Shortly after 10 p.m. on June 7, 2021, Alex Murdaugh called 911 from his property in Islandton, South Carolina, to report that he had found his 22-year-old son Paul and his wife Maggie, 55, murdered. An infectious diseases specialist has told an inquest he was considering amputation to save the life of a gravely ill teenager he was treating at a rural hospital, but that the only option was to fly him elsewhere. 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 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. "There was no system whereby a New South Wales clinician could insistthat acritically-ill, Broken Hill patient be accepted for treatment in South Australia," she said. Coroners' inquisitions are also in KB 13 and KB 140. Browse for your location and find more local ABC News and information. 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. Alex's father wheeled him into the emergency department and a nurse observed him through a window and asked him to wait. Can pain kill you?: Teens final words after he was turned away from NSW hospital. 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.'. By the following morning, Alex's pain was so excruciating, he couldn't walk. A doctor who later saw Alex Braes said the 18-year-old was 'the sickest patient he'd ever seen at Broken Hill' hospital. Dr MacDonald believes the law was being breached. He believes Alex's death was a consequence of poor structure and organisation at the hospital. ': 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. After arriving at Broken Hill base hospital on 21 September, Braes was put in a non-acute bed. What health. "This was a perverseoutcome whichdemanded examination at the inquest.". 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. The majority of Coroner's findings following an inquest are available to the public. "He was our first child, our ray of sunshine," he said. I think it could easily happen I have a great fear it could happen, she said. Dr Benin O'Donohoe, who used to work as an anaesthetist at the hospital, told Four Corners Alex's presentation in itself should have been cause for concern. He went into cardiac arrest. 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. WALTERBORO, S.C. . Mr Braes was a healthy teenager, working as a fitter and turner, when he was put on antibiotics in August 2017 for an infected toenail. 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. Alex Braes. Alex Murdaugh called 911 on the evening of June 7, 2021, and said he'd found his son and wife dead when he returned home from a one-hour visit with his mother, who has dementia. "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.". 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. It's something that troubles local MP Roy Butler. Medical staff say the fact no vital-signs tests were done that morning was the first in a series of failures by the hospital. "I know it was after Alex passed away," she said. "A significant one was the failure on September 20, 2017, to perform vital signs observations," Ms Ryan said. Please note: Broken Hill staff had missed something, but still, no-one did proper observations of Alex. 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. The inquest will continue on August 31 with Sydney-based hearings. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. If this is your first visit to the new AusDoc website, reset your password But I can say to you that I think of that boy frequently," she said. Alex was given a triage category of three, meaning the patient must see a doctor within 30 minutes. "I've worked in 13 different locum hospitals since I've retired and I've never seen anything like Broken Hill in my entire career," he said. Jurors in the murder trial of disbarred South Carolina attorney Alex Murdaugh heard Monday about autopsy evidence on a day the court also publicly released body camera videos from law enforcement . Dr Hooper, who resigned from his position as a senior visiting medical officer at Broken Hill Hospital two months ago, told the inquest yesterday that Mr Braes' death was a "profound event" in his life. . a coroner has heard. 'An unthinkable tragedy': How did this train crash happen? Alex's mother was left standing outside near the airport tarmac for hours as Alex, still back at the hospital, fought for his life. Ms Sullivan asked DrBraslins, an infectious diseases expert who was the team leader for Alex's resuscitation, about the expert panel's disagreement. 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. The 18-year-old died about 1am on 22 September soon after landing in Sydney after a prolonged effort to evacuate him from Broken Hill. The inquest is investigating the treatment the teenager received before he died from a bacterial infection known as Group A Streptococcus (GAS). The delayed transfer also deprived his parents of seeing him in his final hours, as they left the hospital to prepare to travel with him. They included a baby who died after a doctor failed to check her test results, a woman who bled to death in an emergency department without any doctors physically present and a man who was told his ward had run out of morphine and paracetamol. It was far too late. A medical student struggled to insert the cannula. Did you find what you were looking for? The local proceedings of inquest into the death of Broken Hill teenager Alex Braes has finished after hearing of a "distressing"hospital business rule, staffing resources and apologetic doctors. Get the best investigative journalism, delivered to your inbox. Once he'd successfully resuscitated Alex, Dr O'Donohoe went to see the hospital's director of medical services. In lieu of an autopsy, a panel of . This resulted in Braes' parents being denied a formal investigation "for an inexcusable length of time," Ryan said. But questions are expected to continue about the handling of Alex Braes' case. The inquest heard Mr Braes had an ingrown toenail in August 2017 that was successfully treated with antibiotics. It was a call made far more difficult due to a lack of available pilots at the RFDS base in Broken Hill that day. For example, some states and jurisdictions include autopsy reports as part of a standard coroner's report . Ryan found it was potentially dangerous and against NSW Health policy, but a systemic failure that could not be attributed to individual hospital staff. Broken Hill teenager Alex Braes, who died of an infected toenail. He was later medically evacuated to Royal Prince Alfred Hospital, where he died within an hour of his arrival. All the stuff he wanted to do, theyre all memories now.. He went into cardiac arrest. "Unfortunately it's a very serious omission that somebody who's been repeatedly in the emergency department hasn't been gone over with a fine-tooth comb," he said. Our Morning Edition newsletter is a curated guide to the most important and interesting stories, analysis and insights. Again, no-one checked Alex's vital signs. Outside her tent, next to a popular city walking track, homeless Tasha is past caring what people think. "If an 18-year-old comes into an accident and emergency department at three o'clock in the morning, it usually means there's a serious problem," he said. Tragically, what worked against Mr Braeswas his overall health and age, the inquest heard. Two New Fatal Earthquakes Hit Turkey Days After Deadliest Quake Killed 44,000 . "And I think that the clinicians who would have been with him when he was so sick in emergency will not forget him.". There was no "grab and go" for Alex and that would have devastating consequences. It recently handed down 44 recommendations to boost the rural medical workforce and improve the standard of care. Ms Kelly today told the court she was on a break when Mr Braes represented at the hospital with his dad on September 21. "One of the things that really stood out for me when I saw you that night was how sweetly you and Alex treated one another," he said. Broken Hill teen Alex Braes died in 2017. It took 25 minutes for a wheelchair to be brought out so Alex could be taken from the car into the hospital. Dr Greenberg told the inquest thathe first saw Mr Braesabout2:00pm on September 21, 2017, and from that moment on "I was the team leader". It was not until his fourth and final presentationmore than 30 hours laterthat vital observations were taken of him and a suspected toenailinfection was identified. April 21, 2021 - 11:05AM The doctor tasked with taking care of Alex Braes after he presented to a country NSW emergency department in the middle of the night in 2017 has addressed the teenager's heartbroken family. Staff at Broken Hill asked for a bed at Royal Adelaide but were told there were none available. Sign up and stay up to date with our daily newsletter. 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. "[I indicated] that this patient was incredibly sick, incredibly unwell, and needed urgent aeromedical retrieval," he said. Media Access When a Coroner investigates a death or a fire or explosion, the court gathers a range of documents which make up the coronial file. As his pain began to worsen, he was taken to the hospital, where he was diagnosed with a fractured ankle. "Every person (from) the smallest thing to the largest thing, they get a set of obs.". "Twelvehours passed before hisemergency flight landed at Sydney's Royal Price Alfred Hospital," Ms Ryan said. However, at the time of Alexs death, Broken Hill Hospital had implemented a business rule that meant nurses were discouraged from taking vital signs during triage. Counsel Assisting the coronial Inquest Emma Sullivan asked registered nurse Caroline Anderson, who attended to Alex on his first presentation, whether the rule had applied to him at that presentation. About 21 hours after he first presented to the emergency department, and with 12 hours left to live, the treatment of the 18-year-old was handed over to the chief medical officer of the Royal Flying DoctorService (RFDS). "Because it's not good enough in 2019 to have people in the far west of New South Wales having worse health outcomes than people in the city.". 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, The death of Alex Braes still haunts doctors who didn't even know him, 'To lose a son is one of the most traumatic losses in life,' Alex Braes' father tells inquest, Resourcing, hospital business rule highlighted in Broken Hill hearings for Alex Braes inquest, Whistleblower clinicians want ombudsman probe into outback hospital, Postcode health gap: 'This is third-world stuff', Outside her tent, next to a popular city walking track, homeless Tasha is past caring what people think. Alex Braes is believed to have died from a type of flesh eating bacteria, known as necrotising fasciitis, after he was turned away three times from Broken Hill Hospital's emergency department in . There was an "extraordinary lack" of progress between NSW Health and SA Health in establishing a formalized cross-border arrangement to transfer critically-ill patients from Broken Hill to Adelaide, Ryan said. Mr Palmbach testified that the findings in the autopsy report about Paul's wounds - that the head wound was an exit wound - were "inconsistent" with the evidence which he testified shows . Alex's father called triple zero to ask an ambulance to take his son to hospital, but no ambulance was available. 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. Alex Braes. 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. She told Four Corners that by this stage, Alex was desperately unwell, yet he was again left waiting. 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. Experts assembled for the inquest said they had notcompletely agreed on the cause of Alex's death. "You need to move that patient as soon as you possibly can to an organisation that has the facilities, the staff to manage the patient as best as possible," she said. Dr MacDonald believes if you're in a remote centre and become gravely ill, the hospital needs to be equipped for what she describes as a "grab and go". "I feel heartbroken that I still have my children and that you've lost your boy.". 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. Alex Braes, 18, died at Sydney's Royal Prince . But the 18-year-old mechanic died with "tragic suddenness",. If they had flown Mr Braes down to Adelaide, the only available pilot would not have been able to return, as their allowed time would have expired. 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. Alex Braes died on September 22, 2017, with a suspected flesh-eating bacteria known as necrotising fasciitis ravaging his system, after he was turned away three times from Broken Hill Hospitals emergency department. Notcompletely agreed on the cause of Alex would have devastating consequences be brought so. 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