Commissioner slams Wellington Hospital over man's death

"The Health and Disability Commissioner has slammed Wellington Hospital over the standard of care given to a 50-year-old man who died of pneumonia.

Ron Paterson was investigating a complaint from the man’s family after he was found dead, 40 hours after being admitted to hospital in September 2004.

The patient's chest X-ray and blood tests were not reviewed for almost 30 hours.

Mr Paterson says what happened was inexcusable, that staff provided a poor standard of care and the man was deprived of simple interventions that may have saved his life."
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Gary Moller comments:
This report hardly comes as a surprise and is yet another of a string of awful cases over the years at Wellington Hospital causing unnecessary death and disability.

Reading between the lines of this case, it would appear that this man's bipolar disorder, chronic addiction to smoking and serious chest condition made him a difficult and stroppy patient from the momeent he arrived and the hospital staff took a collective dislike to him. The result was grossly inadequate treatment, bordering on deliberate neglect, that saw him dead in next to no time. It reminds me of a case in Dunedin Hospital many years ago that was never reported:

She was elderly, overweight and demented. She was admitted to hospital to lose weight. Her diet consisted of a glass of water and a piece of white bread with a dollop of Marmite. When she objected to her treatment and peed in her bed, she was isolated in a private room with no sensory stimulation. She did not eat or drink. Within a few days of sensory deprivation, starvation and dehydration she was going ga-ga. The treatment and the isolation continued. By the fifth day, she was dead.

Now this was homicide by willful neglect. Nobody intervened. Everybody just did what they were told and that was to administer the treatment and to do nothing else. The fact the patient died was irrelevant and nobody within the medical team felt responsible - or guilty for that matter. They all knew what was going on and nobody cared a damn about her or the horrific way she died.

I have written about this sort of thing in the past and the advice that I always come back to is this: You must ensure that you always have a strong, informed advocate by your side when you enter hospital; especially if you are elderly, cantankerous by nature or have a mental health condition that affects your behaviour. If the hospital staff take a dislike for you, your life may be at risk.

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Hospital Dumps 1,800 Patients off Waiting Lists

The Hawke's Bay District Health Board has unanimously approved a move that would see 1,800 people cut from its waiting lists. They will have to go back to their GPs with no hope of surgery in the foreseeable future. Board CEO Chris Clarke says the hospital cannot keep up with the rising demand for its services. 12/04/2006NewstalkZB

Gary Moller comments:
This news is hardly a surprise and something we are all going to have to get used to as our populations age and the positionally challenged youthful generations begin to get old and suffer diseases of old age, such as diabetes, osteoporosis and CHD, in their 30's and 40's. The current medical model simply can not cope with the tsunami of ill health.

When I was doing my studies in rehabiliation through the Otago School of Medicine, our lecturers frequently referred to the "dreaded specialist appointment". This appointment was dreaded by rehabilitation health professionals because it signaled that nothing would, or could, happen with a patient while waiting to see a specialist. Of course, this appointment would be several months out and it usually would take more than a few further appointments before anything of substance would happen.

A typical interaction between a therapist and a patient goes a bit like this:

Therapist: "I would like to start you with a gentle exercise programme to begin strengthening your lower back"
Patient: "I am not allowed to do anything like that until I have seen my orthopaedic specialist about my suspected prolapsed disc".

Nothing happens and any opportunity for early and active intervention is lost because a lesser expert cannot pre-empt the specialist that is yet to be consulted. This is very frustrating.

What we know is people on waiting lists do not get better; the rule of thumb is that they deteriorate. Adding to the problem; if a person is unable to work, due to a health problem, the chances of getting them back into productive employment plummets with each week they are laid up. After about 3 months, the odds of getting this person back into employment are looking pretty grim.

I have written about this growing problem many times and published a substantial discussion paper that offers one piece to the jigsaw, as far as solutions are concerned. You can read it here.

Resorting to dumping people off waiting lists is not the solution; although it might help a little over the short term by enabling some kind of intervention to begin, instead of having the patient sit around doing nothing and getting worse. Sadly, general practitioners, who are now being asked to deal with these dumped patients, are poorly equipped to offer lasting solutions to ailments that are mostly the result of ageing, combined with the effects of poor lifestyle and nutrition choices.

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