Investigation continues after man dies awaiting hospital admission

Talking points

• A dozen staff were furloughed and all short stay units and emergency cubicles were at capacity on the day a man died after waiting more than three hours in the emergency department of a regional hospital in East Gippsland.
• Bairnsdale Regional Health chief executive Robyn Hayles told media on Wednesday he was assessed by clinical staff upon arrival in the ambulance and triaged, but should have been admitted within 45 minutes.
• An investigation into the man’s death will follow guidelines set out by Safer Care Victoria and will be coordinated by the hospital’s quality unit.

A dozen staff were furloughed and all short-stay units and emergency cubicles were at capacity on the day a man died after waiting more than three hours in the emergency department of a regional hospital in East Gippsland.

The Age revealed on Tuesday an investigation was being undertaken into the death of the 72-year-old man, who went into cardiac arrest and died about 4.15pm on Monday, after waiting 3½ hours to be admitted to the Bairnsdale Regional Health Service in East Gippsland.

Since then, more information surrounding the circumstances of the man’s death and the hours he spent at the hospital have to come to light, including that he was taken via ambulance to the Bairnsdale Regional Health Service following a fall at home.

He arrived at the hospital at midday on Monday and Bairnsdale Regional Health chief executive Robyn Hayles told media on Wednesday he was assessed by clinical staff upon arrival in the ambulance and triaged.

A spokesman for the health service said all nine emergency department cubicles were at capacity at the time. The short-stay unit cubicles in the emergency department were also full of unwell patients.

The day the man died, there were three ambulances ramped outside the hospital in Bairnsdale and a “demand escalation”, designed to increase patient flow through the hospital, had been called due to significant demand in the emergency department, he said.

“Combined with high demand in our partner hospitals across the state, this contributed to a patient flow blockage where we were unable to transfer patients out of the ED to appropriate beds at BRHS or hospitals elsewhere,” the spokesman said.

“We express our deepest sympathy to family and friends.”

Earlier reports briefed to The Age indicated that the man had remained in an ambulance stretcher. However, preliminary investigations into the man’s death have since confirmed that the man experienced a cardiac arrest in the bathroom of the emergency department at 3.30pm on Monday, the health service clarified on Wednesday.

Hayles said the man arrived at the emergency department via ambulance at a time when the hospital was experiencing “significant demand”.

Emergency departments are more crowded than ever.Credit:Damian Shaw

He was still waiting to be admitted when he was escorted to the bathroom by a paramedic and nurse and suffered a cardiac arrest and died. Staff attempted to resuscitate the man for 45 minutes, but he died at 4.15pm.

“We try to see those people in the emergency department, we try to get them off the ambulance, within 40 minutes and see them within our ED within four hours,” Hayles told reporters.

She also revealed another investigation was under way after a woman was not able to visit her husband on Saturday before he died because of restrictions on visitors.

“We do think in that situation that the decision was the wrong decision, so we’re just reviewing those protocols and practices at the moment.”

A spokesman for the health service said 12 doctors and nurses were on sick leave the day the patient died, reflecting about 18 per cent of clinical staff rostered on that day. Six of those staff members had coronavirus.

The shortage in staff on the day the patient died in the emergency department led to acute wards having to close five beds to maintain legislated patient safety ratios, the spokesman said.

“We managed to cover all but two of those unexpected absences by moving clinical staff around the hospital and we were able to keep the ED fully staffed,” he said.

He added that on top of staff furloughing due to a rise in employees being infected with coronavirus, the health service was also dealing with an increasing number of staff absences that are COVID-related, including having children or family members test positive, along with exhaustion, fatigue and stress caused by being on the front line of a pandemic for more than two years.

On Tuesday, doctors said regional hospital staff were struggling to secure intensive care beds at Melbourne hospitals when they attempt to transfer seriously ill patients who require higher levels of critical care than a small hospital can provide.

The investigation into the man’s death will follow guidelines set out by Safer Care Victoria and will be co-ordinated by the hospital’s quality unit.

It will be conducted alongside Ambulance Victoria and an independent health professional. Members of the man’s family will also be invited to participate.

The spokesman said the health service continued to report increasing numbers of people, with more complex illnesses, presenting to the hospital’s emergency department and presentations have increased 19 per cent since 2013.

A number of factors were fuelling pressure on the hospital’s emergency department, he said, this included population growth in East Gippsland as well as many older people living in the community with existing medical conditions.

An increasing number of patients with complex illnesses were also presenting to the emergency department because patients have delayed or abandoned their medical care during COVID-19 and there was an ongoing shortage of medical workers looking to work in regional Victoria.

Of the 650 full-time staff who work for the Bairnsdale Regional Health Service, 19 declined to receive the COVID-19 vaccine as per the mandate for healthcare workers. Of these, five were direct clinical staff and five were casual nurses.

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