The pathologist creates a written record of the autopsy findings, including the microscopic and laboratory tests. So what went wrong? That rule is no longer in place, Ms Edwards told the inquest. 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. Instead, medical staff in the emergency department made the assumption Alex had a sporting injury. "It must have been just horrifying and she must have felt so powerless that she could do nothing," Dr MacDonald said. 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. Broken Hill teen Alex Braes died in 2017. Mr McLean says by this stage Alex's third presentation alarm bells should have been ringing. "It means he'd been unwell for a significant number of hours at that point.". 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. 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. Mr McLean said. Mr McLean says staff had to provide life support before Alex could be put on the plane. Broken Hill Hospital management downgraded the categorisation of Alex's death, meaning it wasn't referred immediately for an investigation, as is required under the state's Health Administration Act. 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. 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. A medical student struggled to insert the cannula. The coroner Elizabeth Ryan has heard the Royal Flying Doctor Service was not able to evacuate Braes as the trip would have exceeded the flying hours for the pilot available that day. 00:00. There was no "grab and go" for Alex and that would have devastating consequences. "What are we doing about avoidable deaths, preventable deaths?" 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.'. Alex died in the early hours of September 22, 2017, at Royal Prince Alfred Hospital, Sydney, after being transferred from his local hospital. Broken Hill hadn't been able to get a GP that week to staff the fast-track clinic which saw less-serious patients, so that put enormous pressure on the emergency department. I just think they were trying to grasp the reality of what was facing them and that he was deteriorating very quickly," Mr McLean said. Ms Kelly today told the court she was on a break when Mr Braes represented at the hospital with his dad on September 21. "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.". It is replayed on Tuesday 10th September at 1.00pm and Wednesday 11th at 11.20pm. 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 "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. The inquest will investigate the treatment Alex Braes received before he died from a bacterial infection known as Group A Streptococcus (GAS). "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 was given a triage category of three, meaning the patient must see a doctor within 30 minutes. In lieu of an autopsy, a panel of experts . In lieu of an autopsy, a panel of experts determined he had. Sign up to receive an email with the top stories from Guardian Australia every morning. Alex Braes died at Sydney's Royal Prince Alfred Hospital after going to another hospital four times. Medical staff say the fact no vital-signs tests were done that morning was the first in a series of failures by 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. The inquest was held while an inquiry by a NSW parliamentary committee uncovered serious gaps in healthcare in rural and regional areas. 95 Hits - Ajith May 31, 2022, 7:26 PM. Far Western Local Health District, through a spokesperson, acknowledged the need to learn from Braes' death and said it would consider the coroner's findings. 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. This service may include material from Agence France-Presse (AFP), APTN, Reuters, AAP, CNN and the BBC World Service which is copyright and cannot be reproduced. 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. Alex Braes, 18, died of multi-organ failure caused by sepsis. It was far too late. I think it could easily happen I have a great fear it could happen, she said. A shortage of resources was one factor contributing to Braes death, Kelly said. 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. Findings and upcoming inquests - Coroners Court Inquest findings (since 2004) as well as non-inquest public interest matters (since 2012) are available below. "I just wanted to send my condolences and I'm so sorry that it happened. He had presented at the same emergency department three times the day before, reporting knee pain and was treated for a possible ligament injury. Broken Hill teenager Alex Braes, who died of septic shock. ': Teen searched internet before dying of suspected toenail infection, inquest hears, Doctor tells inquest why he can't celebrate his birthday since teenager's death, Inquest begins into teen's death from infected toenail, The death of Alex Braes still haunts doctors who didn't even know him, Outside her tent, next to a popular city walking track, homeless Tasha is past caring what people think. . The nearest tertiary hospital to Broken Hill was Royal Adelaide, which although in another state, had a much closer flying time than Sydney. By the time Alex was diagnosed with a bacterial infection he was in septic shock and needed to be medically evacuated to Adelaide. The group of jurors who will decide Alex Murdaugh's fate visited on Wednesday morning the sprawling Islandton, South Carolina, property where the defendant's wife and son were found fatally shot . 'An unthinkable tragedy': How did this train crash happen? 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. A hospital in the Australian state of New South Wales (NSW) repeatedly sent an 18-year-old boy home before he died from sepsis, officials revealed this week. Elizabeth Keft returned, with IV bag in hand, to see doctors and nurses working on Braes in a resuscitation bay. 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. She described the death of the fitter and turner as almost unbearable to imagine for the family. For that (new) triage process to work, there needs to be more staff and more resources to prevent any more tragic circumstances, the nurse said. On Monday, NSW deputy state coroner Elizabeth Ryan revealed in the Broken Hill courthouse her findings into Braes' death, saying there was a serious and unacceptable deficiency in his treatment at Broken Hill Base Hospital. I never got to see him again, Mr Braes sobbed. 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 . He suffered multi-organ failure due to sepsis from a group A streptococcus infection, one month after treatment for an infected ingrown toenail. FOLLOW MORE IBT NEWS ON THE BELOW CHANNELS, IBT Fast Start - Let the best of International News come to you. Registered nurse Michelle Murphy, who attended to Alex on his fourth presentation, told the inquest that nurses found the rule 'quite distressing'. "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.". "She must have hoped beyond hope that he would survive.". Alex Braes, 18, died at Sydney's Royal Prince . 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". Health workers union takes fight for kitchen staff in NSW aged care home to federal court, Original reporting and incisive analysis, direct from the Guardian every morning. 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. "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. 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 . "I've worked in 13 different locum hospitals since I've retired and I've never seen anything like Broken Hill in my entire career," he said. 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. He told the inquest though, that on the balance of probabilities, Alex most likely had necrotising fasciitis. Editor's note: This article contains graphic descriptions from autopsy reports and witness testimony. Braes had taken antibiotics for an ingrown toenail a month before his death, though investigating doctors told the inquest they could not be sure it was the cause of the later infection in his leg. 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. Alex Braes. An inquest was established soon after that report and was due to undertake Broken Hill hearings last yearbut was delayed after coronavirusrestrictions affected proceedings. 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. 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. 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. All rights reserved. Monday marked the fourth week of . 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 highly experienced clinician also took time at the end of his testimony to address the Braes family directly. Says staff had to provide life support before Alex could be put on the BELOW,... It must have hoped beyond hope that he would survive. `` Kelly said hoped! Gaps in healthcare in rural and regional areas got to see doctors nurses. When mr Braes represented at the hospital IBT Fast Start - Let the best of NEWS... 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