"Escalating symptoms after pedestrian accident - repeated ED presentations"

I am sharing my experience of care at Busselton Emergency Department in late 2023 after I was hit by a car as a pedestrian.

I attended the ED on three occasions over a two week period with worsening pain and neurological symptoms, including increasing numbness in my legs. Despite this, I was repeatedly discharged without adequate investigation, pain management, discharge information, or referrals. Spinal precautions applied by ambulance officers were removed without spinal imaging, and my escalating symptoms were not taken seriously.

At the time of the accident, I was working full-time as a Clinical Psychology Registrar in a local clinic. As a result of injuries that were not detected or treated by Busselton ED I was unable to work at all for more than 18 months and currently work no more than 10 hours per week. I have had two surgeries and have been advised that another surgery is likely. My recovery has involved intensive ongoing physiotherapy, input from multiple medical specialists, and other painful and invasive treatments. I have been in pain every day since the accident and continue to experience lasting mobility and functional limitations.

My eventual attendance at another hospital occurred only after untreated numbness spread to my pelvis and I developed acute urinary retention, leaving me completely unable to feel or empty my bladder. This was a medical emergency and highlights how serious my symptoms had become before appropriate care was finally provided by another hospital.

What has been particularly distressing is the hospital’s response to my formal complaint. While it acknowledged some gaps in care, it placed responsibility on me as the patient to ensure I received appropriate treatment by “communicating better,” re-presenting, and disclosing my autism.

I want to be clear that I did re-present twice as my symptoms worsened, and I did disclose that I am autistic during my third visit. That visit resulted in the worst treatment I received, including being spoken to with clear disdain by the doctor. This experience does not give me confidence that disclosing my disability improves care — in fact, it felt like the opposite.

Even for a neurotypical person, it is unreasonable to expect someone who arrives by ambulance after being hit by a car to carry responsibility for ensuring proper assessment and care. For an autistic person, shifting that burden onto the patient is especially harmful.

I am sharing this experience in the hope that the hospital can reflect on and respond to the following:

- How does the hospital prevent repeated dismissal of trauma patients who re-present with escalating neurological symptoms, and ensure timely reassessment when red flags emerge?

- Under what circumstances is it considered acceptable to remove spinal precautions initiated by ambulance officers without spinal imaging, and how is patient safety ensured in those situations?

- What safeguards are in place to ensure that a patient’s disability is not used to excuse or rationalise failures in care, and how is dismissive or disrespectful clinician behaviour addressed?