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Dominico Zapata / Things
The Commissioner of Health and Disabilities has found communication gaps in the Waikato DHB. (File photo)
The Waikato District Board of Health has been asked to apologize to the partner of a man who died while waiting to be treated in a hospital emergency department.
In a report released Monday, Health and Disabilities Commissioner Anthony Hill found that the Waikato DHB had failed to provide services with “reasonable care and skill” to the man.
The man, in his 70s, was at home when he fell, hit his head and lost consciousness for about 30 seconds.
He was rushed to the hospital with chest pains and then transferred to a cardiology ward with an irregular heat rhythm and mild heart failure. The man had several pre-existing health conditions, including high blood pressure, congestive heart failure, and swallowing difficulties.
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Hospital staff released the man five days later in stable condition, but he was readmitted to the hospital a day later after feeling unwell again.
Hill noted that the man’s discharge summary form from his first admission that came with him was in draft form and did not mention that he had had chest pain.
Kelly Hodel / Stuff
Waikato DHB was asked to write a letter of apology after the care of a man admitted to their emergency department was deemed substandard. (File photo)
“There were communication failures in the DHB regarding the man’s symptoms, resulting in the emergency department cardiology registrar prioritizing other patients who appeared to have more urgent complaints first,” Hill wrote.
The man then stopped responding, but could not be resuscitated and died before he could be seen by the cardiology service.
Hill said the failure to provide a timely medical evaluation in the emergency department falls outside the standard of care that should have been met. Systemic problems at DHB contributed to the long delay in getting the man seen by doctors.
In its recommendations, Hill said the DHB should consider implementing a formalized process in which an emergency department physician reviews the patient’s “clinical picture” if there are significant delays in patient care.
Hill also recommended that Waikato DHB provide a report on the effectiveness of the roster changes from its cardiology service, as well as a written apology to the man’s partner.
“This case highlights the importance of district health boards in place to support their staff when the workload is particularly high,” Hill said.
It was not possible to say whether the man would have survived if he had been given earlier treatment, according to the report. A nasal swab showed that the man had contracted influenza.
His death was discussed by cardiologists during their regular mortality and morbidity meeting, and doctors opined that, given the positive result of the influenza test, no “specific cardiac intervention” would have been helpful. The group concluded that the man’s second hospital admission was likely related to influenza sepsis and multi-organ failure.
Since the man’s death, the Waikato DHB has begun the process of appointing a specifically assigned cardiology registrar to the emergency department from 12 noon to 8 p.m., when the department is typically busiest.
The cardiology department has also specifically assigned cardiologists to help with patients in the wards and the emergency department.
Waikato DHB said the reorganization of its cardiology service was designed to improve the turnaround time needed to check patients in the emergency department.
