"He was our first child, our ray of sunshine," he said. "Twelvehours passed before hisemergency flight landed at Sydney's Royal Price Alfred Hospital," Ms Ryan said. NSW coroner Elizabeth Ryan also outlined major delays in transferring Alex Braes from Broken Hill to the Sydney hospital where he died. 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. After his ultrasound, he expected a doctor to review his results but the emergency department was so busy, no-one could see him. In lieu of an autopsy, a panel of . I think it was a totally avoidable death," Dr MacDonald said. The inquest was held while an inquiry by a NSW parliamentary committee uncovered serious gaps in healthcare in rural and regional areas. 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. The investigation, known as a root cause analysis, was completed following complaints by hospital whistleblowers and coincided with the first anniversary of Alexs death. 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. . 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, Girl's thumb replaced with toe after gruesome surgical error, Half-marathon runner dies after broken leg misdiagnosed three times. She told Four Corners that by this stage, Alex was desperately unwell, yet he was again left waiting. A raised temperature is a key indicator of infection. "Alex was semi-conscious, he was rambling, he wasn't responding to simple questions," Dr O'Donohoe said. She had a particular concern for newly graduated nurses assigned to care for non-acute patients who were still learning new skills and could potentially miss a deteriorating patient like Braes. 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. Annual training is also provided for coroners' officers. "He was cold, clammy, sweaty and he was significantly blue and mottled and this mottling colour is really a very ominous feature. 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). 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. Alex Braes died at the Royal Prince Alfred Hospital in Sydney on September 22, 2017, after being transferred from Broken Hill Hospital. Alex Braes, 18, had significant knee pain when he first presented to Broken Hill Hospital in the early hours of September 20, 2017. 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. Alex Braes, of Broken Hill, died in the early hours of Sept. 22, 2017, upon arriving at Royal Prince Alfred Hospital in Sydney, 7News.com.au reported. Broken Hill teenager Alex Braes' parents remember him as a ray of sunshine, a funny and smart . 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. Ms Ryan's report also noted that experts assembled for the inquest could not say what the original source of Alex's infection was. "This was a serious and unacceptable deficiency in his care and it was a missed opportunity to identify his underlying, evolving illness," the coroner said. Alex's father called triple zero to ask an ambulance to take his son to hospital, but no ambulance was available. It's just such a tragedy," he said. All rights reserved. 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. "I feel heartbroken that I still have my children and that you've lost your boy.". Dr O'Donohoe later quit work at Broken Hill Hospital over what he saw as mismanagement, leading to patient safety issues. Alex Braes, 18, died of multi-organ failure caused by sepsis. It recently handed down 44 recommendations to boost the rural medical workforce and improve the standard of care. Doctors identified necrotising fasciitis, a deadly, flesh-eating disease, from an infected toenail in the teenager. Alex and his father arrived back at the hospital. Ms Murphy also told the inquest that there was about a 10-minutewait in the emergency department from the time Alex came to the triage window to when he was looked at by her, as she was busy triaging another patient. 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. Witnesses told the inquest the rule had limited oversight from senior management and staff generally disapproved of it. Ironically, though, the sudden death of Dudley's wife in September 1560 removed any hope that the queen might have . 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. Alex Braes. Ms Sullivan then asked whether the rule was dropped as a direct result of Alex passing away. I have found the failure to perform vital signs observations was a serious deficiency in the care provided to Alex, Ryan said in her findings. 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. 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. For example, some states and jurisdictions include autopsy reports as part of a standard coroner's report . Mr McLean says staff had to provide life support before Alex could be put on the plane. Browse for your location and find more local ABC News and information. 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. AEST = Australian Eastern Standard Time which is 10 hours ahead of GMT (Greenwich Mean Time), abc.net.au/news/alex-braes-inquest-findings-health-systems-criticised/101109422, 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. 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? Broken Hill teenager Alex Braes, who died of an infected toenail. "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.". The inquest also heard the Broken Hill hospital is prevented from transferring patients to Adelaide, despite the SA capital being closer than Sydney. The following month he began to experience pain in his knee. 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. Two New Fatal Earthquakes Hit Turkey Days After Deadliest Quake Killed 44,000 . Authorities said . She noted that there was no realistic possibility that his specific infection could have been identified and successfully treated on September 20, 2017. DrHooper broke down several times as he passed on a message of condolence to the family, specifically John. 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. asked Ms Edwards. He believes Alex's death was a consequence of poor structure and organisation at the hospital. 7 Callum Jones: Sprained Ankle Causes Fatal Blood Clot. Liverpool welcomes UEFA report on Champions League final chaos in Paris. 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. Browse for your location and find more local ABC News and information. There was no autopsy so the cause of death cannot be definitively determined, Ms Edwards said. Coroners' inquisitions are also in KB 13 and KB 140. 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. Part 1 Requesting the Autopsy Report 1 Understand the purpose of an autopsy. 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. 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