I think it could easily happen I have a great fear it could happen, she said. The inquest will continue on August 31 with Sydney-based hearings. Alex arrived at Broken Hill Hospital's emergency department. Alex Braes (Credit: ABC "Four Corners," family photograph) The death has traumatised Braes' family and hospital staff alike. It would eventually take a whole year for an investigation to be done and that only happened because the doctors repeatedly lobbied the Ministry of Health and, ultimately, wrote to NSW Health Minister Brad Hazzard, to intervene. A doctor who later saw Alex Braes said the 18-year-old was 'the sickest patient he'd ever seen at Broken Hill' hospital. By the time Alex was diagnosed with a bacterial infection he was in septic shock and needed to be medically evacuated to Adelaide. a coroner has heard. She had a particular concern for newly graduated nurses assigned to care for non-acute patients who were still learning new skills and could potentially miss a deteriorating patient like Braes. Again, no-one checked Alex's vital signs. Braes had taken antibiotics for an ingrown toenail a month before his death, though investigating doctors told the inquest they could not be sure it was the cause of the later infection in his leg. Mr Braes, 18, was misdiagnosed as having a torn knee tendon while he was battling a life-threatening bacterial infection. He said every time he picked up his son's iPad, "it just reminds me of him. "We had to intubate him so that we could actually keep him stabilised on the flight," he said. Alex Braes. During the flight Alex continued to decline and, as his mother watched, the paramedics struggled to keep him stable, having to phone doctors for advice. It was only then that the source of Alex's pain was finally discovered he had an infected toenail which no-one had picked up on his three previous presentations. 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. 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. 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. Local hearings took place at the Broken Hill Coroner's Court this week, with a number of doctors and nurses who attended to Alex at Broken Hill Hospital appearing as witnesses alongside the teenager's father, John Braes. "There's always time pressure because there's only one triage nurse," replied Ms Murphy. 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. The senior nurse who realised Broken Hill teenager Alex Braes was suffering from septic shock has begged for more help for the understaffed and under-resourced country hospital. "And my greatest sympathy and sorrow, actually, to his family. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. 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. By the following morning, Alex's pain was so excruciating, he couldn't walk. "Almost five years after Alex died this remains the case.". "[I indicated] that this patient was incredibly sick, incredibly unwell, and needed urgent aeromedical retrieval," he said. My first thought was I havent finished obs for him, I havent done anything for him, have I missed something? she told the inquest. The Coroner's Report is a fictional crime scene report of the victims of various horror films. His inquest has heard a full set of vital. "A significant one was the failure on September 20, 2017, to perform vital signs observations," Ms Ryan said. Braes was stranded for hours awaiting medical evacuation as no hospitals in Adelaide were willing to receive him and no pilots were available to fly him to Sydney. She recommended NSW and SA health departments urgently agree to cross-border transfers of critically ill patients from Broken Hill. 'We failed him' The death of Alex Braes still haunts doctors who didn't even know him, 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. Inquest into the death of Alex BRAES CORONIAL LAW: death of a young man - cause of death sepsis - was clinical care at Broken Hill Base Hospital adequate - were arrangements or airlift to a tertiary hospital appropriate - recommendations Download Inquest into the death of Alex BRAES PDF File (358.2 KB) Last updated: 27 May 2020 The 18-year-old TAFE student's death was featured in a Four Corners report, which revealed he presented to Broken Hill Hospital's emergency department four times before vital signs observations were administered. The veteran clinician and patient-retrieval specialist, who has 36 years' experience, said he believed, inhindsight and now that he was "aware of the outcome", that there were a number of "ifs" including if Mr Braes had been takento Adelaide instead of Sydney. The inquest also heard from DrBaalbaki about whether expert recommendations surrounding Mr Braes' final presentation, such as having contact with an Intensive Care Unit (ICU) in Sydney, would havebeen of assistance. Doctors suspected he had a ruptured tendon and recommended rest and ice. One of them, DrAli Baalbaki, told the inquest he longer celebratedhis own birthday because it falls on the same day he reviewed the teenager. They sat there. In lieu of an autopsy, a panel of experts . His death has also devastated the clinicians working at Broken Hill. "I was aware that many of the staff felt that it affected the way they triaged and potentially could affect the accuracy of their triages," replied Ms Kelly. Sign up and stay up to date with our daily newsletter. 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. The inquest also heard the Broken Hill hospital is prevented from transferring patients to Adelaide, despite the SA capital being closer than Sydney. John Braes told the inquest at its first day of local hearings that his son had looked up 'can pain kill you' on his iPad in the days before his death. A medical student struggled to insert the cannula. 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. "What I do know is it was not a satisfactory outcome and that's why when I heard about it from the doctors, I had the ministry go back out there, go through it, and determine why this had been downgraded," he said. 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. About 21 hours after he first presented to the emergency department, and with 12 hours left to live, the treatment of the 18-year-old was handed over to the chief medical officer of the Royal Flying DoctorService (RFDS). "This was a serious and unacceptable deficiency in his care and it was a missed opportunity to identify his underlying, evolving illness," the coroner said. Key points: The Coroner's Court hears evidence about Alex Braes' medical treatment in his final 12 hours More from Latest News Danish ex-minister charged with revealing state secrets He would follow them to Sydney on a commercial flight. Alex Braes, of Broken Hill, died in the early hours of Sept. 22, 2017, upon arriving at Royal Prince Alfred Hospital in Sydney, 7News.com.au reported. You often need to be in two places at once, she told Braes inquest. "We've gone back to the full set of obs (observations) at every triage," she said. 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. 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. The clock starts ticking "as soon as they get the first phone call", according to Dr Greenberg. 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. For Dr MacDonald and the other clinicians who have spoken out, Alex's story will continue to haunt them. Mr McLean says he spoke up and tried to get something done but he was ignored by hospital management. After arriving at Broken Hill base hospital on 21 September, Braes was put in a non-acute bed. Health workers union takes fight for kitchen staff in NSW aged care home to federal court, Original reporting and incisive analysis, direct from the Guardian every morning. A man died just hours after entering a secure mental health unit. The "first and only option" available to a specialist doctor treating a gravely ill teenager in a country hospital was to fly him elsewhere, a coroner has been told. An inquest into how a Broken Hill teenager died from an infected toenail has heard his condition deteriorated rapidly in his final hours. It's something that troubles local MP Roy Butler. Findings and upcoming inquests - Coroners Court Inquest findings (since 2004) as well as non-inquest public interest matters (since 2012) are available below. Kelly said she had raised staffing levels with hospital management but was led to believe the departments patient numbers did not warrant an extra nurse. "I remember thinking that I wished I would have the same relationship with my children when they grew up. 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. "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.". The second day of hearings heard from DrDavid Hooper, who reviewed Alex during his third presentation to the local hospital on September 20, 2017. It recently handed down 44 recommendations to boost the rural medical workforce and improve the standard of care. AEST = Australian Eastern Standard Time which is 10 hours ahead of GMT (Greenwich Mean Time), abc.net.au/news/senior-treating-doctor-reflects-on-day-two-of-alex-braes-inquest/100703130, Get breaking news alerts directly to your phone with our app, Help keep family & friends informed by sharing this article, China leaving US behind on development of critical technologies, report finds, Former minister takes 'absolute responsibility' for Robodebt, admits defending scheme despite knowing it could be unlawful, 'Sickening, callous and brazen': Sydney man dies in hail of bullets in front of 12yo son, Evelyn worked three jobs when she was in her 20s to build up her super. a coroner has heard. A coroner has blasted a NSW hospital for attempting to avoid an investigation into a teenager's death from sepsis after he was sent home from its emergency department, finding efforts to deny the significance of the tragedy inexcusable and deeply distressing to his family. Like that day, she said the nurses were still often very busy and under an awful lot of pressure. Broken Hill teenager Alex Braes's parents remember him as a ray of sunshine, a funny and smart young man ready to live a full life. But the 18-year-old mechanic died with "tragic suddenness",. "Because it's not good enough in 2019 to have people in the far west of New South Wales having worse health outcomes than people in the city.". The pathologist creates a written record of the autopsy findings, including the microscopic and laboratory tests. The inquest will investigate the treatment Alex Braes received before he died from a bacterial infection known as Group A Streptococcus (GAS). Yesterday's fourth and final day of the Broken Hill hearing heard from two more doctors who reviewed Alex Braes while he was still in the city. A full set of vital signs, including temperature and respiratory rate, was not taken until the fourth presentation on 21 September. "Every person (from) the smallest thing to the largest thing, they get a set of obs.". Alex Braes, 18, died at Sydney's Royal . But the Flying Doctors were unable to transport Alex because the only available pilot had already reached their maximum flying hours a regulation governed by the Civil Aviation Safety Authority. It was far too late. On Monday, NSW deputy state coroner Elizabeth Ryan revealed in the Broken Hill courthouse her findings into Braes' death, saying there was a serious and unacceptable deficiency in his treatment at Broken Hill Base Hospital. In her comments before delivering the findings,Ms Ryan was critical of abusiness rulethat was then inplace at Broken Hill Hospital which effectively discouraged nursesfrom taking vital signs observations. Experts assembled for the inquest said they had notcompletely agreed on the cause of Alex's death. 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"Twelvehours passed before hisemergency flight landed at Sydney's Royal Price Alfred Hospital," Ms Ryan said. "All I can say is since I became aware of the death of Alex Braes, I don't think I have stopped thinking about that young man.". On Monday, New South Waless deputy state coroner, Elizabeth Ryan, handed down her findings into Braes death, saying there was a serious and unacceptable deficiency in his treatment at Broken Hill base hospital. 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. For that (new) triage process to work, there needs to be more staff and more resources to prevent any more tragic circumstances, the nurse said. 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. In conjunction with the Chief Coroner, the Judicial College delivers a varied training programme for all coroners involving induction, continuation and one-day training on specific topics. Ryan also outlined major delays in transferring Braes to the Sydney hospital where he died in the early hours of 22 September 2017, after he was refused admission at a South Australian tertiary facility due to a policy preventing interstate transfers. Broken Hill teen Alex Braes died in 2017. Because you left the triage window unattended and there were a lot of patients there," asked Ms Edwards. Coroner's Report: With Willa Ford, Peter Barton, Michael Swan, Kyle Labine. "One of the things that really stood out for me when I saw you that night was how sweetly you and Alex treated one another," he said. "Yes that's my understanding," replied Ms Anderson. The inquest into the death of Broken Hill teenager Alex Braes, who died of an infected toenail four years ago, will begin on Monday. So what went wrong? All rights reserved. There was an "extraordinary lack" of progress between NSW Health and SA Health in establishing a formalized cross-border arrangement to transfer critically-ill patients from Broken Hill to Adelaide, Ryan said. According to these figures, for every 100,000 people, there are 91.6 avoidable deaths in major cities, compared to 248.7 avoidable deaths in very remote parts of the country. 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While Broken Hill Hospital's deficiencies did not cause or contribute to Braes' death, the hospital's administration and the Far West Local Health District downgraded the severity classification of the incident. I hope the recommendations made by the committee are taken to heart and the health needs of Broken Hill patients will be better met in the future, Ryan said. Follow our Australia news live blog for the latest updates, serious gaps in healthcare in rural and regional areas. Ironically, though, the sudden death of Dudley's wife in September 1560 removed any hope that the queen might have . 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. Copyright IBTimes 2023. The inquest heard Mr Braes had an ingrown toenail in August 2017 that was successfully treated with antibiotics. 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 . Alex Braes, 18, suffered multi-organ failure due to sepsis and died after hospitals either despatched him domestic or refused to admit him. Dr Hooper, who resigned from his position as a senior visiting medical officer at Broken Hill Hospital two months ago, told the inquest yesterday that Mr Braes' death was a "profound event" in his life. He turned up three times at the emergency department of Broken Hill Hospital as his knee became increasingly swollen and painful but was sent home each time. Infectious diseases specialist Phillip Braslins said he was considering amputation after 18-year-old Alex Braes went into septic shock in Broken Hill Base Hospital on September 21 . In addition to being told to return home on his first three visits to Broken Hill Hospital, Braes was also refused admission at a South Australian tertiary facility on Sept. 21, 2017, due to a policy preventing interstate transfers. The death of a healthy 18-year-old man who first attended a hospital with moderate knee pain is almost incomprehensible, she said. Alex Braes, 18, died at Sydney's Royal Prince . 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. All NSW magistrates are coroners by virtue of their status: s 16. Alex Braes is believed to have died from a type of flesh eating bacteria, known as necrotising fasciitis, after he was turned away three times from Broken Hill Hospital's emergency department in . When a death is reported to the Coroner The coronial process explained for the family and friends of a deceased or missing person east Access to Coronial documents How to apply for documents used in an inquest or inquiry east Help and support Support for family and friends of a deceased or missing person east In a statement, the FarWest Local Health District said it expressedits deepest sympathies to the family of Mr Braes and acknowledgedthe heartache caused by his death. We will use your rating to help improve the site. Broken Hill teenager Alex Braes, who died of septic shock. This was due to a business rule, which discouraged staff from taking vitals during the triage stage in order to improve efficiency. . Labor set a superannuation trap and Dutton immediatelytook the bait, Here's what the super tax changes might mean for you, NT Labor candidate confirms involvement in fatal car crash that led to conviction of driving without due care, Freya is one of 15,000 Australians who must find a new life-saving medication or pay a much higher price, Man who murdered Jay Brogden convicted of contempt of court, Live: Australia loses first wicket on day two but still on top in Indore. Alex was now in toxic shock from a deadly, flesh-eating disease known as necrotising fasciitis. Alex Braes, 18, died at Sydney's Royal Prince Alfred hospital nearly 46 hours after limping into Broken Hill Base hospital at 3am on 20 September 2017. On the first day, the Broken Hill hearings heard that Alex mighthave died from an infection, invasive Grade A Streptococcus, possibly from the ingrown toenail or a cut. He went into cardiac arrest. 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. The inquest heard that during that time, Alex was in a wheelchair, John Braes had already reported Alex's knee problem, and they'd already seen a doctor. Unfortunately, the night pilot had called in sick. Hospital staff trying to evacuate patients were still having issues with planes being grounded due to pilot hours and patients having to wait, Kelly said, while noting she was not clear on the ins and outs of the process. 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. Of experts iPad, `` it means he 'd been unwell for alex braes coroner report significant number hours... Gaps in healthcare in rural and regional areas Twelvehours passed before hisemergency landed. 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