Catastrophic event predicted by nurses
Australian Nursing Federation state secretary Mark Olson said its members at PCH were gutted, particularly because they had raised concerns about under-resourcing at the hospital’s emergency department as far back as December.
“They met with the hospital executive where they said, ‘You’ve got to do something about this under-resourcing, it’s not safe’ and they said it would, unfortunately, take a catastrophic event to occur for anything to change because they had been waiting months and months,” he said.
“Should that catastrophic event occur they told the executive that nurses would no doubt be thrown under the bus or used as scapegoats.”
Answers not expected for months
The Child and Adolescent Health Service will undertake a root cause analysis which Mr Cook said included “inspection by independent authorities, and those qualified to undertake such a review,” following calls earlier on Tuesday for an independent and transparent inquiry.
Before an investigation of a clinical incident can take place, a severity assessment code rating out of three must be decided: Aishwarya’s death is being treated as a SAC 1, a clinical incident that has caused serious harm or death, and which is attributed to health care provision rather than the patient’s underlying condition or illness.
A coronial investigation will also take place as with all unexpected deaths, with the coroner to determine the appropriate course of action.
Mr Cook cautioned there were limitations on what could be said publicly at this stage due to legal patient confidentiality constraints.
“The girl was taken to ED and parents observed her condition was deteriorating,” he said.
“They brought that to the attention of the ED staff.
“We need to then understand what happened.”
About 200 people presented to the ED that day. It was a busy day but not unusual for PCH, Mr Cook said.
He cautioned against making an assumption that staffing was to blame, after CAHS board chair Debbie Karasinski confirmed four doctors out of the 18 who would ideally have been rostered on were off sick.
Ms Karasinski also committed to do her best to get answers for the Aswath family.
“We’re working as quickly as we can,” she said.
“We’ve started that internal review … it will have an independent clinical expert on it.
“What actually happened, the parents trying to make contact with staff, the outcome of all of that in the end, the tragic, tragic outcome for this little girl; will be part of that investigation.
“Did [staffing] make a difference to the outcome … we don’t know the answer to that. And we will know the answer to that at the end of that investigation,” she said.
“I anticipate the investigation will take four to six weeks, but that investigation will be first reported to the board along with the recommendations, and we will have oversight of those recommendations.”
Health system not in crisis but performing ‘magnificently’
Mr Cook has remained staunch in his position that the current challenges facing WA’s health system did not amount to a ‘crisis’.
He said he had told Aishwarya’s father the health system had been under pressure.
“But what, clearly, I wanted to communicate to him is that we have a health system which is performing magnificently,” he said.
WA’s health system has been under stress for months and could remain so in the near future as the government tries to find solutions and fill staff vacancies in hospitals.
The number of hours ambulances spent waiting on WA hospital ramps with patients inside waiting to go into the emergency department eclipsed the 4000-hour mark for the second time ever last month.
The figure was also reached in January but Mr Cook has played down the situation as a challenge, which stands in stark contrast to his rhetoric in opposition when he labelled ramping which reached the 2000-hour mark under a Liberal-National government as a crisis.
“I continue to work with the leaders in our hospitals, to make sure that they have the resources they need, what they tell me at the moment is that they continue to be challenged,” he said.
The Department of Health recently advertised the need for 85 full-time midwives in Perth to help deal with a baby boom.
Mr Cook also announced during the election the government wanted to hire an extra 400 nursing graduates over the next two years.
Liberal health spokeswoman Libby Mettam said the tragic death of Aishwarya was about the failure of a system rather than individual staff members.
“We are currently facing a significant health crisis with ambulance ramping at record levels, an unprecedented number of code yellow emergencies being called weekly, and an elective surgery waitlist which has continued to balloon,” she said.
“The McGowan government must face the fact that WA is experiencing a serious health crisis at this time and take the necessary steps to address this crisis in our hospitals as a matter of urgency.”
Emma Young is a WAtoday reporter focusing on environmental issues, urban planning, social justice and the arts. She has won eight WA Media Awards, including the Matt Price Award for Best Columnist.
Peter de Kruijff is a journalist with WAtoday.