The widely reported death of a young Central Coast university student raises questions about what rights and remedies patients and their families have when things go wrong in a hospital emergency department. Mischelle Rhodes, who died from meningococcal disease, was sent home from Gosford Hospital the evening before with pain killers. We do not yet know all of the facts of this particular case but it was heartbreaking to see Mischelle’s mother on Nine News regret not being more forceful with hospital staff. She said she is not angry with nurses and doctors, but that she “made a mistake leaving the hospital that night”.
The Central Coast Health District said it will review the case as part of standard processes. But others, including Wyong MP David Harris, are calling for an external review.
They were four meningococcal deaths of children and teenagers between 1999 and 2007 that exposed significant failings in how Central Coast public hospitals responded to meningococcal cases. As Fairfax media journalist Joanne McCarthy reports, coroners later found their deaths were “preventable”, hospital staff and doctor failures were “inexcusable” and “catastrophic”, clear warning signs were missed or ignored and parents’ desperate pleas for help and treatment in their children’s final hours were dismissed by staff. One child, Stephen Sanig was also sent home with painkillers.
From the cases we see there is an argument that regional hospitals are often understaffed and resourced to properly care for patients. The latest Bureau of Health Information Quarterly Report for NSW public hospitals shows that, across the state, one in four people presenting to emergency departments waited too long to be treated.
It shows that the number of people attending Gosford Hospital Emergency Department continues to grow, quarter on quarter, particularly for the more urgent triage cases. An external review is appropriate in Ms Rhodes case.
The right to open disclosure
Mischelle’s mother is entitled to know what happened in her daughter’s case. For some people, knowing what went wrong in a hospital or other health care facility and why is all they require to put the incident behind them and move on.
There are systems in place in hospitals for adverse events to be investigated, the cause of the problem identified and measures put in place to prevent a recurrence. The NSW Health Open Disclosure Policy has more information. It was developed because patients, their family members and health care staff report that their expectations for care and information following a patient safety incident have not always been met.
These tragic cases always reinforce the need for patients and families to feel confident to speak up and challenge health staff if they feel that the level of care is inappropriate or taking too long.
Compensation
When death or injury occurs because of medical negligence or failures in hospital systems, patients and their families may be entitled to compensation. Read more about that in a blog by some of my colleagues.
One case that may serve as an example of the type of things that can happen when ED departments are understaffed is Curtis v Queen Elizabeth Hospital [2008] SADC 22. In that case the plaintiff established that the doctor employed at the hospital failed to diagnose and treat her meningitis. The plaintiff was treated for migraine and discharged without a diagnosis of meningitis having been considered.
Another relevant case is that of Wang v Central Sydney Area Health Service [2000] NSWSC 515. In that case the plaintiff left the hospital after seeing the triage nurse but before being seen by a doctor due to the lengthy wait to be seen. The case confirmed that the hospital owed a duty to assign persons presenting to the ED with appropriate priority, via a triage system. However, Justice Hidden said that no duty to provide medical services would arise until a person was able to be accommodated in the treatment area. Justice Hidden also stated that hospital’s duty required them to furnish patients with appropriate advice if they indicated that they intend to leave the hospital before they have seen a doctor.
About Meningococcal disease
Meningococcal is difficult to diagnose and has a fatality rate of 5-10 per cent despite advanced treatment. Symptoms include sudden onset of fever, headache, neck stiffness, joint pain, a dislike of bright lights, nausea and vomiting. A rash of red-purple spots or bruises appear in about 75 per cent of cases after the disease has progressed to a serious degree. Immunisation for meningococcal is available in NSW for babies and for teenagers in Yrs 10, 11 and 12.
Our expert health law team can help
If you or someone you know feels they received inadequate care, particularly if it caused death or injury, please do not hesitate to call our expert, caring team of health lawyers to discuss what options are available to you to seek answers, justice or compensation.
