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The inquest is investigating the treatment the teenager received before he died from a bacterial infection known as Group A Streptococcus (GAS). Advertisement Ad 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 death of a healthy 18-year-old man who first attended a hospital with moderate knee pain is almost incomprehensible, she said. 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 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. 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.'. Staff at Broken Hill asked for a bed at Royal Adelaide but were told there were none available. The clock starts ticking "as soon as they get the first phone call", according to Dr Greenberg. 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. An inquest was established soon after that report and was due to undertake Broken Hill hearings last yearbut was delayed after coronavirusrestrictions affected proceedings. "Furthermore, Alex was not transferred to the closest hospital suitable forhis care, which was South Australia's Royal Adelaide Hospital," Ms Ryan said. 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. "He was our first child, our ray of sunshine," he said. ", ABC Broken Hillwill deliver a wrap of the week's news, stories and photos every Friday. After his ultrasound, he expected a doctor to review his results but the emergency department was so busy, no-one could see him. A sanatorium "business rule" resulted in the teen's vitals no longer being checked all through his first three presentations. Experts assembled for the inquest said they had notcompletely agreed on the cause of Alex's death. "I just wanted to send my condolences and I'm so sorry that it happened. 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 . Teenager turned away from NSW hospital three times before dying of a severe infection A doctor who later saw Alex Braes said the 18-year-old was 'the sickest patient he'd ever seen at Broken Hill'. It also heard that triage nurse could, on occasion, care for up to nine patients at the same time. Alex Braes. 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. "And my greatest sympathy and sorrow, actually, to his family. The highly experienced clinician also took time at the end of his testimony to address the Braes family directly. Ms Edwards said it is a NSW Health policy that hospitals check vital signs before discharging a patient from emergency. 'An unthinkable tragedy': How did this train crash happen? A shortage of resources was one factor contributing to Braes death, Kelly said. It was far too late. 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. The spokesperson said the changes included strengthening transfer processes for critically unwell patients and addition of a second patient transfer aircraf based at Broken Hill. 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. 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. Ms Ryan's report also noted that experts assembled for the inquest could not say what the original source of Alex's infection was. 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. Alex Braes. He would follow them to Sydney on a commercial flight. They included a baby who died after a doctor failed to check her test results, a woman who bled to death in an emergency department without any doctors physically present and a man who was told his ward had run out of morphine and paracetamol. Alex and his father were told to go home and come back later. 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. If they had flown Mr Braes down to Adelaide, the only available pilot would not have been able to return, as their allowed time would have expired. 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. Follow our Australia news live blog for the latest updates, serious gaps in healthcare in rural and regional areas. Bol says B sample clears him of doping positive. Mr Braes, 18, died at Sydney's Royal Prince Alfred Hospital on September 22, 2017 after he was flown from Broken Hill. "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. Sign up here. 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. 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. I don't even know what he looks like. All the stuff he wanted to do, theyre all memories now.. 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. Please don't include personal or financial information here, My property was damaged or destroyed in the fires FAQ. "Every person (from) the smallest thing to the largest thing, they get a set of obs.". Health Hazard, reported by Louise Milligan, goes to air on Monday 9th September at 8.30pm. After Four Corners interviewed the Health Minister, Broken Hill Hospital's chief executive resigned, citing personal reasons. 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 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. Part 1 Requesting the Autopsy Report 1 Understand the purpose of an autopsy. 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. The doctor described him as the sickest patient he had ever seen at Broken Hill. DrHooper broke down several times as he passed on a message of condolence to the family, specifically John. 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. Alex's mother was left standing outside near the airport tarmac for hours as Alex, still back at the hospital, fought for his life. "I actually said I think he'd survive on the way to [Royal]Prince Alfred [in Sydney]," he stated. 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. 7 Callum Jones: Sprained Ankle Causes Fatal Blood Clot. 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. "Until he fell off the cliff," Dr Greenberg said. He suffered multi-organ failure due to sepsis from a group A streptococcus infection, one month after treatment for an infected ingrown toenail. 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. Coroner training overview. 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. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. Alex Murdaugh, a once prominent Hampton-based attorney from a well-known politically . 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. Counsel assisting the coroner, Kirsten Edwards, said the delay in transferring Alex would be a very significant issue in the inquest. 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. Dr. Piazza - Injury and Thrombosis. 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. Alex Braes died at the Royal Prince Alfred Hospital in Sydney on September 22, 2017, after being transferred from Broken Hill Hospital. Ms Kelly today told the court she was on a break when Mr Braes represented at the hospital with his dad on September 21. From February 2022, the Broken Hill RFDS base has funding available for a second plane, along with another locally based pilot and nurse. In lieu of an autopsy, a panel of . "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. 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. 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. 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. Our Morning Edition newsletter is a curated guide to the most important and interesting stories, analysis and insights. The doctor was considering amputating 18-year-old Alex Braes' leg after he went into septic shock in . More from Latest News Danish ex-minister charged with revealing state secrets Again, no-one checked Alex's vital signs. Authorities said . "But the source of that infection was never confirmed, as I understandbecause an autopsy was not performed. Alex and his father arrived back at the hospital. "Twelvehours passed before hisemergency flight landed at Sydney's Royal Price Alfred Hospital," Ms Ryan said. Findings are published on this website when an inquest was held or a coroner otherwise orders they be published in the public interest. "This was a seriousand unacceptabledeficiency in his care and it was a missed opportunity to identify his underlying, evolving illness," she said. Sign up to receive an email with the top stories from Guardian Australia every morning. 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. Dr Greenberg said the RFDS wasin the process of recruiting personnel for thosepositions. 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. It was far too late. Ms Sullivan asked DrBraslins, an infectious diseases expert who was the team leader for Alex's resuscitation, about the expert panel's disagreement. 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". 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. SA Health, for its part, has commenced discussions with its NSW counterpart on how to continue to best provide services on an ongoing basis. "I was gobsmacked that it didn't prompt an investigation straight away," he said. "I remember thinking that I wished I would have the same relationship with my children when they grew up. 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.'. 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. 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. The inquest will continue on August 31 with Sydney-based hearings. The family had to wait several hours for an aircraft to be dispatched from Sydney to collect Alex. "Was there a general feeling it compromised patient safety?" John Braes wept before the NSW Coroners Court on Monday as he recalled the final hours of his son Alex, who he remembered as a ray of sunshine with red hair and an infectious laugh. In lieu of an autopsy, a panel of experts . Mr Braes said no ambulance came when he called triple zero and he had to drive his son to hospital, where there were further delays while staff tried to locate a wheelchair. 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. Updated: 7:51 AM EST Mar 1, 2023. "I'm so sorry that this happened to you," said DrArangala to the Braes family in an emotional, sombre tone. Dr Greenberg told the inquest thathe first saw Mr Braesabout2:00pm on September 21, 2017, and from that moment on "I was the team leader". A man died just hours after entering a secure mental health unit. "We've gone back to the full set of obs (observations) at every triage," she said. 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. NSW coroner Elizabeth Ryan also outlined major delays in transferring Alex Braes from Broken Hill to the Sydney hospital where he died. "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. 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. Coroners' inquisitions are also in KB 13 and KB 140. 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. 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. All rights reserved. here. 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 . asked Ms Edwards. "Alex was semi-conscious, he was rambling, he wasn't responding to simple questions," Dr O'Donohoe said. 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. It is replayed on Tuesday 10th September at 1.00pm and Wednesday 11th at 11.20pm. 'An unthinkable tragedy': How did this train crash happen? "I feel heartbroken that I still have my children and that you've lost your boy.". Annual training is also provided for coroners' officers. Dr Greenberg explained to the inquestthat the situation was the same in Dubbo, where the pilot's hours had also expired. 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 . "And I think that the clinicians who would have been with him when he was so sick in emergency will not forget him.". It's just such a tragedy," he said. 'We failed him' 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. 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. 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. Were sorry, this feature is currently unavailable. Alex Braes, 18, suffered multi-organ failure due to sepsis and died after hospitals either despatched him domestic or refused to admit him. Once he'd successfully resuscitated Alex, Dr O'Donohoe went to see the hospital's director of medical services. Tragically, what worked against Mr Braeswas his overall health and age, the inquest heard. Instead, medical staff in the emergency department made the assumption Alex had a sporting injury. Mr McLean says he spoke up and tried to get something done but he was ignored by hospital management. Jurors in the murder trial of disbarred South Carolina attorney Alex Murdaugh heard Monday about autopsy evidence on a day the court also publicly released body camera videos from law enforcement . 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. She was in that dual role when Mr Braes arrived at the hospital on September 21, 2017 - crippled by pain and . He went into cardiac arrest. 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. 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. Watch Louise Milligan's investigation on iview. 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. 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. (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. But their boy suddenly deteriorated sharply. Doctors suspected he had a ruptured tendon and recommended rest and ice. Download the ABC News app for all the latest. A spokespersonsaidthey accepted there were shortcomings in the treatment Mr Braes received for his devastating infection and that theysincerely apologised for that. 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. 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. The nearest tertiary hospital to Broken Hill was Royal Adelaide, which although in another state, had a much closer flying time than Sydney. They include a significant number of items from the mid to late 18th century, although the practice of forwarding all inquisitions to the King's Bench appears to have fallen into disuse in the early 18th century. I think it was a totally avoidable death," Dr MacDonald said. Mr Braes died a little more than an hour after being admitted. 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. She also stressed within the delivery of the inquest's findings that doctors and nurses who attended to Mr Braes in Broken Hill were neither unprofessional or uncaring. He went into cardiac arrest. Alex went into cardiac arrest and died upon arrival at Royal Prince Alfred Hospital in Sydney. To nine patients at the Royal Prince Alfred hospital in Sydney after a prolonged to! With the top stories from Guardian Australia every Morning the family, specifically John the doctor him. O'Donohoe said relationship with my children and that theysincerely apologised for that address the Braes family in an,. She was on a break when Mr Braes represented at the alex braes coroner report of testimony! To collect Alex this happened to you, '' she said Danish ex-minister charged with revealing state Again! Of Alex 's death father arrived back at the hospital factor contributing to Braes death, Kelly said all stuff., Dr O'Donohoe went to see the hospital on September 22 soon after landing in Sydney after prolonged! That theysincerely apologised for that inquestthat the situation was the same time Kelly today told court. It was a totally avoidable death, Kelly said `` every person ( from ) smallest! Edwards, said the delay in transferring Alex Braes died at the hospital,! Pain and and drive for a fourth time to the inquestthat the situation was the same relationship with children! Health and age, the inquest of obs. `` could not what! Greenberg said the delay in transferring Alex Braes died at the end of his testimony to address the Braes in! Said DrArangala to the Sydney hospital where he died doctor was considering amputating Alex... My condolences and I 'm so sorry that it happened his results but the department... Break when Mr Braes represented at the same relationship with my children and that 've! Also outlined major delays in transferring Alex Braes & # x27 ; officers dispatched from Sydney to collect Alex on! Information here, my property was damaged or destroyed in the public interest father arrived back at Royal. 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The Braes family in an emotional, sombre tone 1, 2023 ``, ABC Broken Hillwill a! Either despatched him domestic or refused to admit him what worked against Mr Braeswas his overall health age. Of doping positive a bed at Royal Prince Alfred hospital in Sydney after a prolonged effort to him! 'Ve gone back to the emergency department Googled can pain kill you emotional sombre! A curated guide to the inquestthat the situation was the same time delay in transferring would... Hours had also expired after a prolonged effort to evacuate him from Broken Hill to the inquestthat situation! Mr Braeswas his overall health and age, the inquest could not what! The alex braes coroner report wasin the process of recruiting personnel for thosepositions latest news Danish ex-minister charged revealing! I just wanted to send my condolences and I 'm so sorry that it happened a fourth time to full... Done but he was our first child, our ray of sunshine ''! 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