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"Lack of care and proper assessment in ED"

About: Broome Health Campus / Emergency Department

(as the patient),

I was taken to the Broome Hospital a few months ago around mid-afternoon, after falling directly onto a seatbelt on a tour bus back from Eco Beach which caused me to faint, vomit and be given Panadene Forte and a Green whistle by the staff at Eco Beach Resort just to get me standing and in the car so we could head to the hospital. Ambulances/helicopters were called but I believe none were available, so we had to travel in the eco beach manager’s car. I believe the hospital had been informed of my arrival and reassured that when I arrived at the hospital, I would be a priority patient and taken straight in, as there was concern that there had been damage to my spinal region.

When I arrived, I had to wait about 3 hours in Emergency to be seen by a doctor. Once I was finally taken in, the young doctor I saw clearly felt uncomfortable about checking for an injury in the coccyx region and in my opinion, appeared to be incredibly uncertain and lacking confidence about what to do. They checked around the area very briefly (but barely even looked at it or felt it), chatted quickly to another doctor and then sent me off within about 5 minutes with a script for oxycodone and said all was fine and an x-ray was not needed.

I have finally, after 6 weeks, just been sent for an MRI due to lingering pain and ongoing requirements for strong pain killers and recently, it was confirmed that I have in fact fractured my coccyx.

I understand there’s a high chance it was because of the busy-ness of the hospital and that the doctor I saw was potentially a prac student and I’m not saying it’s entirely their fault, I am just a bit frustrated at what I felt was a lack of time given and concern shown by this doctor despite my severe reaction to the pain, indicating there was in fact something wrong. I also believe that if the doctor felt uncomfortable and unsure of how to manage it (which in my opinion, was rather evident) they should have thought to and felt comfortable to call in a more senior doctor to look after me instead and make sure I was properly cared for.

My main concern stems from the fact I was sent off without any x-ray, or alternative scans or even really feeling as though the doctor was taking my pain seriously. I then trusted the doctor’s judgement and got on a flight the following day and was pretty active after the incident when I became more mobile. This has ultimately led to the injury being incredibly sore still after 6.5 weeks, as I didn’t allow myself the adequate resting time for it to heal. I am now being told by the doctor that I shouldn’t be exercising for another 3 weeks, despite exercising and pushing through the pain for the past 4 weeks after being told it must just be bruised and being given no direction about healing time/what I should and shouldn’t do.  

I just wanted to raise this concern with the Broome hospital as I strongly feel that when someone’s fainted, vomited, felt tingles in their legs and been rushed to hospital with a green whistle (indicating severe pain) after injuring their coccyx, it should be taken more seriously and some tests should be performed to determine if there has been any breaks or fractures to the area. If this break had been determined at the time, I’m sure my recovery experience would have been very different, and I most definitely wouldn’t have gotten on an aeroplane 24 hours later and pushed myself to exercise 2 weeks later.

I hope this incident can be considered when dealing with future patients to avoid others also being sent off without being properly checked so they don’t prolong their recovery time and find out later that there has been a serious injury, whereby healing time could have been more minimal, as I now have. I believe for this to happen it may mean running prac students more thoroughly through what to do if they’re unsure of how to treat a patient, as well as re-assessing the protocols in place for when there is a call to emergency and the patient is guaranteed to be admitted straight away. I’m not so sure of the answer but based on my experience, I think some reconsideration about the whole system is needed. I hope this makes sense and helps to improve other patients' hospital experiences. 

Responses

Response from Bec Smith, Regional Director, WACHS - Kimberley last month
Bec Smith
Regional Director,
WACHS - Kimberley
Submitted on 30/08/2021 at 15:22
Published on Care Opinion at 15:30


picture of Bec Smith

Dear hydrarz96,

Thank you for taking to time to provide feedback to Broome Hospital via the Care Opinion. I sincerely apologise that the experience you describe is not reflective of our aim, which is to provide care focussed on you, during what sounds like a very painful and traumatic time for you.

I understand that having to wait in the Emergency Department would have been very frustrating for you, particularly when you were in pain and experiencing discomfort. In all hospital Emergency Departments, there are rules and protocols governing how patients are prioritised when they come into the Emergency Department. Assessments consider a person’s presenting health conditions/s and their relevant personal health history which helps to ensure that all patients receive appropriate care in a safe and timely way. As you were experiencing a high level of pain, I would have expected that you would have been offered pain relief to keep you comfortable and that your condition would be monitored to ensure that you had not deteriorated while you were waiting to see a doctor. Please accept my apologies that this didn’t take place and that the processes guiding Emergency Department protocols were not properly explained to you at the time of your presentation.

At Broome Hospital we have junior doctors who practice independently with supervision from senior doctors. You are correct in stating that all doctors should be comfortable in communicating with senior doctors at any stage when providing care and we aim to provide an environment where they feel supported and comfortable to do this. I apologise that you felt this was not the case during your care and I will take the opportunity to share your feedback and experience with the Emergency Department team and at our upcoming Emergency Management Review meeting to reiterate the importance of communication between medical staff and treating teams. All of our patients have a right to be informed about the rationale behind decisions that are made about their care, along with being provided with a safe follow-up plan should things not improve. I am also sorry to read that you did not receive this clear information.

To gain a better understanding of your care and treatment, I would be grateful if you contact Dr Alex Harris via email at; alexander.harris@health.wa.gov.au or on 9194 2222. With your permission, he can formally review your medical records regarding the issues you have raised.

I hope that your recovery is going well and would like to, again, thank you for sharing your story with us and giving us the opportunity to improve the experience for our patients.

Kind Regards,

Bec Smith

Regional Director

WACHS Kimberley

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