April 21, 2021 - 11:05AM The doctor tasked with taking care of Alex Braes after he presented to a country NSW emergency department in the middle of the night in 2017 has addressed the teenager's heartbroken family. Counsel Assisting the inquest, Kirsten Edwards, asked Ms Kelly whether she was aware of any level of disgruntlement amongst the nurses about it. She said the inquest established therewereshortcomings in thecare provided to MrBraes at the hospital. 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. 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. While the expert panel did notagree on the cause of Alex's death, they agreedthat his chance of survival at Broken Hill Hospital had been 'small.'. 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. Infectious diseases specialist Phillip Braslins said he was considering amputation after 18-year-old Alex Braes went into septic shock in Broken Hill Base Hospital on September 21 . There was no bed available in Adelaide and a pilot could not take him to Sydney without exceeding his maximum allowable working hours. More from Latest News Danish ex-minister charged with revealing state secrets "His parents were just shell-shocked. 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. 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. 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. 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). I think it was a totally avoidable death," Dr MacDonald said. Alex finally left the hospital and was put onto the air ambulance which took off with his mother also on board. 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. 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. (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. 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. 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. 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 Authorities said . Enabling and empowering the medical community to come together. 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? "Was there a general feeling it compromised patient safety?" The doctor was considering amputating 18-year-old Alex Braes' leg after he went into septic shock in . There was no "grab and go" for Alex and that would have devastating consequences. Broken Hill teenager Alex Braes, who died of an infected toenail. "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. 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. 7 Callum Jones: Sprained Ankle Causes Fatal Blood Clot. Findings are published on this website when an inquest was held or a coroner otherwise orders they be published in the public interest. AEST = Australian Eastern Standard Time which is 10 hours ahead of GMT (Greenwich Mean Time), abc.net.au/news/alex-braes-infected-toenail-inquest-ends/100091576, Get breaking news alerts directly to your phone with our app, 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. 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 In lieu of an autopsy, a panel of . He called his father home from work. In lieu of an autopsy, a panel of experts . In October 2021, 27-year-old Callum Jones was peacefully walking his dog when he sprained his ankle by slipping on a wooden bridge. "I remember thinking that I wished I would have the same relationship with my children when they grew up. Alex Braes died at Sydney's Royal Prince Alfred Hospital after going to another hospital four times. Alex Braes died at the Royal Prince Alfred Hospital in Sydney on September 22, 2017, after being transferred from Broken Hill Hospital. Were working to restore it. 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's something that troubles local MP Roy Butler. The Coroner's Report is a fictional crime scene report of the victims of various horror films. 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 nearest tertiary hospital to Broken Hill was Royal Adelaide, which although in another state, had a much closer flying time than Sydney. 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. Editor's note: This article contains graphic descriptions from autopsy reports and witness testimony. She told Four Corners that by this stage, Alex was desperately unwell, yet he was again left waiting. 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. "A young man who died, essentially, from an infected toenail, from the consequences of an untreated and very common infection. "This was a seriousand unacceptabledeficiency in his care and it was a missed opportunity to identify his underlying, evolving illness," she 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. Two days before his death, Braes presented to Broken Hill Hospital with severe leg pain, but the facility's staff did not check his full vital signs, Ryan said. 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. The teen's vitals were only observed during his fourth and final presentation, and a suspected toenail infection was identified. "Alex was semi-conscious, he was rambling, he wasn't responding to simple questions," Dr O'Donohoe 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. Were sorry, this feature is currently unavailable. 7 (PDF, 113.1 KB), Coffs Harbour Local Court, 2-16 Beryl St, Coffs Harbour 2450, Before her Honour Magistrate Forbes, Deputy State Coroner, Forensic Medicine and Coroners Court Complex, 1A Main Ave, Lidcombe, Before his Honour Magistrate Lee, Deputy State Coroner, Forensic and Coroners Court Complex, 1A Main Ave, Lidcombe, Inquest into the Death of A.W. Sign up to receive an email with the top stories from Guardian Australia every morning. We will use your rating to help improve the site. 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 . Copyright 2023 IBTimes LLC. 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. Findings and upcoming inquests - Coroners Court Inquest findings (since 2004) as well as non-inquest public interest matters (since 2012) are available below. The inquest heard that at the hospital, only one doctor is on duty overnight and two nurses in the emergency department. 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. . "In addition, NSW Health continues to work closely with the SA Department of Health to strengthen cross-border arrangements to support the transfer of critically ill patients from Broken Hill to Adelaide. 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. For legal cases involving intentional or accidental death and for insurance claims, The Records Company retrieves coroner's reports and autopsy reports. 'An unthinkable tragedy': How did this train crash happen? 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. "He was our first child, our ray of sunshine," he said. 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. After arriving at Broken Hill base hospital on 21 September, Braes was put in a non-acute bed. Alex Braes, 18, had significant knee pain when he first presented to Broken Hill Hospital in the early hours of September 20, 2017. Coroner identifies unacceptable treatment in lead-up to death from multi-organ failure due to sepsis, calls for new interstate rules. Registered nurse Michelle Murphy, who attended to Alex on his fourth presentation, told the inquest that nurses found the rule 'quite distressing'. 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. "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.". Broken Hill teenager Alex Braes's parents remember him as a ray of sunshine, a funny and smart young man ready to live a full life. Yesterday's fourth and final day of the Broken Hill hearing heard from two more doctors who reviewed Alex Braes while he was still in the city. 95 Hits - Ajith May 31, 2022, 7:26 PM. Broken Hill teen Alex Braes died in 2017. Because you left the triage window unattended and there were a lot of patients there," asked Ms Edwards. But questions are expected to continue about the handling of Alex Braes' case. She recommended NSW and SA health departments urgently agree to cross-border transfers of critically ill patients from Broken Hill. 'An unthinkable tragedy': How did this train crash happen? Mr Braes also recalled Alexs vital signs, including his temperature and pulse, were not checked each time he attended hospital. He went into cardiac arrest. Alex Braes. 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. Dr O'Donohoe spoke to the Royal Flying Doctor Service at Broken Hill. 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 inquest heard that the rule stated, in effect, that 'clinical observations of a patient should only be taken if vital signs influenced the assigned triage category a patient had been given.'. "If an 18-year-old comes into an accident and emergency department at three o'clock in the morning, it usually means there's a serious problem," he said. 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. 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 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. "Twelvehours passed before hisemergency flight landed at Sydney's Royal Price Alfred Hospital," Ms Ryan said. 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 turned up three times at the emergency department of Broken Hill Hospital as his knee became increasingly swollen and painful but was sent home each time. "There's always time pressure because there's only one triage nurse," replied Ms Murphy. Transfer 'only option' after teen Alex Braes went into septic shock in Broken Hill hospital, coroner hears. His death has also devastated the clinicians working at Broken Hill. It grieves his parents deeply that they were not able to be with him in his last conscious hours, Ryan said. In the Sydney metropolitan area, coronial matters are always handled by the State Coroner and Deputy State Coroners (senior coroners) situated at the Lidcombe Forensic Medicine and Coroners Court Complex. Eighteen-year-old Alex Braes' knee was so painful, he asked his father to take him to Broken Hill Hospital. 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. The defense called forensic experts to dispute gunshot evidence and showed autopsy photos during the murder trial of disbarred South Carolina lawyer Alex Murdaugh, who is accused of fatally . Ms Ryan said there had an been "extraordinarylack" of progress between NSW Health and SA Healthestablishinga formalised cross-border arrangement to transfer critically-ill patients from BrokenHill to Adelaide. If this is your first visit to the new AusDoc website, reset your password He told the inquest though, that on the balance of probabilities, Alex most likely had necrotising fasciitis. 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. Braes was in "excruciating pain" and was described by one doctor as "the sickest patient the hospital had ever seen" by the time he visited the hospital for the third time, according to the outlet. 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. A shortage of resources was one factor contributing to Mr Braes' death, Ms Kelly said. CORONIAL LAW - cause and manner of death, underlying cardiac pathology, methamphetamine use, conduct of police officers, execution of arrest warrant Inquest into the disappearance and suspected death of Alexander Stetz Decision of Deputy State Coroner Kennedy Coronial law, cause and manner of death, missing person, police search, dementia Alex was given a triage category of three, meaning the patient must see a doctor within 30 minutes. A man died just hours after entering a secure mental health unit. It was a horrific outcome and such a young man, only 18 years old.". "I'm so sorry that this happened to you," said DrArangala to the Braes family in an emotional, sombre tone. 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. "To the extentthere were deficiencies in your clinical practice, do you think one cause was you feeling under time pressure? 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. The following month he began to experience pain in his knee. It is replayed on Tuesday 10th September at 1.00pm and Wednesday 11th at 11.20pm. 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. "Because it's not good enough in 2019 to have people in the far west of New South Wales having worse health outcomes than people in the city.". 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. 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. In lieu of an autopsy, a panel of experts determined he had. "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.". Drarangala to the Braes family in an emotional, sombre tone of was... Consequences of an untreated and very common infection handling of Alex Braes ' case the! 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