"Patient's wishes were not adhered to"

About: Fiona Stanley Hospital / Emergency Department

(as a volunteer/advocate),

I am a patient advocate and have been asked to raise this issue by the patient. 

The patient is an elderly lady, who around two years ago called an ambulance due to feeling extremely unwell. She was taken to Fiona Stanley Hospital in WA when she learnt that she was experiencing a heart attack. She recalls asking staff that she be allowed to die and instructed no medical invention be undertaken to save her life. 
The patient says she was devastated to discover later that she had a pacemaker fitted and that the hospital had obtained consent for this from her brother with whom she had barely spoken in recent years. 
The patient says that in the two days that followed, she was kept in a very small bed in a thoroughfare, with people constantly walking past. She recalls that she could barely move as the bed was too small for her. Also, she says that no one spoke to her and she felt completely ignored. 
The patient says that she alerted someone that she intended to go home and made her way to the exit of the hospital. She says no one aided her to the exit and she had to organise transport herself at the front desk. 
She then recalls that she had to mount herself into a vehicle that was very high and upon arriving home had to slide out herself which she found very difficult.
The patient says that since having the pacemaker, her life has been awful and she wishes she had been left for nature to take its course in the hope that she would have passed away. She describes that she is unable to mobilise herself properly and is too frail to have any quality of life.
She is adamant that she will not seek out medical help herself due to the trauma of this experience however, should she present again to hospital, she wishes to be made comfortable and does not want any intervention to save her life. 
She wants a guarantee that the hospital will follow her wishes in the future. 
She believes that the hospital failed to take her wishes on board and she is now left to lead what she describes as an unbearable existence. 


Response from Janet Zagari, Executive Director Transformation, South Metropolitan Health Service, South Metropolitan Health Service 2 years ago
Janet Zagari
Executive Director Transformation, South Metropolitan Health Service,
South Metropolitan Health Service
Submitted on 31/07/2018 at 16:16
Published on Care Opinion at 16:16

picture of Janet Zagari

Dear ella1712

I am very sorry to hear about this patient’s story and that she felt had such a distressing experience at Fiona Stanley Hospital.

I would like to assure her that we take patient wishes very seriously, especially with regard to end of life care. When patients are very unwell, medical teams have to make decisions with the best information available; this includes making sure that patients are well enough to make their own decisions. If a patient is considered to be too unwell, next of kin consent is sought to undertake the treatment. Next of kin details are taken from the records that we hold in our administrative system.

Wherever possible, and if requested, our teams will assist patients with support for leaving the hospital and getting home. I apologise that was not the experience for the patient on this occasion.

I would recommend the lady considers discussing her wishes with her clinical treating team and General Practitioner. Her preferences can be recorded officially and held in her medical record to ensure that any future treatment is what she would want. This process encourages patients and doctors to have open and honest discussions so that we understand what care they would like if they are unable to speak for themselves when they are unwell. The patient should also make sure that her next of kin is correctly recorded. She can do this by contacting the Patient and Family Liaison Service. The PFLS can be contacted during business hours on 6152 4013 or via email fshpatientfamilyliaison @health.wa.gov.au.

If there are any other specific details that you or the patient would like followed up, please do not hesitate to contact to contact the Patient and Family Liaison Service who will be also able to assist you.

Kind regards

Janet Zagari

Executive Director Fiona Stanley Fremantle Hospitals Group

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