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 "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. All NSW magistrates are coroners by virtue of their status: s 16. Broken Hill teen Alex Braes died in 2017. Coroner's Report: With Willa Ford, Peter Barton, Michael Swan, Kyle Labine. Broken Hill teen Alex Braes died in 2017. 00:00. 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. Mr McLean says by this stage Alex's third presentation alarm bells should have been ringing. Browse for your location and find more local ABC News and information. As his pain began to worsen, he was taken to the hospital, where he was diagnosed with a fractured ankle. Watch Louise Milligan's investigation on iview. 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. In lieu of an autopsy, a panel of experts . An inquest into how a Broken Hill teenager died from an infected toenail has heard his condition deteriorated rapidly in his final hours. 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. Mr McLean says he spoke up and tried to get something done but he was ignored by hospital management. 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. Alex and his father arrived back at the emergency department. "I'm so sorry that this happened to you," said DrArangala to the Braes family in an emotional, sombre tone. "Certainly other hospitals will highlight a second presentation or third presentation, [to ask] 'have we missed something?'" "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.". 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. Dr Kerrie MacDonald is a paediatrician who used to work at Broken Hill Hospital and is still in the NSW health system. 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. An autopsy is an examination of the body of a deceased person, carried out by a qualified pathologist. Dr. Piazza - Injury and Thrombosis. 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. I think it could easily happen I have a great fear it could happen, she said. In lieu of an autopsy, a panel of experts . I don't even know what he looks like. Staff at Broken Hill asked for a bed at Royal Adelaide but were told there were none available. Findings and upcoming inquests - Coroners Court Inquest findings (since 2004) as well as non-inquest public interest matters (since 2012) are available below. Authorities said . 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. 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. 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 Sydney's Royal Prince Alfred Hospital after going to another hospital four times. She said the inquest established therewereshortcomings in thecare provided to MrBraes at the hospital. 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. Alex Braes, 18, had significant knee pain when he first presented to Broken Hill Hospital in the early hours of September 20, 2017. However, the rule did not comply with NSW Health policy, was "potentially dangerous" and should not have been introduced, according to Ryan. 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. 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. In Newcastle and Wollongong, a magistrate is appointed by the Chief . Please confirm you want to block this member. 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. In lieu of an autopsy, a panel of experts determined he had an unusual presentation of a fast-acting, highly lethal infection, the NSW Coroners Court has been told. Doctors identified necrotising fasciitis, a deadly, flesh-eating disease, from an infected toenail in the teenager. "Many changes have already been implemented by Far West NSW Health District and NSW Ambulance.". 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. Justifiably outraged at the poor care of his son, John Braes. A raised temperature is a key indicator of infection. "Yes that's my understanding," replied Ms Anderson. Advertisement Ad 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. But their boy suddenly deteriorated sharply. Broken Hill teenager Alex Braes' parents remember him as a ray of sunshine, a funny and smart . All the stuff he wanted to do, theyre all memories now.. After arriving at Broken Hill base hospital on 21 September, Braes was put in a non-acute bed. "What are we doing about avoidable deaths, preventable deaths?" Alex Braes (Credit: ABC "Four Corners," family photograph) The death has traumatised Braes' family and hospital staff alike. Inquest into the death of Alex BRAES CORONIAL LAW: death of a young man - cause of death sepsis - was clinical care at Broken Hill Base Hospital adequate - were arrangements or airlift to a tertiary hospital appropriate - recommendations Download Inquest into the death of Alex BRAES PDF File (358.2 KB) Last updated: 27 May 2020 It's something that troubles local MP Roy Butler. Tragically, what worked against Mr Braeswas his overall health and age, the inquest heard. "He complained that he might pass out or faint, so his father asked for a pillow," she said. Alex went into cardiac arrest and died upon arrival at Royal Prince Alfred Hospital in Sydney. 00:00. Alex's ultrasound showed a possible torn tendon and again Alex was sent home and told to rest, ice and elevate his leg and to come back in two weeks if the pain hadn't stopped. "Was there a general feeling it compromised patient safety?" 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. A medical student struggled to insert the cannula. The senior nurse who realised Broken Hill teenager Alex Braes was suffering from septic shock has begged for more help for the understaffed and under-resourced country hospital. here. 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. 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. Elizabeth Keft returned, with IV bag in hand, to see doctors and nurses working on Braes in a resuscitation bay. The inquest heard that at the hospital, only one doctor is on duty overnight and two nurses in the emergency department. Were working to restore it. "And I think that the clinicians who would have been with him when he was so sick in emergency will not forget him.". 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. "His parents were just shell-shocked. 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. Alex Braes, 18, was only tested for . Please don't include personal or financial information here, My property was damaged or destroyed in the fires FAQ. 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.'. 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. Alex Braes, 18, died at Sydney's Royal Prince Alfred hospital nearly 46 hours after limping into Broken Hill Base hospital at 3am on 20 September 2017. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. We will use your rating to help improve the site. Alex was told to go home and come back later that morning for an ultrasound. Alex Braes, 18, died on 22 September 2017 from multi-organ failure due to sepsis from a Group A streptococcus infection. 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. 'An unthinkable tragedy': How did this train crash happen? "I know it was after Alex passed away," she said. SA Health, for its part, has commenced discussions with its NSW counterpart on how to continue to best provide services on an ongoing basis. He told the inquest though, that on the balance of probabilities, Alex most likely had necrotising fasciitis. "She must have hoped beyond hope that he would survive.". The second day of hearings heard from DrDavid Hooper, who reviewed Alex during his third presentation to the local hospital on September 20, 2017. Former Broken Hill obstetrician Dr Simon Stewart-Rattray told Four Corners the failure to do vital-signs observations was "indefensible". Each season is dedicated to a different series in horror. 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 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. Dr MacDonald believes the law was being breached. 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. . 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. Deputy State Coroner Elizabeth Ryan delivered the inquest's findings in the Broken Hill courthouse on Monday. Eighteen-year-old Alex Braes' knee was so painful, he asked his father to take him to Broken Hill Hospital. "I didn't know his family, I didn't know Alex Braes. Copyright 2023 IBTimes LLC. Ms Anderson was then asked when the rule was disbanded. "We've gone back to the full set of obs (observations) at every triage," she said. "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.". Local hearings took place at the Broken Hill Coroner's Court this week, with a number of doctors and nurses who attended to Alex at Broken Hill Hospital appearing as witnesses alongside the teenager's father, John Braes. Because you left the triage window unattended and there were a lot of patients there," asked Ms Edwards. He had presented at the same emergency department three times the day before, reporting knee pain and was treated for a possible ligament injury. 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. Sign up to receive an email with the top stories from Guardian Australia every morning. "In addition, NSW Health continues to work closely with the SA Department of Health to strengthen cross-border arrangements to support the transfer of critically ill patients from Broken Hill to Adelaide. In the small hours of a Wednesday in an outback town, a teenager struggled to sleep. 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. ': 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. A coroner has blasted a NSW hospital for attempting to avoid an investigation into a teenager's death from sepsis after he was sent home from its emergency department, finding efforts to deny the significance of the tragedy inexcusable and deeply distressing to his family. But the Flying Doctors were unable to transport Alex because the only available pilot had already reached their maximum flying hours a regulation governed by the Civil Aviation Safety Authority. From February 2022, the Broken Hill RFDS base has funding available for a second plane, along with another locally based pilot and nurse. For legal cases involving intentional or accidental death and for insurance claims, The Records Company retrieves coroner's reports and autopsy reports. Two New Fatal Earthquakes Hit Turkey Days After Deadliest Quake Killed 44,000 . On the first day, the Broken Hill hearings heard that Alex mighthave died from an infection, invasive Grade A Streptococcus, possibly from the ingrown toenail or a cut. Alex arrived at Broken Hill Hospital's emergency department. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. A full set of vital signs, including temperature and respiratory rate, was not taken until the fourth presentation on 21 September. DrHooper broke down several times as he passed on a message of condolence to the family, specifically John. If this is your first visit to the new AusDoc website, reset your password Witnesses told the inquest the rule had limited oversight from senior management and staff generally disapproved of it. The death of a healthy 18-year-old man who first attended a hospital with moderate knee pain is almost incomprehensible, she said. During the flight Alex continued to decline and, as his mother watched, the paramedics struggled to keep him stable, having to phone doctors for advice. Dr O'Donohoe later quit work at Broken Hill Hospital over what he saw as mismanagement, leading to patient safety issues. "A young man who died, essentially, from an infected toenail, from the consequences of an untreated and very common infection. In lieu of an autopsy, a panel of experts . John Braes told the inquest at its first day of local hearings that his son had looked up 'can pain kill you' on his iPad in the days before his death. "I was aware that many of the staff felt that it affected the way they triaged and potentially could affect the accuracy of their triages," replied Ms Kelly. Dr Greenberg explained to the inquestthat the situation was the same in Dubbo, where the pilot's hours had also expired. Ryan found it was potentially dangerous and against NSW Health policy, but a systemic failure that could not be attributed to individual hospital staff. 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. 'An unthinkable tragedy': How did this train crash happen? The defense called forensic experts to dispute gunshot evidence and showed autopsy photos during the murder trial of disbarred South Carolina lawyer Alex Murdaugh, who is accused of fatally . By the time Alex was diagnosed with a bacterial infection he was in septic shock and needed to be medically evacuated to Adelaide. Alex finally left the hospital and was put onto the air ambulance which took off with his mother also on board. "Furthermore, Alex was not transferred to the closest hospital suitable forhis care, which was South Australia's Royal Adelaide Hospital," Ms Ryan said. 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. Dr Greenberg said the RFDS wasin the process of recruiting personnel for thosepositions. Alex's mother was left standing outside near the airport tarmac for hours as Alex, still back at the hospital, fought for his life. She noticed he was sweaty and unwell and moved him into a bed in the emergency department. It was a horrific outcome and such a young man, only 18 years old.". There was no "grab and go" for Alex and that would have devastating consequences. Alex Braes, 18, died of multi-organ failure caused by sepsis. 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. (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. He revealed all the medical staff "misjudged" Mr Braes, who was "compensating very well" because he was "a young, fit fellow". Ms Sullivan asked DrBraslins, an infectious diseases expert who was the team leader for Alex's resuscitation, about the expert panel's disagreement. Broken Hill staff had missed something, but still, no-one did proper observations of Alex. She said as a hospital practice it was not compliant with NSW Health policy. Inquisitions on prisoners who died in the King's Bench prison are in KB 14. "This was a perverseoutcome whichdemanded examination at the inquest.". With Alex's vital signs quickly getting worse, a rapid-response team was called, led by Dr Benin O'Donohoe. She recommended NSW and SA health departments urgently agree to cross-border transfers of critically ill patients from Broken Hill. Alex and his father were told to go home and come back later. FOLLOW MORE IBT NEWS ON THE BELOW CHANNELS, IBT Fast Start - Let the best of International News come to you. This resulted in Braes' parents being denied a formal investigation "for an inexcusable length of time," Ryan said. AEST = Australian Eastern Standard Time which is 10 hours ahead of GMT (Greenwich Mean Time), abc.net.au/news/senior-treating-doctor-reflects-on-day-two-of-alex-braes-inquest/100703130, 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. Alex Braes, 18, suffered multi-organ failure due to sepsis and died after hospitals either despatched him domestic or refused to admit him. An inquest into his death by the NSW Coroners Court is investigating the treatment the teenager received before he died from a bacterial infection known as Group A Streptococcus (GAS). 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. 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. the NSW member for Barwon said. The timeline of what happened next is a harrowing account of failure in Australia's regional hospitals, where resources are stretched and staff are under constant pressure. 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 Mr Braes had an ingrown toenail in August 2017 that was successfully treated with antibiotics. 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". 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. Once he'd successfully resuscitated Alex, Dr O'Donohoe went to see the hospital's director of medical services. He was later medically evacuated to Royal Prince Alfred Hospital, where he died within an hour of his arrival. This action will also remove this member from your connections and send a report to the site admin. 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. He went into cardiac arrest. Again, no-one checked Alex's vital signs. Browse for your location and find more local ABC News and information. But so shocking is his case that it's prompted a group of clinicians who worked at Broken Hill Hospital to blow the whistle on what they believe is a hospital that had dangerous, systemic failures for years. She described the death of the fitter and turner as almost unbearable to imagine for the family. There was no autopsy so the cause of death cannot be definitively determined, Ms Edwards said. Part 1 Requesting the Autopsy Report 1 Understand the purpose of an autopsy. 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. In lieu of an autopsy, a panel of . It was far too late. 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. 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. 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. It took 25 minutes for a wheelchair to be brought out so Alex could be taken from the car into the hospital. She was in that dual role when Mr Braes arrived at the hospital on September 21, 2017 - crippled by pain and . His inquest has heard a full set of vital. She told Four Corners that by this stage, Alex was desperately unwell, yet he was again left waiting. 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. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. "He was cold, clammy, sweaty and he was significantly blue and mottled and this mottling colour is really a very ominous feature. 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alex braes coroner report