Far Western Local Health District, through a spokesperson, acknowledged the need to learn from Braes' death and said it would consider the coroner's findings. It's just such a tragedy," he said. Mr Braes was conscious and speaking to staff and was "compensating for the sepsis until he couldn't". But the 18-year-old mechanic died with "tragic suddenness",. She recommended NSW and SA health departments urgently agree to cross-border transfers of critically ill patients from Broken Hill. "This was a perverseoutcome whichdemanded examination at the inquest.". 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. "We had to intubate him so that we could actually keep him stabilised on the flight," he said. 'An unthinkable tragedy': How did this train crash happen? The hospital at the time had a policy running contrary to a NSW Health mandate that allowed staff to send patients home without taking a full set of vital signs. Alex's father called triple zero to ask an ambulance to take his son to hospital, but no ambulance was available. Dr MacDonald believes if you're in a remote centre and become gravely ill, the hospital needs to be equipped for what she describes as a "grab and go". I think it could easily happen I have a great fear it could happen, she said. Download the ABC News app for all the latest. Alex Braes, 18, died at the Royal Prince Alfred Hospital in . 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. 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. 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. She said as a hospital practice it was not compliant with NSW Health policy. He called his father home from work. All rights reserved. "I feel heartbroken that I still have my children and that you've lost your boy.". Alex Braes died at the Royal Prince Alfred Hospital in Sydney on September 22, 2017, after being transferred from Broken Hill Hospital. "An older person would've been much more unwell, prior to me arriving.". As his pain began to worsen, he was taken to the hospital, where he was diagnosed with a fractured ankle. 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. 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 Edwards asked Ms Murphy whether it was still the case that a nurse with three years of experience could be caring for nine patients. 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. Each season is dedicated to a different series in horror. 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, 'Can pain kill you? 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". 'An unthinkable tragedy': How did this train crash happen? 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 . 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. The family had to wait several hours for an aircraft to be dispatched from Sydney to collect Alex. 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. 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. 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. Broken Hill Hospital management downgraded the categorisation of Alex's death, meaning it wasn't referred immediately for an investigation, as is required under the state's Health Administration Act. "This was a seriousand unacceptabledeficiency in his care and it was a missed opportunity to identify his underlying, evolving illness," she said. Thirty-three hours after he had first presented to Broken Hill Hospital, hospital staff finally did vital-signs observations. Alex's father wheeled him into the emergency department and a nurse observed him through a window and asked him to wait. Two New Fatal Earthquakes Hit Turkey Days After Deadliest Quake Killed 44,000 . Please don't include personal or financial information here, My property was damaged or destroyed in the fires FAQ. The inquest will continue on August 31 with Sydney-based hearings. 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. She said evidence highlightedthat Mr Braes was effectively refused admission to a South Australian tertiary hospital on September 21, 2017. "Certainly other hospitals will highlight a second presentation or third presentation, [to ask] 'have we missed something?'" 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. Alex Braes, 18, died on 22 September 2017 from multi-organ failure due to sepsis from a Group A streptococcus infection. Copyright 2023 IBTimes LLC. Counsel assisting Coroner Kristen Edwards asked Arangala how it felt getting the call from doctors at Royal Prince Alfred Hospital in Sydney, informing him Braes had died on September 22. A medical student struggled to insert the cannula. Alex's parents were too distressed to be interviewed, but conveyed to Four Corners the loss of their son had left them feeling that, to the hospital system, he was worth nothing. The inquest is investigating the treatment the teenager received before he died from a bacterial infection known as Group A Streptococcus (GAS). However, the rule did not comply with NSW Health policy, was "potentially dangerous" and should not have been introduced, according to Ryan. Alex Braes. Browse for your location and find more local ABC News and information. "Almost five years after Alex died this remains the case.". After arriving at Broken Hill base hospital on 21 September, Braes was put in a non-acute bed. An infectious diseases specialist has told an inquest he was considering amputation to save the life of a gravely ill teenager he was treating at a rural hospital, but that the only option was to fly him elsewhere. "I was gobsmacked that it didn't prompt an investigation straight away," he said. By the fourth visit Alex was in excruciating pain and the leg was turning a dark purple colour. They sat there. Please confirm you want to block this member. Alex Murdaugh, a once prominent Hampton-based attorney from a well-known politically . Alex Braes, 18, died at Sydney's Royal Prince Alfred Hospital nearly 46 hours after limping into Broken Hill Base Hospital at 3am on September 20, 2017. Our Morning Edition newsletter is a curated guide to the most important and interesting stories, analysis and insights. "And I think that the clinicians who would have been with him when he was so sick in emergency will not forget him.". In lieu of an autopsy, a panel of experts . These figures meant the odds were against Alex Braes from the start. Authorities said . The inquest heard Mr Braes had an ingrown toenail in August 2017 that was successfully treated with antibiotics. 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. Part 1 Requesting the Autopsy Report 1 Understand the purpose of an autopsy. Ms Kelly today told the court she was on a break when Mr Braes represented at the hospital with his dad on September 21. Experts assembled for the inquest said they had notcompletely agreed on the cause of Alex's death. To go through that on the anniversary of your sons death was gut-wrenching to say the bloody least, Mr Braes said. We will use your rating to help improve the site. 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. The 18-year-old died about 1am on 22 September soon after landing in Sydney after a prolonged effort to evacuate him from Broken Hill. 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 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. 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. 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. "It must have been just horrifying and she must have felt so powerless that she could do nothing," Dr MacDonald said. First doctor to treat NSW teenager who died from infection admits he should have taken vital signs, Original reporting and incisive analysis, direct from the Guardian every morning. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. 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. He told the inquest though, that on the balance of probabilities, Alex most likely had necrotising fasciitis. 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. "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. Dr. Piazza - Injury and Thrombosis. 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 . 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. Alex finally left the hospital and was put onto the air ambulance which took off with his mother also on board. Unfortunately, the night pilot had called in sick. 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. 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. 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. 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. 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. 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 Follow our Australia news live blog for the latest updates, serious gaps in healthcare in rural and regional areas. The investigation, known as a root cause analysis, was completed following complaints by hospital whistleblowers and coincided with the first anniversary of Alexs death. Justifiably outraged at the poor care of his son, John Braes. Sign up here. Tragically, what worked against Mr Braeswas his overall health and age, the inquest heard. Alex was told to go home and come back later that morning for an ultrasound. 00:00. In Newcastle and Wollongong, a magistrate is appointed by the Chief . Key points: Mr Braes' cause of death identified as multi-organ failure due to sepsis from a group A streptococcus infection I don't even know what he looks like. Broken Hill teen Alex Braes died in 2017. The 18-year-old died about 1am on September 22 soon after landing in Sydney after a prolonged effort to evacuate him from Broken Hill. Like that day, she said the nurses were still often very busy and under an awful lot of pressure. This action will also remove this member from your connections and send a report to the site admin. After his ultrasound, he expected a doctor to review his results but the emergency department was so busy, no-one could see him. "I just wanted to send my condolences and I'm so sorry that it happened. A shortage of resources was one factor contributing to Braes death, Kelly said. 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. What health. 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. 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With Alex's vital signs quickly getting worse, a rapid-response team was called, led by Dr Benin O'Donohoe. 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. Can pain kill you?: Teens final words after he was turned away from NSW hospital. "Many changes have already been implemented by Far West NSW Health District and NSW Ambulance.". "Every person (from) the smallest thing to the largest thing, they get a set of obs.". 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. Please allow a few minutes for this process to complete. Mr McLean says staff had to provide life support before Alex could be put on the plane. (Supplied) Friday, 12.50am 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. The death of a healthy 18-year-old man who first attended a hospital with moderate knee pain is almost incomprehensible, she said. Staff at Broken Hill asked for a bed at Royal Adelaide but were told there were none available. 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. Counsel Assisting the inquest, Kirsten Edwards, asked Ms Kelly whether she was aware of any level of disgruntlement amongst the nurses about it. 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. 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. An inquest into how a Broken Hill teenager died from an infected toenail has heard his condition deteriorated rapidly in his final hours. 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. An autopsy is an examination of the body of a deceased person, carried out by a qualified pathologist. Ms Anderson was then asked when the rule was disbanded. Alex went into cardiac arrest and died upon arrival at Royal Prince Alfred Hospital in Sydney. He revealed all the medical staff "misjudged" Mr Braes, who was "compensating very well" because he was "a young, fit fellow". Doctors at the hospital initially suspected that Braes' pain was caused by a ruptured tendon even though the teen's father mentioned he did not play sports, a report by the Sydney Morning Herald said. The high-profile . "I'm so sorry that this happened to you," said DrArangala to the Braes family in an emotional, sombre tone. It was far too late. Mr Braes, 18, was misdiagnosed as having a torn knee tendon while he was battling a life-threatening bacterial infection. "Alex was semi-conscious, he was rambling, he wasn't responding to simple questions," Dr O'Donohoe said. Laws governing each of these documents and their contents vary from state to state. WALTERBORO, S.C. . 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. Transfer 'only option' after teen Alex Braes went into septic shock in Broken Hill hospital, coroner hears. Coroner training overview. 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. 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". The nearest tertiary hospital to Broken Hill was Royal Adelaide, which although in another state, had a much closer flying time than Sydney. 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. 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.. Alex arrived at Broken Hill Hospital's emergency department. 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. She said it was likely that Mr Braes' temperature was measured that morning but not his pulse rate,rate of breathing or blood pressure. She described the death of the fitter and turner as almost unbearable to imagine for the family. It can also be seen on . 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. His inquest has heard a full set of vital. 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. "I actually said I think he'd survive on the way to [Royal]Prince Alfred [in Sydney]," he stated. Dr Greenberg said the teenager was in a "relatively good" conditionfor someone who was critically ill. "The only evidence that we have is that Alex had Streptococcus pyogenes grown in his bloodstream and he had septic shock," he said. 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. Ryan found it was potentially dangerous and against NSW Health policy, but a systemic failure that could not be attributed to individual hospital staff. Ms Edwards said it is a NSW Health policy that hospitals check vital signs before discharging a patient from emergency. 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. 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. The practice was the result of a hospital "business rule" that discouraged staff from taking vitals during the triage stage in order to improve efficiency, the inquest heard. The decision not to transfer the teenager to a better-equipped, major hospital sooner was also under the microscope. "I know it was after Alex passed away," she said. It grieves his parents deeply that they were not able to be with him in his last conscious hours, Ryan said. 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. "Yes that's my understanding," replied Ms Anderson. "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.". This would have left the state's Far West region without a pilot or plane, according to the retrieval specialist. 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. 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 is replayed on Tuesday 10th September at 1.00pm and Wednesday 11th at 11.20pm. Alex Braes. 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. The Deputy State Coroner has criticised a regional hospitals treatment of a boy who was repeatedly sent home before dying from sepsis. Were sorry, this feature is currently unavailable. Dr Kerrie MacDonald is a paediatrician who used to work at Broken Hill Hospital and is still in the NSW health system. 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. Max McLean was the after-hours nurse manager at Broken Hill. 95 Hits - Ajith May 31, 2022, 7:26 PM. Broken Hill teen Alex Braes died in 2017. Key points: The Coroner's Court hears evidence about Alex Braes' medical treatment in his final 12 hours A centralised medevac dispatch system has since been introduced and Broken Hill now has formalised agreements to evacuate patients to Royal Adelaide hospital and The Womens and Childrens hospital, Adelaide. 00:00. Alex's father managed to bundle his six-foot-three son into the family's car and drive for a fourth time to the emergency department. Coroners' inquisitions are also in KB 13 and KB 140. "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.". 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. Several changes had occurred to the patient triage process at Broken Hill base hospitals emergency department since the September 2017 death of Alex Braes, the registered nurse Kristy Kelly told the NSW coroners court on Wednesday. "And my greatest sympathy and sorrow, actually, to his family. 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. 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