Health Alert (Australia) - 10 February 2014

JUDGMENTS

New South Wales

McKenna v Hunter & New England Local Health District [2013] NSWCA 476

In July 2004, Mr Rose (Rose) arranged for his friend, Mr Pettigrove (Pettigrove) to be taken to hospital as he was concerned about his mental state. Pettigrove was detained under the Mental Health Act and after psychiatric assessment, was discharged the following day into Rose's custody. While driving to Victoria that night, Pettigrove strangled and killed Rose. He told police he acted on impulse, believing Rose had killed him in a past life. Rose's family claimed the hospital breached the duty of care it owed Rose by discharging Pettigrove into his custody.

Macfarlan JA (for the majority) found the hospital owed Rose a duty of care, with relevant factors including the hospital's control over Pettigrove (who was a foreseeable risk of harm to Rose) and that Rose's safety was dependent upon the hospital's judgment because he said he would take Pettigrove to Victoria when he was well enough. Macfarlan JA concluded the risk of harm to Rose was not insignificant because, inter alia, a short time had passed since the acute psychotic episode, and Pettigrove had a history of irrationally endangering himself and others on the road during psychotic episodes. Macfarlan JA held that a reasonable person in the position of the hospital would have taken precautions against the risk of harm to Rose by continuing to detain Pettigrove. Therefore, the hospital breached its duty of care. Macfarlan JA also held that the injuries Rose, and the plaintiffs, suffered were causally related to the psychiatrist's negligence in discharging Mr Pettigrove.

South Australia

Inquest into the death of Eileen Cook 1/2013

Eileen Cook died from causes including hospital acquired pneumonia, multiple organ dysfunction and small bowel obstruction. The Inquest's focus was on the quality of care she received at South Coast District Hospital (SCDH).

Two sets of blood results from the first day of admission demonstrated dangerously high potassium levels. The deceased also had significant acute renal failure, among other problems. Despite this, Dr Byrne opted for conservative management through intravenous fluid therapy, rather than immediate transfer to a tertiary hospital for surgical management.

A transfer was eventually arranged the next day but delayed seven and a half hours due to higher category patients. The nurses who communicated with the ambulance service had been instructed by Dr Byrne that transfer be "as soon as possible" (a vague arrangement in the Coroner's view). No one saw biochemistry results that further confirmed the deceased was seriously ill. The Coroner found this to be highly unsatisfactory, as it meant the ambulance service was kept in the dark about the deceased's correct prioritisation.

The Coroner determined Dr Byrne misjudged the seriousness of the deceased's condition. "It is unfathomable that [she] was permitted to linger at the SCDH for what effectively was all of the following day when clearly [she] required...immediate transfer...to a facility that could provide appropriate care."

The Coroner found it difficult to provide recommendations, as he considered there was an element of irrationality about the deceased's clinical management which was difficult to explain. He did recommend that vague arrangements be eliminated from conversations with the ambulance service.

Commonwealth

6 February 2014 - Kong v Minister for Health [2014] FCA 34

Administrative law - judicial review of exercise of Minister's discretion to personally approve pharmacy to supply pharmaceutical benefits under s 90A of National Health Act 1953 (Cth) - whether Minister obliged to give the applicants an opportunity to be heard - whether applicants denied procedural fairness - whether applicants have standing - whether Minister misunderstood the meaning of 'public interest.'

Queensland

20 January 2014 - Ladhams v Australian Health Practitioner Regulation Agency [2014] QCAT 23

Professions and trades - health care professionals - medical practitioners - licences and registration - where the Board took immediate action under Health Practitioner Regulation National Law (Queensland) s 156 and imposed conditions on the registrant's registration - where the registrant sought a stay of the Board's decision - whether a stay of the Board's decision should be granted.

20 September 2014 - Medical Board of Australia v Doolabh [2013] QCAT 704.

Health professionals - medical practitioners - disciplinary proceedings - where the Board sought to rely on more than one expert - where Practice Direction No. 4 of 2009 limits the number of experts that may give evidence in each...