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. the NSW member for Barwon said. Coroner identifies unacceptable treatment in lead-up to death from multi-organ failure due to sepsis, calls for new interstate rules. Ms Ryan was also concerned that Mr Braes' retrieval and transfer out of Broken Hill Hospital was beset by numerous delays. 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. 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. 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'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. A doctor who later saw Alex Braes said the 18-year-old was 'the sickest patient he'd ever seen at Broken Hill' hospital. The high-profile . Eighteen-year-old Alex Braes' knee was so painful, he asked his father to take him to Broken Hill Hospital. Editor's note: This article contains graphic descriptions from autopsy reports and witness testimony. "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. 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. The clock starts ticking "as soon as they get the first phone call", according to Dr Greenberg. "Unfortunately it's a very serious omission that somebody who's been repeatedly in the emergency department hasn't been gone over with a fine-tooth comb," he said. 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 don't include personal or financial information here, My property was damaged or destroyed in the fires FAQ. The highly experienced clinician also took time at the end of his testimony to address the Braes family directly. This was due to a business rule, which discouraged staff from taking vitals during the triage stage in order to improve efficiency. 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. For legal cases involving intentional or accidental death and for insurance claims, The Records Company retrieves coroner's reports and autopsy reports. 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. 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 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. The inquest will continue on August 31 with Sydney-based hearings. He was later medically evacuated to Royal Prince Alfred Hospital, where he died within an hour of his arrival. All rights reserved. Broken Hill teen Alex Braes died in 2017. 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. Mr McLean says staff had to provide life support before Alex could be put on the plane. 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. Dr O'Donohoe spoke to the Royal Flying Doctor Service at Broken Hill. 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. 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. It will include an autopsy report, police report, the victim number of the series, personal information of the victim, and much, much more to make the Coroner's Report . "Yes that's my understanding," replied Ms Anderson. The nearest tertiary hospital to Broken Hill was Royal Adelaide, which although in another state, had a much closer flying time than Sydney. 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 perverseoutcome whichdemanded examination at the inquest.". 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 Braes, 18, died on 22 September 2017 from multi-organ failure due to sepsis from a Group A streptococcus infection. 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. Alex Braes (Credit: ABC "Four Corners," family photograph) The death has traumatised Braes' family and hospital staff alike. It grieves his parents deeply that they were not able to be with him in his last conscious hours, Ryan said. Before Alex's death, doctors had complained repeatedly that management was not open to criticism and did not listen to safety concerns they raised. "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 delayed transfer also deprived his parents of seeing him in his final hours, as they left the hospital to prepare to travel with him. Broken Hill teen Alex Braes died in 2017. "Twelvehours passed before hisemergency flight landed at Sydney's Royal Price Alfred Hospital," Ms Ryan said. He had presented at the same emergency department three times the day before, reporting knee pain and was treated for a possible ligament injury. Mr McLean says he spoke up and tried to get something done but he was ignored by hospital management. WALTERBORO, S.C. . A shortage of resources was one factor contributing to Braes death, Kelly said. It was far too late. I just think they were trying to grasp the reality of what was facing them and that he was deteriorating very quickly," Mr McLean said. Dr Kerrie MacDonald is a paediatrician who used to work at Broken Hill Hospital and is still in the NSW health system. Sign up and stay up to date with our daily newsletter. "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. 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. You often need to be in two places at once, she told Braes inquest. Alex went into cardiac arrest and died upon arrival at Royal Prince Alfred Hospital in Sydney. I never got to see him again, Mr Braes sobbed. Mr McLean said. 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. 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. But their boy suddenly deteriorated sharply. 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 inquest heard that a mandatory investigation into the cause of Alexs death was not carried out by Far West Local Health District for a year after he died. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. She was in that dual role when Mr Braes arrived at the hospital on September 21, 2017 - crippled by pain and . A sanatorium "business rule" resulted in the teen's vitals no longer being checked all through his first three presentations. 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. She said as a hospital practice it was not compliant with NSW Health policy. Outside her tent, next to a popular city walking track, homeless Tasha is past caring what people think. Alex and his father arrived back at the emergency department. Max McLean was the after-hours nurse manager at Broken Hill. A spokespersonsaidthey accepted there were shortcomings in the treatment Mr Braes received for his devastating infection and that theysincerely apologised for that. 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. The inquest into the death of Broken Hill teenager Alex Braes, who died of an infected toenail four years ago, will begin on Monday. "I was gobsmacked that it didn't prompt an investigation straight away," he said. Alex Braes died at Sydney's Royal Prince Alfred Hospital after going to another hospital four times. The death of a healthy 18-year-old man who first attended a hospital with moderate knee pain is almost incomprehensible, she said. It can also be seen on . 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 Hospital is one of several under the spotlight as a parliamentary inquiry probes the state of regional hospitals. 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 pathologist creates a written record of the autopsy findings, including the microscopic and laboratory tests. Justifiably outraged at the poor care of his son, John Braes. 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. 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. 00:00. But the 18-year-old mechanic died with "tragic suddenness",. Like that day, she said the nurses were still often very busy and under an awful lot of pressure. Alex Braes, 18, had significant knee pain when he first presented to Broken Hill Hospital in the early hours of September 20, 2017. He went into cardiac arrest. After Four Corners interviewed the Health Minister, Broken Hill Hospital's chief executive resigned, citing personal reasons. 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. Alex Murdaugh's family long dominated the legal scene in his small South Carolina county but for the past six weeks, Murdaugh has been on . The NSW deputy state coroner criticized Broken Hill Hospital's shortcomings in its treatment of Braes, including its failure to perform vital signs observations at the emergency department. "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. I have found the failure to perform vital signs observations was a serious deficiency in the care provided to Alex, Ryan said in her findings. Shortly after 10 p.m. on June 7, 2021, Alex Murdaugh called 911 from his property in Islandton, South Carolina, to report that he had found his 22-year-old son Paul and his wife Maggie, 55, murdered. Mr Braes died a little more than an hour after being admitted. 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. In lieu of an autopsy, a panel of experts determined he had. 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. 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. They sat there. 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 . Get the best investigative journalism, delivered to your inbox. "And my greatest sympathy and sorrow, actually, to his family. The inquest heard hospital staff did not check Braes full vital signs including temperature, pulse and blood pressure when he presented to the emergency department with severe leg pain on the morning of 20 September. 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. Alex's mother was sent to wait at Broken Hill airport while his father went home to pack a suitcase. The inquest is investigating the treatment the teenager received before he died from a bacterial infection known as Group A Streptococcus (GAS). The doctor was considering amputating 18-year-old Alex Braes' leg after he went into septic shock in . Liverpool welcomes UEFA report on Champions League final chaos in Paris. It was a call made far more difficult due to a lack of available pilots at the RFDS base in Broken Hill that day. These figures meant the odds were against Alex Braes from the start. The second day of hearings heard from DrDavid Hooper, who reviewed Alex during his third presentation to the local hospital on September 20, 2017. But questions are expected to continue about the handling of Alex Braes' case. A retrieval team from Sydney then made the return trip to Broken Hill. 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. A shortage of resources was one factor contributing to Mr Braes' death, Ms Kelly said. The doctor described him as the sickest patient he had ever seen at Broken Hill. Enabling and empowering the medical community to come together. 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. That rule is no longer in place, Ms Edwards told the inquest. Coroner's report into the death of Amy Robsart, August 1561 (KB 9/1073/f.80) For all that she liked to keep foreign suitors in play, Elizabeth was already deeply in love with her Master of Horse, Robert Dudley. "I just wanted to send my condolences and I'm so sorry that it happened. The first doctor to treat a limping teenager, whose sudden death from a fast-acting infection is under coronial investigation, says in retrospect he should have taken a full set of basic readings such as blood pressure. Please allow a few minutes for this process to complete. Experts assembled for the inquest said they had notcompletely agreed on the cause of Alex's death. 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, Inquest into teen's tragic death from infected toenail resumes, More complaints about Broken Hill Hospital following patient deaths, Inquest begins into teen's death from infected toenail, Outside her tent, next to a popular city walking track, homeless Tasha is past caring what people think. Ms Sullivan then asked whether the rule was dropped as a direct result of Alex passing away. 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 inquest into how a Broken Hill teenager diedfrom an infected toenailhas heard his condition deteriorated rapidly in his final hours. 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. 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. He would follow them to Sydney on a commercial flight. Sign up here. Coroner in Alex Braes inquest scathing of care at Broken Hill Hospital provided to 18yo who died of sepsis, 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. Alex Braes. Dr Greenberg explained to the inquestthat the situation was the same in Dubbo, where the pilot's hours had also expired. 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. "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. The nurse did not provide the pillow but left her post to go out into the waiting room to check on Alex. She recommended NSW and SA health departments urgently agree to cross-border transfers of critically ill patients from Broken Hill. Report. It recently handed down 44 recommendations to boost the rural medical workforce and improve the standard of care. 'An unthinkable tragedy': How did this train crash happen? Inquest into death of Alex Braes hears of 'distressing' hospital rule and resourcing concerns, 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. "I feel heartbroken that I still have my children and that you've lost your boy.". a coroner has heard. "He was our first child, our ray of sunshine," he said. Australian Institute of Health and Welfare figures released in July show the further Australians live from capital cities, the higher the rate of potentially avoidable deaths. 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. "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.". I think it was a totally avoidable death," Dr MacDonald said. "Certainly other hospitals will highlight a second presentation or third presentation, [to ask] 'have we missed something?'" . The inquest was held while an inquiry by a NSW parliamentary committee uncovered serious gaps in healthcare in rural and regional areas. Mr Braes, 18, was misdiagnosed as having a torn knee tendon while he was battling a life-threatening bacterial infection. Broken Hill teen Alex Braes died in 2017. 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. This action will also remove this member from your connections and send a report to the site admin. Mr Braes was conscious and speaking to staff and was "compensating for the sepsis until he couldn't". 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. Alex and his father arrived back at the hospital. 7 Callum Jones: Sprained Ankle Causes Fatal Blood Clot. Broken Hill teenager Alex Braes, who died of septic shock. Ms Kelly today told the court she was on a break when Mr Braes represented at the hospital with his dad on September 21. "You need to move that patient as soon as you possibly can to an organisation that has the facilities, the staff to manage the patient as best as possible," she said. 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. We acknowledge the traditional owners and custodians of the land on which we work and we pay respect to the Elders, past, present and future. Alex Braes died at Sydney's Royal Prince Alfred Hospital after going to another hospital four times. "He was cold, clammy, sweaty and he was significantly blue and mottled and this mottling colour is really a very ominous feature. New South Wales Health Department figures show Broken Hill has the highest potentially avoidable death rate in New South Wales at 189 deaths per 100,000 people and most recent figures show it is rising. In lieu of an autopsy, a panel of experts . So what went wrong? Broken Hill staff had missed something, but still, no-one did proper observations of Alex. "The kidneys start to fail in what is an overwhelming sepsis and that is something that we were battling against, because we didn't actually have the resources to support failing kidneys that's why we needed to get him out," nurse Max McLean said. 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. 'We failed him' What health. Stay up to date with our daily newsletter, Seriously Ill COVID-19 Patient Turned Away By 100 Hospitals In Japan, COVID-Positive Pregnant Woman Delivers Near Hospital Gate After Doctors Turn Her Away, Canada's Trudeau Denies Report That Liberals Told To Drop Candidate Over China Ties, After Italian Migrant Boat Wreck, Police Arrest Three Alleged Traffickers, 14 Chinese Military Aircraft Tracked Around Country, China's Annual Parliament To Implement Xi's Tightening Grip, Alex Braes, 18, sufferedmulti-organ failure due tosepsis and died after hospitals either sent him home or refused to admit him, A hospital "business rule" resulted in the teen's vitals not being checked duringhis first three presentations, A coroner said there was a serious and unacceptable deficiency in his treatment at the hospital. A raised temperature is a key indicator of infection. One nurse is responsible for two jobs at the Broken Hill hospital, the inquest into the death of Alex Braes has heard. It's something that troubles local MP Roy Butler. (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 18-year-old died about 1am on September 22 soon after landing in Sydney after a prolonged effort to evacuate him from Broken Hill. Friday, 2.00am Eighteen-year-old Alex Braes was pronounced dead. 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. ", ABC Broken Hillwill deliver a wrap of the week's news, stories and photos every Friday. 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. 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. Alex Braes, 18, died of multi-organ failure caused by sepsis. FOLLOW MORE IBT NEWS ON THE BELOW CHANNELS, IBT Fast Start - Let the best of International News come to you. It took 25 minutes for a wheelchair to be brought out so Alex could be taken from the car into the hospital. 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. See State Coroner's Memorandum No. Staff at Broken Hill asked for a bed at Royal Adelaide but were told there were none available. "There's always time pressure because there's only one triage nurse," replied Ms Murphy. 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. Did you find what you were looking for? 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 Please confirm you want to block this member. 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. : this article contains graphic descriptions from autopsy reports and witness testimony often need to be in places! The waiting room to check on Alex to a lack of available pilots at the RFDS in... Be taken from the car into the waiting room to check on Alex delays... 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