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. The local proceedings of inquest into the death of Broken Hill teenager Alex Braes has finished after hearing of a "distressing"hospital business rule, staffing resources and apologetic doctors. 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. Mr Braes died a little more than an hour after being admitted. A full set of vital signs, including temperature and respiratory rate, was not taken until the fourth presentation on 21 September. His inquest has heard a full set of vital. Crucially, no-one did vital-signs observations such as check Alex's pulse, blood pressure, or temperature and they didn't take any blood for testing. "The only evidence that we have is that Alex had Streptococcus pyogenes grown in his bloodstream and he had septic shock," he said. An autopsy is an examination of the body of a deceased person, carried out by a qualified pathologist. 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. 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. He suffered multi-organ failure due to sepsis . 'An unthinkable tragedy': How did this train crash happen? Broken Hill teen Alex Braes died in 2017. Inquisitions on prisoners who died in the King's Bench prison are in KB 14. 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. "I feel heartbroken that I still have my children and that you've lost your boy.". Dr O'Donohoe later quit work at Broken Hill Hospital over what he saw as mismanagement, leading to patient safety issues. But so shocking is his case that it's prompted a group of clinicians who worked at Broken Hill Hospital to blow the whistle on what they believe is a hospital that had dangerous, systemic failures for years. Our Morning Edition newsletter is a curated guide to the most important and interesting stories, analysis and insights. The delayed transfer also deprived his parents of seeing him in his final hours, as they left the hospital to prepare to travel with him. 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". 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. In Newcastle and Wollongong, a magistrate is appointed by the Chief . Counsel assisting the coroner, Kirsten Edwards, said the delay in transferring Alex would be a very significant issue in the inquest. In lieu of an autopsy, a panel of experts determined he had an unusual presentation of a fast-acting, highly lethal infection, the NSW Coroners Court has been told. But questions are expected to continue about the handling of Alex Braes' case. 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, Girl's thumb replaced with toe after gruesome surgical error, Half-marathon runner dies after broken leg misdiagnosed three times. Tragically, what worked against Mr Braeswas his overall health and age, the inquest heard. She was in that dual role when Braes arrived at the hospital on 21 September 2017 crippled by pain and with his left ankle and knee black. A medical student struggled to insert the cannula. "An older person would've been much more unwell, prior to me arriving.". 00:00. Alex Braes died on September 22, 2017, with a suspected flesh-eating bacteria known as necrotising fasciitis ravaging his system, after he was turned away three times from Broken Hill Hospitals emergency department. Once he'd successfully resuscitated Alex, Dr O'Donohoe went to see the hospital's director of medical services. 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. "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.". The pathologist creates a written record of the autopsy findings, including the microscopic and laboratory tests. 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. There was no "grab and go" for Alex and that would have devastating consequences. More from Latest News Danish ex-minister charged with revealing state secrets Mr Braes, 18, died at Sydney's Royal Prince Alfred Hospital on September 22, 2017 after he was flown from Broken Hill. Alex went into cardiac arrest and died upon arrival at Royal Prince Alfred Hospital in Sydney. The clock starts ticking "as soon as they get the first phone call", according to Dr Greenberg. 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. Two New Fatal Earthquakes Hit Turkey Days After Deadliest Quake Killed 44,000 . This resulted in Braes' parents being denied a formal investigation "for an inexcusable length of time," Ryan said. 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. Again, no-one checked Alex's vital signs. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. Sign up here. 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. The high-profile . "Twelvehours passed before hisemergency flight landed at Sydney's Royal Price Alfred Hospital," Ms Ryan said. "To the extentthere were deficiencies in your clinical practice, do you think one cause was you feeling under time pressure? Alex Braes, 18, died at the Royal Prince Alfred Hospital in . By the following morning, Alex's pain was so excruciating, he couldn't walk. "Furthermore, Alex was not transferred to the closest hospital suitable forhis care, which was South Australia's Royal Adelaide Hospital," Ms Ryan said. "It means he'd been unwell for a significant number of hours at that point.". 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. Before his Honour Magistrate Lee, Deputy State Coroner Wednesday 1 March 2023 Inquest into the Death of A.W. All NSW magistrates are coroners by virtue of their status: s 16. Coroner training overview. . She recommended that, as matter of urgency, the healthdepartments agree to continue discussions for formalising that arrangement and that the matter be escalated to the NSW Health Secretary if that was not in place within a year. Posted by posopa9401 January 4, 2022 Posted in Opinions Tags: after, Braes, coroner, hears, septic, shockBrokenhospital, Transferoption. He suffered multi-organ failure due to sepsis from a group A streptococcus infection, one month after treatment for an infected ingrown toenail. NSW coroner Elizabeth Ryan also outlined major delays in transferring Alex Braes from Broken Hill to the Sydney hospital where he died. Copyright 2023 IBTimes LLC. 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. Like that day, she said the nurses were still often very busy and under an awful lot of pressure. 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. 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). 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. here. Broken Hill teenagerAlex Braes, who died of an infected toenail. It is replayed on Tuesday 10th September at 1.00pm and Wednesday 11th at 11.20pm. The inquest is investigating the treatment the teenager received before he died from a bacterial infection known as Group A Streptococcus (GAS). Annual training is also provided for coroners' officers. Alex's father wheeled him into the emergency department and a nurse observed him through a window and asked him to wait. 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. There was no bed available in Adelaide and a pilot could not take him to Sydney without exceeding his maximum allowable working hours. "Almost five years after Alex died this remains the case.". 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. I think it could easily happen I have a great fear it could happen, she said. Ryan found it was potentially dangerous and against NSW Health policy, but a systemic failure that could not be attributed to individual hospital staff. 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. 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. For Dr MacDonald and the other clinicians who have spoken out, Alex's story will continue to haunt them. 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 Braes. I think it was a totally avoidable death," Dr MacDonald said. Alex Murdaugh, a once prominent Hampton-based attorney from a well-known politically . 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. Ryan recommended the communication between the two states be escalated to the NSW secretary of health if cross-border transfer arrangements are not in place within a year. Alex arrived at Broken Hill Hospital's emergency department. 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. But one nurse was still responsible for both triaging patients in the waiting room and overseeing the departments nursing team. Broken Hill teenager Alex Braes, who died of septic shock. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. There was no autopsy so the cause of death cannot be definitively determined, Ms Edwards said. 7 Callum Jones: Sprained Ankle Causes Fatal Blood Clot. "I didn't know his family, I didn't know Alex Braes. "A significant one was the failure on September 20, 2017, to perform vital signs observations," Ms Ryan 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. 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. 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. "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. AEST = Australian Eastern Standard Time which is 10 hours ahead of GMT (Greenwich Mean Time), abc.net.au/news/alex-braes-death-still-haunts-doctors/11470424, Your information is being handled in accordance with the, 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. An inquest was established soon after that report and was due to undertake Broken Hill hearings last yearbut was delayed after coronavirusrestrictions affected proceedings. 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