15 April 2024

St John staff failed to assess seriousness of man’s condition, says HDC

The Deputy Health and Disability Commissioner has found Hato Hone St John breached the Code of Health and Disability Services Consumers’ Rights for failures in assessing the seriousness of a man’s condition, with a suspected heart attack and contradicting a GP’s advice.

Dr Vanessa Caldwell found the organisation breached Right 4(2) of the Code which provides people the right to services of an appropriate standard that comply with legal, professional and ethical standards.

The man was contacted by his GP after tests confirmed elevated troponin levels, which can indicate a heart attack. As the man lived approximately 90 minutes from the hospital, and the GP was concerned about possible deterioration in his condition en route, the GP advised the man to call for an ambulance to take him to hospital immediately.

At the 111 call centre, the man’s condition was initially triaged as being potentially serious but not immediately life-threatening and a first response team was sent. An ambulance arrived just over an hour after the first response team to take over the man’s care. After discussion, it was decided that the man’s wife would drive him to hospital, where he was admitted and then referred to the critical care unit and found to have experienced a heart attack.

Dr Caldwell said, “I am concerned that attending St John staff failed to recognise the seriousness of the man’s condition and ensure he was assessed fully prior to leaving the scene, when he was not to be transported by ambulance…”

“Further, the team’s decision to support the man to self-drive to hospital was in direct contradiction of the man’s GP who had directed him to go by ambulance even if he was not in pain. Without undertaking their own assessments and knowing the urgency of the referral from the GP, I am critical that this decision was supported contrary to another health professional’s directions.”

Dr Caldwell was critical about a St John officer’s lack of appropriate care of the man and the call handler for minimising the clinical advice of the man’s doctor to use an ambulance.

St John has told HDC that education and guidance continues to be given to its ambulance staff on using its clinical procedures and guidelines, clinical bulletins and education material about the need for complete and accurate documentation. 

St John, a charity organisation, is known because of their ambulance services, and according to info available on their website, their staff respond to 600,000 emergency calls annually.

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