Wait could have killed terminally ill girl
Officials have apologised after a terminally ill girl with lifethreatening symptoms was denied treatment for more than an hour and a half.
Kathleen Mackay rushed her daughter Brennagh to Palmerston North Hospital in August after gastric acid, which looked like green slime, blocked her feeding tube.
Brennagh, 11, was born with a rare genetic disorder called trisomy 18 and has been in and out of hospital ever since. Four years ago, three-quarters of her bowel was removed and a tube was connected directly to her stomach for feeding.
Surgeons told Mackay if she noticed green liquid leaking from the tube to have her daughter seen within an hour – for X-rays to check the bowel hadn’t twisted – or else the acid could become fatal.
Mackay first noticed the blocked tube at 10.15pm on August 29. She called the children’s ward, and staff urged her to take Brennagh to the emergency room immediately.
Mackay was told the children’s ward would notify the registrar on duty and Brennagh would be taken straight through for examination.
However, that communication was not relayed to the hospital’s emergency room.
After arriving at 10.45pm, frustration festered as midnight ticked over and Brennagh was still yet to be seen. Mackay demanded to see the registrar.
‘‘I was ringing the children’s ward, telling them it was urgent and I was just getting the standard answer: ‘I’ll let someone know’.
‘‘I was so close to getting in the car and driving to Wellington Hospital.’’
The waiting room was overflowing that night and Brennagh was forced to lie on a coffee table to take pressure off her abdomen.
Brennagh’s discharge summary said she presented with ‘‘bilious aspirates’’ from her tube and ‘‘retching’’ while being fed. X-rays showed ‘‘multiple grossly dilated’’ loops of bowel.
She was given medication and told to spend the night on the ward, for re-examination in the morning.
However, with a severely compromised immune system, Mackay said Brennagh should not have been admitted to the wards and opted to discharge her daughter and return the next day.
The slow reaction from doctors and their refusal to accept Mackay’s cry for urgency prompted her to lay a complaint with Health Minister Jonathan Coleman and Midcentral District Health Board chief executive Kathryn Cook.
Midcentral was approached for comment, but did not respond.
In a letter to Mackay following the event, Ministry of Health chief adviser Pat Tuohy apologised for the family’s struggles with Midcentral.
He ordered officials at Midcentral to develop a ‘‘clear’’ management plan in consultation with Mackay and Brennagh’s medical team.
The plan would set out how Brennagh’s care was to be managed if a similar emergency occurred.
‘‘I believe this is a matter of some urgency as Brennagh has unstable health and there needs to be a clear process in place,’’ he said.
‘‘I’m sorry to read about the trouble you have been having getting care for her, and want to acknowledge all you and your family have done to get this far, despite all of the odds.’’
In a letter to Mackay, Cook said if Brennagh had an emergency during office hours then the hospital’s homecare team would arrange to either visit her at home or bring her to hospital to see the paediatric registrar.
In case of an event after hours, Cook said Brennagh could visit the emergency room with the expectation she would be seen by the registrar ‘‘depending on other clinical priorities occurring in the service at that time’’.
‘‘I was ringing the children’s ward, telling them it was urgent.’’
Kathleen Mackay