KEMH doctors delayed treating man with burst appendix - Appeals judges
The Supreme Court will reconsider the value of damages suffered by a man who waited 12 hours for an appendectomy.
Kamal Williams had been awarded $2,000 for pain and suffering caused by delays at King Edward VII Memorial Hospital, but the Court of Appeal have returned the matter of damages to the Supreme Court.
The court had heard that Mr Williams began to feel unwell on the morning of May 30, 2011.
He went to work but began to feel serious pain in his lower abdomen.
He was taken to the hospital, arriving at around 10.15am and was examined and admitted to the Emergency Department an hour later.
He was examined again at 11.44am, at which time he was screaming in considerable pain and would not allow the doctor to touch his belly.
The doctor said he had possible symptoms of appendicitis and gave medicine for the pain.
The doctor subsequently ordered a CT scan, the appropriate test before surgical consultation, at 1.10pm.
The CT scan was carried out at 5.30pm but, because the on-call radiologist had left the office early due to illness, the results had to be sent to the Overseas Reporting Agency in Australia.
The results were received at 7.19pm, finding that Mr Williams was suffering acute appendicitis and needed surgery.
The surgery began at around 10.15pm — 12 hours after he first arrived at the hospital — but surgeons discovered that his appendix had ruptured causing complications including sepsis.
Mr Williams remained on a respirator for seven days following the surgery and remained in hospital until June 13.
He subsequently sued the BHB for $100,000 in pain, suffering and lasting injuries caused by the burst appendix, arguing that the rupture may not have occurred if he had been treated faster.
Puisne Judge Stephen Hellman had ordered the BHB pay the complainant $2,000 in damages for pain and suffering due to the delays, but found that Mr Williams had not proven the complications were the result of the hospital's delay in diagnosing and treating him.
However, in a recent judgement the Court of Appeal ruled that Mr Justice Hellman had set the bar “unattainably high”.
“The numerous delays individually and collectively were contributing factors to the damage ultimately suffered,” the judgement stated.
“There were delays between arrival, admission, examination, the ordering, taking and reading of the CT scan and the surgery.
“When viewed against the background of the physical signs exhibited by the appellant on his arrival at the KEMH, his tossing and screaming, I find the delay to be inordinate.”
The court ruled that Mr Williams didn't need to prove that the delays caused the complications experienced, only that they contributed to them.
“The proper test of causation was not whether the negligent delay and inadequate system caused the injury to the appellant, but rather whether the breaches of duty by the BHB contributed materially to the injury,” the judgement stated. “That those breaches did contribute is beyond argument.”
The court noted that the BHB had conducted its own Root Cause Analysis, which determined that the CT scan should have been carried out immediately rather than being delayed until it could be fit into the Diagnostic Imaging Department technician's busy schedule.
The judgement also made two suggestions about the system in place, suggesting that surgeons should be prepared to consider exploratory surgery if a CT scan cannot be performed expeditiously, and that should the radiologist have to leave early, a physician should be left in charge to cover for him.
The court ruled that the matter be returned to the Supreme Court for damages to be accessed.