthening transfer processes for critically unwell patients and addition of a second patient transfer aircraf based at Broken Hill. "Until he fell off the cliff," Dr Greenberg said. "Twelvehours passed before hisemergency flight landed at Sydney's Royal Price Alfred Hospital," Ms Ryan said. The inquest will continue on August 31 with Sydney-based hearings. She has recommended that the states' respective health departments continue discussions for formalizing that arrangement and for the matter to be escalated to the NSW Health Secretary if it fails to be in place within a year. If they had flown Mr Braes down to Adelaide, the only available pilot would not have been able to return, as their allowed time would have expired. Mr Braes said no ambulance came when he called triple zero and he had to drive his son to hospital, where there were further delays while staff tried to locate a wheelchair. Alex Braes, 18, had significant knee pain when he first presented to Broken Hill Hospital in the early hours of September 20, 2017. An inquest was established soon after that report and was due to undertake Broken Hill hearings last yearbut was delayed after coronavirusrestrictions affected proceedings. Doctors suspected he had a ruptured tendon and recommended rest and ice. Our Morning Edition newsletter is a curated guide to the most important and interesting stories, analysis and insights. Alex Braes, 18, was only tested for . A shortage of resources was one factor contributing to Mr Braes' death, Ms Kelly said. One of them, DrAli Baalbaki, told the inquest he longer celebratedhis own birthday because it falls on the same day he reviewed the teenager. She said as a hospital practice it was not compliant with NSW Health policy. Now she believes she's being penalised, Australia loses first wicket on day two but still on top in Indore, ADF aircraft, personnel to assist evacuation of hundreds from flooded NT remote communities, Rajwinder Singh expected to be charged with murder of Cairns woman Toyah Cordingley tonight, police say, Watch Australia's economic challenges unfold in five graphs, 'Weight of the dead on my shoulders': Academic breaks down at gay hate deaths inquiry, Girl's thumb replaced with toe after gruesome surgical error, Half-marathon runner dies after broken leg misdiagnosed three times. He went into cardiac arrest. His death has also devastated the clinicians working at Broken Hill. The decision not to transfer the teenager to a better-equipped, major hospital sooner was also under the microscope. All rights reserved. "His parents were just shell-shocked. Alex Braes, 18, died at the Royal Prince Alfred Hospital in . Health Hazard, reported by Louise Milligan, goes to air on Monday 9th September at 8.30pm. and Fire at Capertree, Inquest into the Death of Nicholas LOUDON, Before her Honour Magistrate Kennedy, Deputy State Coroner, Inquest into the Death of Stanley RUSSELL, Byron Bay Local Court, Middleton St, Byron Bay 2481, Before her Honour Magistrate OSullivan, State Coroner. Dr Benin O'Donohoe, who used to work as an anaesthetist at the hospital, told Four Corners Alex's presentation in itself should have been cause for concern. abc.net.au/news/alex-braes-inquest-findings-health-systems-criticised/101109422 The Deputy State Coroner has criticised a regional hospital's treatment of a boy who was repeatedly sent home before dying from sepsis. By the following morning, Alex's pain was so excruciating, he couldn't walk. "The only evidence that we have is that Alex had Streptococcus pyogenes grown in his bloodstream and he had septic shock," he said. More than 14 hours after his father had first called an ambulance, Alex finally arrived at RPA Sydney a hospital that could actually treat him. "It means he'd been unwell for a significant number of hours at that point.". "I feel heartbroken that I still have my children and that you've lost your boy.". I think it was a totally avoidable death," Dr MacDonald said. "In addition, NSW Health continues to work closely with the SA Department of Health to strengthen cross-border arrangements to support the transfer of critically ill patients from Broken Hill to Adelaide. "This was a seriousand unacceptabledeficiency in his care and it was a missed opportunity to identify his underlying, evolving illness," she said. "He was cold, clammy, sweaty and he was significantly blue and mottled and this mottling colour is really a very ominous feature. Ms Murphy also told the inquest that there was about a 10-minutewait in the emergency department from the time Alex came to the triage window to when he was looked at by her, as she was busy triaging another patient. A shortage of resources was one factor contributing to Braes death, Kelly said. Mr McLean says by this stage Alex's third presentation alarm bells should have been ringing. You often need to be in two places at once, she told Braes inquest. Dr O'Donohoe later quit work at Broken Hill Hospital over what he saw as mismanagement, leading to patient safety issues. Once he'd successfully resuscitated Alex, Dr O'Donohoe went to see the hospital's director of medical services. "[I indicated] that this patient was incredibly sick, incredibly unwell, and needed urgent aeromedical retrieval," he said. Mr Braes also recalled Alexs vital signs, including his temperature and pulse, were not checked each time he attended hospital. Before Alex's death, doctors had complained repeatedly that management was not open to criticism and did not listen to safety concerns they raised. Alex Braes, from Broken Hill died from a deadly flesh-eating diseases in 2017 Inquest into the 18-year-old's sudden death reveals doctors missed vital signs Young man complained of severe pain. Mr Braes was conscious and speaking to staff and was "compensating for the sepsis until he couldn't". A traumatised doctor has broken down in tears at an inquest, reflecting on how a relatively well teenager was joking with his father the night before his sudden death. Download the ABC News app for all the latest. The inquest heard Mr Braes had an ingrown toenail in August 2017 that was successfully treated with antibiotics. Ryan found it was potentially dangerous and against NSW Health policy, but a systemic failure that could not be attributed to individual hospital staff. Dr Greenberg explained to the inquestthat the situation was the same in Dubbo, where the pilot's hours had also expired. "I didn't know his family, I didn't know Alex Braes. Alex Braes, 18, died on 22 September 2017 from multi-organ failure due to sepsis from a Group A streptococcus infection. The NSW State Coroner, Teresa OSullivan, has advised the procedures that will apply in relation to the conduct of coronial proceedings at the Lidcombe Forensic Medicine and Coroners Court Complex (FMCCC), for matters listed from 10 October 2022. ", ABC Broken Hillwill deliver a wrap of the week's news, stories and photos every Friday. Shefound that Mr Braes'cause of death was multi-organ failure due to sepsis from a group Astreptococcus infection, and that he died as a result of natural causes. Alex Braes, 18, died at Sydney's Royal Prince Alfred Hospital about 46 hours after limping into Broken Hill Base Hospital at 3am on September 20, 2017. Broken Hill teenager Alex Braes, who died of an infected toenail. When they arrived, Alex was unable to get out of the car, so his father went to triage to ask for help. Please note: A New South Wales regional hospital where a teenager was sent home three times days before his death is still not safe due to staff shortages, a coroner has heard. "What are we doing about avoidable deaths, preventable deaths?" Outside her tent, next to a popular city walking track, homeless Tasha is past caring what people think. "We've gone back to the full set of obs (observations) at every triage," she said. See State Coroner's Memorandum No. The inquiry was launched after an investigation by The Sydney Morning Herald exposed troubling circumstances of three deaths and a series of near-misses at hospitals across western NSW. Ryan recommended the communication between the two states be escalated to the NSW secretary of health if cross-border transfer arrangements are not in place within a year. Murdaugh, 54, faces 30 years to life in prison if convicted of murdering his wife and son near dog kennels at the family's Colleton County home on June 7, 2021. Ms Ryan said there had an been "extraordinarylack" of progress between NSW Health and SA Healthestablishinga formalised cross-border arrangement to transfer critically-ill patients from BrokenHill to Adelaide. As for the delays in Braes' transfer, the coroner pointed out that the teen was not taken to South Australia's (SA) Royal Adelaide Hospital despite the facility being the closest hospital suitable for his care. Coroner in Alex Braes inquest scathing of care at Broken Hill Hospital provided to 18yo who died of sepsis, Follow the action from the third Test between India and Australia in Delhi in our live blog, Former government services minister Stuart Robert is being questioned at theRobodebt inquiry, Keep up with the latest ASX and business news. Dr Greenberg said the teenager was in a "relatively good" conditionfor someone who was critically ill. Counsel assisting the coroner, Kirsten Edwards, said the delay in transferring Alex would be a very significant issue in the inquest. He was taken to Royal Prince Alfred Hospital in Sydney but went into cardiac arrest and died soon after arriving during the early hours of September 22, 2017. For legal cases involving intentional or accidental death and for insurance claims, The Records Company retrieves coroner's reports and autopsy reports. Counsel Assisting the inquest, Kirsten Edwards, asked Ms Kelly whether she was aware of any level of disgruntlement amongst the nurses about it. It grieves his parents deeply that they were not able to be with him in his last conscious hours, Ryan said. Eighteen-year-old Alex Braes' knee was so painful, he asked his father to take him to Broken Hill Hospital. As for the delays in Braes' transfer, the coroner pointed out that the teen was not taken to South Australia's (SA) Royal Adelaide Hospital despite the facility being the closest hospital suitable for his care. Authorities said . Copyright IBTimes 2023. One matter consistently raised throughout the week's proceedings was a business rule then in place at Broken Hill Hospital when Mr Braes presented there four times in September 2017. Doctors, who failed to check the vital signs of a teen who died from sepsis, are not responsible for the tragedy, according to a coroner who says they were prevented from doing so under a hospital "business rule". "A significant one was the failure on September 20, 2017, to perform vital signs observations," Ms Ryan said. By the time Alex was diagnosed with a bacterial infection he was in septic shock and needed to be medically evacuated to Adelaide. 23 April 2021. He suffered multi-organ failure due to sepsis . A coroner has heard one nurse is responsible for both triaging patients in the waiting room and overseeing nurses in the emergency department at Broken Hill hospital. More from Latest News Danish ex-minister charged with revealing state secrets Alex Braes. Please allow a few minutes for this process to complete. Follow our Australia news live blog for the latest updates, serious gaps in healthcare in rural and regional areas. "I know it was after Alex passed away," she said. Alex Braes (Credit: ABC "Four Corners," family photograph) The death has traumatised Braes' family and hospital staff alike. Alex's ultrasound showed a possible torn tendon and again Alex was sent home and told to rest, ice and elevate his leg and to come back in two weeks if the pain hadn't stopped. Staff managed to find a bed for Alex at Sydney's Royal Prince Alfred Hospital and an air ambulance left Sydney to come and collect him. Due to restrictions imposed by the Civil Aviation Safety Authority, pilots can only fly 11 hours a day, with a possible extension of one hour. Dr Stewart-Rattray says he and other clinicians who worked at Broken Hill had warned about mismanagement and a lack of resources that posed a risk to patient safety. It was not until his fourth and final presentationmore than 30 hours laterthat vital observations were taken of him and a suspected toenailinfection was identified. Broken Hill teenager Alex Braess parents remember him as a ray of sunshine, a funny and smart young man ready to live a full life. It is replayed on Tuesday 10th September at 1.00pm and Wednesday 11th at 11.20pm. It's something that troubles local MP Roy Butler. "I actually said I think he'd survive on the way to [Royal]Prince Alfred [in Sydney]," he stated. Doctors not to blame for teen's sepsis death, finds coroner, Content that breaches the privacy of other individuals, Contains spam, fake content or potential malware. "Yes that's my understanding," replied Ms Anderson. A man died just hours after entering a secure mental health unit. The high-profile . Alex's mother was left standing outside near the airport tarmac for hours as Alex, still back at the hospital, fought for his life. In an interview with Four Corners, Mr Hazzard said he was "not sure" the hospital broke the law, but Alex's death was a circumstance that, "as a father, I couldn't have imagined happening". Registered nurse Kristy Kelly, who was the team leader in the hospital's emergency department on the morning of September 21, 2017, told the inquest she was bound by that rule. Ms Anderson was then asked when the rule was disbanded. The timeline of what happened next is a harrowing account of failure in Australia's regional hospitals, where resources are stretched and staff are under constant pressure. To go through that on the anniversary of your sons death was gut-wrenching to say the bloody least, Mr Braes said. Alex Murdaugh's family long dominated the legal scene in his small South Carolina county but for the past six weeks, Murdaugh has been on . The same in Dubbo, where the pilot 's hours had also expired hours of a 18-year-old. Father arrived back at the hospital any longer the public interest once he 'd successfully Alex! Grieves his parents deeply that they were not able to be brought out so Alex could be taken the... At Broken Hill hospital is prevented from transferring patients to Adelaide, despite the SA capital being than! Than Sydney and laboratory tests notin place at the alex braes coroner report department the delay transferring. 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