Australia: Sydney's killer hospital strikes again

And nothing is being done about the gross negligence concerned

A major [public] hospital has admitted that it failed to properly treat a disabled woman who died while in its care. Karen Stone, 41, was admitted to Sydney's St George Hospital in October 2004, with acute leg pain. She died a few days later from pulmonary thromboembolism after an undiagnosed clot in her leg travelled to her lung, the State Coroner found the following year. Now her mother wants to know why doctors at the hospital failed to give her routine preventative treatment.

Lynette Stone said both she and her daughter repeatedly asked hospital staff to investigate if the pain was caused by deep vein thrombosis. Their concerns were dismissed, even though Ms Stone was a high-risk patient. Mrs Stone questions if her daughter's disability meant she received less care and attention from staff. Ms Stone had a rare medical condition called Prader-Willi Syndrome that causes an obsession with food and eating, poor muscle tone and learning difficulties.

Debora Picone, who was in charge of the hospital at the time and is now the Director-General of NSW Health, said in a letter to the Health Care Complaints Commission soon after the autopsy that there was no excuse for the failure. "A satisfactory explanation was not documented in the clinical record nor was the caring medical team able to provide one when questioned," she wrote. She admitted the hospital should have provided anticoagulant therapy. The simple, but life-saving, injection was finally ordered by a professor who was taking a group of medical students on tour of the ward two days later, but the treatment was still not administered for another 24 hours. Ms Stone died the next day.

"It cannot be ascertained why the omission of treatment occurred," Professor Picone wrote. The Health Care Complaints Commission did not investigate the death, instead offering conciliation - an informal discussion with no power to make any decisions. Lorraine Long from Medical Error Action Group said government departments set up to deal with complaints had proved to be "ineffective" and a "waste of time" for bereaved families. "I have not encountered a person to be satisfied with a health-care complaints commission anywhere in the country," she said. "They want you to conciliate a death - it's obscene."

Mrs Stone said her daughter was a "wonderful soul" who brought endless joy to her family and friends. "In my heart I feel she should still be with us. If only they had taken more care, questioned more about why the pain wouldn't go away, she would not have died," she said. "If she'd been 'normal' would they have taken more notice of her?"

Venous thromboembolism, which refers to deep vein thrombosis and pulmonary embolism, causes 10,000 deaths each year in hospitals - more than lung and breast cancer combined. Professor Beng Chong, a hematologist at St George Hospital and head of the Department of Medicine at the University of NSW, said many hospitals did not assign the task of venous thromboembolism risk assessment to particular doctors or nurses, while many simply forgot.

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Absurd: Firefighters answering medical emergencies

FIRE crews in Queensland [Australia] have been used as a first response in medical emergencies for several years, despite denials by authorities. Documents obtained under Freedom of Information laws reveal that crews have been diverted from fires to attend medical matters because of a shortage of ambulances. In one case, a Cairns fire crew had to abort a fire call and attend a person who had been knocked unconscious in a nightclub fight.

In an exclusive Sunday Mail report in December, sources said fire trucks would soon be known as "red ambulances" in a radical plan to have firefighters attend more medical emergencies. The vehicles were to be fitted with life-saving defibrillators and used as a first response while the crisis-hit Queensland Ambulance Service struggled to cope with soaring life-threatening emergency calls.

Emergency Services Minister Neil Roberts, Fire Commissioner Lee Johnson and then Ambulance Commissioner Jim Higgins strenuously denied the claims. Mr Roberts said there was "no current plan" to convert fire trucks into red ambulances. But in a letter from the United Firefighters Union in July 2006, Mr Johnson and Mr Higgins were advised of "inappropriate requests" to use fire trucks as first responders.

Union state secretary Mark Walker said members were told the Queensland Fire and Rescue Service would not be used in this capacity - but it happened regularly. "Clearly, the QAS communications centre has requested QFRS attendance to provide a first-responder role . . . (when) there is no agreement with QAS for such a role," he said. Mr Walker said TV footage had shown an incident in the Brisbane CBD where a cyclist hit a pedestrian, with firies in attendance and no ambulance. A Charters Towers fire crew had been placed on standby for medical calls one weekend due to unavailability of QAS crews.

"We have serious concerns with our members being exposed to additional risks by being called upon to do the work of the ambulance service," Mr Walker said. "We also have concerns regarding the additional risks to the community when 13-tonne fire appliances are responded to any number of other incidents that do not warrant our attention." Mr Walker sought reassurance from the commissioners that the QAS would not dispatch fire crews "to incidents for the sole purpose of providing medical assistance".

In subsequent correspondence last year, the union said it was prepared to discuss an emergency medical service role for firefighters, but there needed to be a restriction on the number and type of incidents attended plus appropriate training.

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