The Unbelievable Arrogance of a Medical Specialist.

I was going to write a post on the unsatisfactory nature of Centrelink tonight. The post was going to be titled - "we're from the government - we're here to help you..." Then I started watching "Four Corners" about rampant bullying in the hospital/medical hierarchy. How registrars become like their masters. And so  I changed the focus of this post. Because registrars and residents aren't the only victims of bullying in hospitals.

Thirteen months ago, Michael nearly died from pneumonia. He nearly died in a private hospital in the affluent western suburbs of Perth. I compiled a seven-page complaint concerning the specialist, his registrars, the nursing staff and the hospital initially to HADSCO (Health and Disability Services Complaints Office). They could not proceed because the specialist "refused to participate in the process". End of story.

So I referred my complaint to AHPRA (Australian Health Practitioner Regulation Agency). Thirteen months later, I am still waiting for a response. I get "updates" every three months or so. In the meantime, the specialist continues practising. No sanctions whatsoever, despite the serious elements of my complaint.

I  want to reveal this specialist's name. But I will not do so yet. I continue to be appalled at the inaction of the complaint process. I will ring AHPRA tomorrow with my concerns. Just don't tell me to hold my breath. Here is our story  -

10 April 2014

·         After an appointment with our GP, Doctor F, at 12 noon at H Medical Centre, he advised us that Michael needed to go to hospital. As Michael’s Joondalup Consultant, Doctor C, was on leave, Doctor F assured us we would be well cared for by Doctor S at XXXX Hospital.

·         We arrived at XXXX Hospital at 1pm (approximately) with a letter for Doctor S from our GP Doctor F with requests for fluids, oxygen and a review for Michael.

·         Michael waited on Ward xx to be seen by any Doctor from about 1.30pm. He was given no fluids or oxygen. One of the nurses was about to insert nasal prongs when she withdrew, stating she could do nothing until Michael was seen by a Doctor.

·         I repeatedly asked for help for Michael and when a Doctor would examine him.

·         Michael was delirious and very dehydrated by the time Doctor S arrived with two Registrars at approximately 4pm.

·         Doctor S talked about Michael to the Registrars, rather than to him, ignored me, rolled his eyes at me and spoke about treatment information to the Registrars. He also made a pointed remark about Michael’s smoking history in our presence, which in my opinion, was unprofessional and inappropriate.

·         None of the Doctors inserted an IV whilst they were actually examining Michael.  A nurse then attempted to insert the IV into Michael’s hand after they departed the ward. She had two attempts; then she stated nurses were not permitted to insert an IV above the hand and left us, apparently to get the Registrar to insert the drip.

·         We waited for the Registrar for approximately another hour (about 5pm).  When she arrived, she commented she had been forced to curtail her time with three other patients to attend to Michael and then instructed me to step out of Michael’s room. I only did so when Michael asked me to do so as well, given he needed the IV inserted as soon as possible, as he was increasingly delirious.

·         I apologised to the Registrar when she came to tell me the IV insertion had been completed and Michael had been started on fluids and antibiotics (Saline and Gentamycin).

11 April – 13 April 2014

·        Michael was started on new antibiotic on 11 April (Tazocin) and was receiving nebulizers.

·        Michael was given one set of steroids for his lungs (either oral or injection – he can’t remember).

·        Michael’s IV fluids were ceased even though he was continually nauseated.

·        Michael rang me on the morning of Sunday 13 April as I was about to return to Perth. I had only left him on his own due to a planned family reunion at our house. He sounded extremely distressed and very unwell.

·        On arrival back in the ward, at approximately 1pm, I attended to Michael’s needs, fetched and carried for him and liaised with nurses. We were becoming increasingly alarmed and dissatisfied with the level of care by both nursing staff and doctors

.

·        Doctor S saw Michael on Saturday morning (12 April), not at all on Sunday 13 April.

·        Michael was started on yet another new antibiotic (Meropenem), on Sunday 13 April, as according to his drug chart, he wasn’t responding to Tazocin. Doctor S authorised this via a phone conversation, rather than in person.

·        We later discovered through the HBF representative that Meropenem wasn’t on the PBS and Michael can’t remember giving financial consent to receive this drug.

·        One of  the Registrars  divulged that liver function changes in Michael’s blood results were potentially caused by this latest medication.

·        One of  the Registrars told us that Michael couldn’t have regular Panadol to control his fever as this was problematic for his current liver function.

·        On the evening of 13 April, Michael and I discussed transferring to Joondalup Hospital if his care and his condition didn’t markedly improve.

14 April 2014 –

·         I rang Doctor  C’s rooms to enquire if he had returned from leave.

·         As he had returned, I requested a transfer back to Joondalup Hospital under Doctor C’s care.

·         Doctor C’s staff rang Joondalup Hospital Admissions repeatedly that day requesting a transfer for Michael. We were aware of a wait, possibly until the next day.

·         Doctor S and Ward xx were also aware we wished to transfer back to Joondalup Hospital.

·         Registrars saw Michael twice that day. I asked for chest physiotherapy (no response) and enquired about further steroid therapy (no response).

·         Due to inconsistent application of Panadol, Michael’s temperature was spiking episodically. Throughout  that afternoon, Michael was deteriorating before my eyes.

·         About mid-afternoon, I reported that he was unable to urinate. There was no action for this added problem.

·         I was informed that Doctor S would be in to see Michael that afternoon and repeatedly asked the nursing staff when this would be.

·         Michael expressed the desire to leave XXXX and go home – a trip of 150 kilometres. He had lost all faith in either the care on the ward or the care of Doctor S and his Registrars.

·         At 5pm, I asked (again) when Doctor S would be seeing Michael. I was told he would be in “shortly”. At that point, I told the nurse that the Doctor had 15 minutes to arrive before we left the Hospital.

·         I packed Michael’s belongings.

·         At 5.30pm, Doctor S arrived with the Registrars. He turned his back on me and asked Michael how he was.  Michael replied that he felt “dreadful”.

·         Doctor S then proposed leaving Michael on the Meropenem, despite the fact his own Registrars had told us the drug was probably responsible for the changes in Michael’s liver function.

·         Doctor S ignored my protests.

·         I lost my temper. I believe I called Doctor S an “arsehole” and a “prick” and told him to leave Michael’s room. I added I was taking Michael to Joondalup Hospital immediately.

·         Doctor S’ only response was to raise his hands, say “good luck” and leave the room, his Registrars in his wake.

·         We left approximately fifteen minutes later.

      Ward xx refused to send any documentation with us. All I had was Michael’s initial chest x-ray from 11 April.  

      We arrived at Joondalup Hospital Emergency Department on the first Monday of the school holidays at about 6.30pm. Every child in the northern metropolitan area seemed to have become sick or injured on that very day. We could see the Emergency Department was already crowded as I parked outside the entry. I found a wheelchair and loaded Michael into it, wheeling him straight to the Triage window.

The staff was outstanding from the first minute. I explained the situation of Michael’s deterioration over the previous five days. I also confessed that I had more or less kidnapped him from the other hospital and we had no information, given the nature of our escape.

One of the Emergency doctors organised Michael’s admission in the waiting room, as there were no beds in the Department. They initiated observations on him and began treatment immediately. With a cheerful grin to calm me down, the doctor cracked “Don’t do this at home!” as he gave Michael fifteen puffs of Ventolin through a spacer to open up his airways.

We waited, Michael propped up in a wheelchair for nearly two hours. Just when I was about to beg for a bed, we were moved into the Emergency Department and Michael was helped onto a bed. I felt we’d been saved, just in time.

After that, everything happened very rapidly indeed. The nursing staff gently removed the old cannula out of Michael’s arm and began continuous observations. Two physicians inserted a new line, took blood and started fluids and IV Panadol on a rapid induction. Michael’s specialist was phoned and new IV antibiotics were commenced. 

Suddenly, all seemed back in control. Michael slipped into semi-consciousness through total exhaustion.

We were told that Michael’s kidney function was satisfactory, which was all that saved him from being admitted into the Intensive Care Unit. Within an hour, Michael was on the ward, asleep after a terrible day.

Michael’s specialist and his team continued their excellent care over the following fourteen days. Michael was very, very sick with pneumonia on admission. He developed fluid trapped in the pleural sac, which felt like an elephant was sitting on his chest. While inserting the chest drain, his left lung collapsed, an unfortunate but not uncommon side effect of the procedure.

He was pronounced well enough to return home at the end of April. I had boarded with him in his hospital room the whole of his stay. In the last few days, he had a PICC line inserted in his arm, as he returned home on IV antibiotics for another  two weeks. He remained on oral antibiotics for another four weeks.

He took three months to recover.

And I am still waiting for an explanation and apology from AHPRA thirteen months later. Brilliant.

Dawn from Michael's hospital window, Joondalup Health Campus 14 - 28 April 2014.