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. He revealed all the medical staff "misjudged" Mr Braes, who was "compensating very well" because he was "a young, fit fellow". 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. 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. "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. Justifiably outraged at the poor care of his son, John Braes. 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. 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. Ms Murphy also told the inquest that there was about a 10-minutewait in the emergency department from the time Alex came to the triage window to when he was looked at by her, as she was busy triaging another patient. She told Four Corners that by this stage, Alex was desperately unwell, yet he was again left waiting. 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. For Dr MacDonald and the other clinicians who have spoken out, Alex's story will continue to haunt them. Alex finally left the hospital and was put onto the air ambulance which took off with his mother also on board. But I can say to you that I think of that boy frequently," she said. Alex Braes, 18, died on 22 September 2017 from multi-organ failure due to sepsis from a Group A streptococcus infection. That rule is no longer in place, Ms Edwards told the inquest. 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. 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 See State Coroner's Memorandum No. In lieu of an autopsy, a panel of . Ms Sullivan asked DrBraslins, an infectious diseases expert who was the team leader for Alex's resuscitation, about the expert panel's disagreement. Findings are published on this website when an inquest was held or a coroner otherwise orders they be published in the public interest. Broken Hill teenager Alex Braes, who died of septic shock. 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 family had to wait several hours for an aircraft to be dispatched from Sydney to collect Alex. "Every person (from) the smallest thing to the largest thing, they get a set of obs.". Mr Braes was a healthy teenager, working as a fitter and turner, when he was put on antibiotics in August 2017 for an infected toenail. Unfortunately, the night pilot had called in sick. "Alex was semi-conscious, he was rambling, he wasn't responding to simple questions," Dr O'Donohoe said. 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. "Was there a general feeling it compromised patient safety?" 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. Mr Braes said the hardest thing was returning home to find his sons iPad, where the last thing he Googled was can pain kill you?, Every time I pick that iPad up, it just reminds me of him, he said. 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. Doctors suspected he had a ruptured tendon and recommended rest and ice. This action will also remove this member from your connections and send a report to the site admin. Alex Braes died at Sydney's Royal Prince Alfred Hospital after going to another hospital four times. Were sorry, this feature is currently unavailable. 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. "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. She said evidence highlightedthat Mr Braes was effectively refused admission to a South Australian tertiary hospital on September 21, 2017. 'An unthinkable tragedy': How did this train crash happen? 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. 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. . Alex Braes, 18, died of multi-organ failure caused by sepsis. It's just such a tragedy," he said. Witnesses told the inquest the rule had limited oversight from senior management and staff generally disapproved of it. "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. Alex Braes, 18, died on 22 September 2017 from multi-organ failure due to sepsis from a Group A streptococcus infection. Liverpool welcomes UEFA report on Champions League final chaos in Paris. 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. The nearest tertiary hospital to Broken Hill was Royal Adelaide, which although in another state, had a much closer flying time than Sydney. 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. 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. The inquest also heard the Broken Hill hospital is prevented from transferring patients to Adelaide, despite the SA capital being closer than Sydney. By the fourth visit Alex was in excruciating pain and the leg was turning a dark purple colour. "And I think that the clinicians who would have been with him when he was so sick in emergency will not forget him.". Ms Kelly today told the court she was on a break when Mr Braes represented at the hospital with his dad on September 21. Alex Braes. 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. Sign up here. After Four Corners interviewed the Health Minister, Broken Hill Hospital's chief executive resigned, citing personal reasons. Alex Braes, 18, died at Sydney's Royal Prince . Outside her tent, next to a popular city walking track, homeless Tasha is past caring what people think. She said the inquest established therewereshortcomings in thecare provided to MrBraes at the hospital. From February 2022, the Broken Hill RFDS base has funding available for a second plane, along with another locally based pilot and nurse. His death has also devastated the clinicians working at Broken Hill. In lieu of an autopsy, a panel of experts determined he had. 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. Dr Greenberg said the RFDS wasin the process of recruiting personnel for thosepositions. the NSW member for Barwon said. 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. NSW coroner Elizabeth Ryan also outlined major delays in transferring Alex Braes from Broken Hill to the Sydney hospital where he died. "What are we doing about avoidable deaths, preventable deaths?" 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. So what went wrong? In Newcastle and Wollongong, a magistrate is appointed by the Chief . 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 18-year-old died about 1am on September 22 soon after landing in Sydney after a prolonged effort to evacuate him from Broken Hill. Dr Kerrie MacDonald is a paediatrician who used to work at Broken Hill Hospital and is still in the NSW health system. 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. 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. 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. But the 18-year-old mechanic died with tragic suddenness, suffering multi-organ failure due to sepsis, one month after treatment for an infected ingrown toenail. 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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. "He was our first child, our ray of sunshine," he 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. 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. Ironically, though, the sudden death of Dudley's wife in September 1560 removed any hope that the queen might have . Max McLean was the after-hours nurse manager at Broken Hill. 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. SA Health, for its part, has commenced discussions with its NSW counterpart on how to continue to best provide services on an ongoing basis. 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 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. 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. "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.". 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 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. Counsel assisting the coroner, Kirsten Edwards, said the delay in transferring Alex would be a very significant issue in the inquest. 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. 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. Monday marked the fourth week of . In October 2021, 27-year-old Callum Jones was peacefully walking his dog when he sprained his ankle by slipping on a wooden bridge. 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. 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 example, some states and jurisdictions include autopsy reports as part of a standard coroner's report . 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. 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. Can pain kill you?: Teens final words after he was turned away from NSW hospital. "A young man who died, essentially, from an infected toenail, from the consequences of an untreated and very common infection. Again, no-one checked Alex's vital signs. Watch Louise Milligan's investigation on iview. 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. 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". 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. Senior doctor gives evidence about Alex Braes' final hours on day two of inquest, 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. All NSW magistrates are coroners by virtue of their status: s 16. Mr McLean says he spoke up and tried to get something done but he was ignored by hospital management. It was a call made far more difficult due to a lack of available pilots at the RFDS base in Broken Hill that day. As his pain began to worsen, he was taken to the hospital, where he was diagnosed with a fractured ankle. 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. An inquest into how a Broken Hill teenager diedfrom an infected toenailhas heard his condition deteriorated rapidly in his final hours. In the small hours of a Wednesday in an outback town, a teenager struggled to sleep. 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. Had to wait several hours for an aircraft to be dispatched from to... 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