One nurse is responsible for two jobs at the Broken Hill hospital, the inquest into the death of Alex Braes has heard. 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. 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. "He was our first child, our ray of sunshine," he said. Dr Greenberg explained to the inquestthat the situation was the same in Dubbo, where the pilot's hours had also expired. Ms Edwards said it is a NSW Health policy that hospitals check vital signs before discharging a patient from emergency. She noted that there was no realistic possibility that his specific infection could have been identified and successfully treated on September 20, 2017. 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. "A significant one was the failure on September 20, 2017, to perform vital signs observations," Ms Ryan said. 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. Before Alex's death, doctors had complained repeatedly that management was not open to criticism and did not listen to safety concerns they raised. Ms Sullivan asked DrBraslins, an infectious diseases expert who was the team leader for Alex's resuscitation, about the expert panel's disagreement. 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 nurse did not provide the pillow but left her post to go out into the waiting room to check on Alex. 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. "To the extentthere were deficiencies in your clinical practice, do you think one cause was you feeling under time pressure? 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. 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). An inquest into his death by the NSW Coroners Court is investigating the treatment the teenager received before he died from a bacterial infection known as Group A Streptococcus (GAS). Alex Braes died at Sydney's Royal Prince Alfred Hospital after going to another hospital four times. "After Alex's tragic death, Broken Hill Hospital retuned to the practice of taking a full set of vital signs measurements for all patients coming to the emergency department," she said. Eighteen-year-old Alex Braes' knee was so painful, he asked his father to take him to Broken Hill Hospital. She told Four Corners that by this stage, Alex was desperately unwell, yet he was again left waiting. She noticed he was sweaty and unwell and moved him into a bed in the emergency department. 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. Broken Hill teen Alex Braes died in 2017. Mr Braes died a little more than an hour after being admitted. "But the source of that infection was never confirmed, as I understandbecause an autopsy was not performed. 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. 23 April 2021. Experts assembled for the inquest said they had notcompletely agreed on the cause of Alex's death. Alex Braes, 18, died on 22 September 2017 from multi-organ failure due to sepsis from a Group A streptococcus infection. When asked by Ms Edwards if she was feeling under a lot of pressure that morningand finding it difficult to manage workflow, Ms Murphy answered 'yes' to both questions. Alex Murdaugh's defence has rested its case after calling a total of 14 witnesses to try to convince jurors he is innocent of the murders of his wife Maggie and son Paul.. The teen's vitals were only observed during his fourth and final presentation, and a suspected toenail infection was identified. 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 A medical student struggled to insert the cannula. 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 . 'An unthinkable tragedy': How did this train crash happen? Mr Braes was conscious and speaking to staff and was "compensating for the sepsis until he couldn't". He said every time he picked up his son's iPad, "it just reminds me of him. A teenager who had been turned away three times from Broken Hill Hospitals emergency department Googled can pain kill you? on his tablet device before he died from septic shock. Two New Fatal Earthquakes Hit Turkey Days After Deadliest Quake Killed 44,000 . Download the ABC News app for all the latest. Media Access When a Coroner investigates a death or a fire or explosion, the court gathers a range of documents which make up the coronial file. Ms Kelly today told the court she was on a break when Mr Braes represented at the hospital with his dad on September 21. Dr Randall Greenberg on Wednesday spokeat length in the New South Wales Coroner's Court about Mr Braes' condition, and issues thatprevented the RFDS from transferring him to Sydney or Adelaide sooner. 00:00. Doctor leading team in NSW's far west 'deeply shocked' to learn 18-year-old died after being evacuated to Sydney Broken Hill doctor who led team working on 18-year-old Alex Braes teenager has. It's something that troubles local MP Roy Butler. 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. He was later medically evacuated to Royal Prince Alfred Hospital, where he died within an hour of his arrival. "It is entirely possible that Alex had a severe cellulitis without reaching the threshold of necrotising fasciitis, which led to his bloodstream infection and sepsis.". One of them, DrAli Baalbaki, told the inquest he longer celebratedhis own birthday because it falls on the same day he reviewed the teenager. Registered nurse Michelle Murphy, who attended to Alex on his fourth presentation, told the inquest that nurses found the rule 'quite distressing'. He went into cardiac arrest. Broken Hill Hospital is one of several under the spotlight as a parliamentary inquiry probes the state of regional hospitals. A shortage of resources was one factor contributing to Mr Braes' death, Ms Kelly said. In October 2021, 27-year-old Callum Jones was peacefully walking his dog when he sprained his ankle by slipping on a wooden bridge. Counsel assisting the coroner, Kirsten Edwards, said the delay in transferring Alex would be a very significant issue in the inquest. 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. 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. "Yes, it would've been very helpful to have such contact with a big centre ICU," he replied, "That you get expertise as early as possible involved.". Mr Braes told the inquest that even once Alex became gravely ill, there was no ambulance available to take him to Broken Hill Hospital, no hospitals willing to admit him in Adelaide and no pilot available to fly him to Sydney. Ms Edwards asked Ms Murphy whether it was still the case that a nurse with three years of experience could be caring for nine patients. Alex's father wheeled him into the emergency department and a nurse observed him through a window and asked him to wait. However, at the time of Alexs death, Broken Hill Hospital had implemented a business rule that meant nurses were discouraged from taking vital signs during triage. Alex died in the early hours of September 22, 2017, at Royal Prince Alfred Hospital, Sydney, after being transferred from his local hospital. The family had to wait several hours for an aircraft to be dispatched from Sydney to collect Alex. 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 . Alex Murdaugh called 911 on the evening of June 7, 2021, and said he'd found his son and wife dead when he returned home from a one-hour visit with his mother, who has dementia. The decision not to transfer the teenager to a better-equipped, major hospital sooner was also under the microscope. This would have left the state's Far West region without a pilot or plane, according to the retrieval specialist. By the time Alex was diagnosed with a bacterial infection he was in septic shock and needed to be medically evacuated to Adelaide. The Deputy State Coroner has criticised a regional hospitals treatment of a boy who was repeatedly sent home before dying from sepsis. Counsel Assisting the coronial Inquest Emma Sullivan asked registered nurse Caroline Anderson, who attended to Alex on his first presentation, whether the rule had applied to him at that presentation. the NSW member for Barwon said. But questions are expected to continue about the handling of Alex Braes' case. But their boy suddenly deteriorated sharply. As his pain began to worsen, he was taken to the hospital, where he was diagnosed with a fractured ankle. Sign up here. A doctor who later saw Alex Braes said the 18-year-old was 'the sickest patient he'd ever seen at Broken Hill' hospital. Alex was given a triage category of three, meaning the patient must see a doctor within 30 minutes. 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. and Fire at Capertree Directions Hearing Forensic Medicine and Coroner's Court Complex, 1A Main Ave, Lidcombe Courtroom 2 at 9:30am Before her Honour Magistrate Forbes, Deputy State Coroner Wednesday 1 March 2023 Broken Hill Base Hospital in NSW had a 'business rule' that discouraged the taking of routine vital signs at ED triage, reports hearing into Alex Braes' death in 2017. Alex Braes. Alex arrived at Broken Hill Hospital's emergency department. Broken Hill teenager Alex Braes, who died of septic shock. Did you find what you were looking for? Were working to restore it. "This was a perverseoutcome whichdemanded examination at the inquest.". In lieu of an autopsy, a panel of experts determined he had an unusual presentation of a fast-acting, highly lethal infection called invasive group A streptococcal. 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. 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. 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. All Rights Reserved. In lieu of an autopsy, a panel of experts . He would follow them to Sydney on a commercial flight. They include a significant number of items from the mid to late 18th century, although the practice of forwarding all inquisitions to the King's Bench appears to have fallen into disuse in the early 18th century. Because you left the triage window unattended and there were a lot of patients there," asked Ms Edwards. 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. 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. 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. Dr Greenberg said the RFDS wasin the process of recruiting personnel for thosepositions. Alex and his father arrived back at the emergency department. There was no bed available in Adelaide and a pilot could not take him to Sydney without exceeding his maximum allowable working hours. Posted by posopa9401 January 4, 2022 Posted in Opinions Tags: after, Braes, coroner, hears, septic, shockBrokenhospital, Transferoption. 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. "I know it was after Alex passed away," she said. "An older person would've been much more unwell, prior to me arriving.". Dr Kerrie MacDonald is a paediatrician who used to work at Broken Hill Hospital and is still in the NSW health system. Deputy State Coroner Magistrate, Elizabeth Ryan, asked Ms Murphy whether the rule resulted in fewer cases of vital signs being taken and recorded at the hospital once implemented. The coroner Elizabeth Ryan has heard the Royal Flying Doctor Service was not able to evacuate Braes as the trip would have exceeded the flying hours for the pilot available that day. "I didn't know his family, I didn't know Alex Braes. 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. "A young man who died, essentially, from an infected toenail, from the consequences of an untreated and very common infection. "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.". A coroner found serious and unacceptable deficiency in a teen's treatment at Broken Hill hospital. "And I think that the clinicians who would have been with him when he was so sick in emergency will not forget him.". It was a horrific outcome and such a young man, only 18 years old.". The highly experienced clinician also took time at the end of his testimony to address the Braes family directly. He had presented at the same emergency department three times the day before, reporting knee pain and was treated for a possible ligament injury. 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