Patient dies after overworked paramedics opt for a shift change, delaying treatment
by: Alison Sandy
From: The Courier-Mail
January 02, 2013
A PATIENT has died after sick, tired and overworked paramedics opted to do a shift change instead of taking the patient straight to hospital.
Documents obtained by The Courier-Mail confirmed the incident.
The ambulance union says the case is another example of cracks in a desperately under-resourced system.
Opinion: We can handle the truth, not the cover-up
The Department of Community Safety tried to cover up the incident, which revealed one paramedic was sick and both were fatigued after working past the end of their shift.
The Health Quality and Complaints Commission investigation found the chances of survival would have been greater if the patient had received hospital care sooner.
"QAS have acknowledged the care provided to (the patient) was below the expected standard, this was confirmed by the independent medical adviser," assessment officer Paul Rogers wrote on December 1, 2011.
"It is accepted that even if (the patient) was in a hospital setting at the time, (they) may not have survived. However, (their) chance of survival may have been greater."
Concerns were also raised as to why there was an attempt to "hot swap" the "fatigued" paramedics with the patient still on board, particularly when there was no crew to replace them.
Questions remain as to why this couldn't have been discovered earlier by using their radio before arriving for the crew swap with the patient still on board.
"The HQCC considers that QAS has taken reasonable and appropriate steps to avoid similar situations," Mr Rogers wrote.
In its clinical review, QAS acting medical director Ben Clarke admitted "a number of rostering reforms have occurred over recent years in an effort to control paramedic fatigue" including "hot swaps" and taxis to send them home at the end of significantly overrun shifts.
United Voice ambulance paramedic state councillor Craig Crawford said officer fatigue was still a big issue which had not been resolved.
"Our crews in busy areas are still forced to work mostly 12 or more hours without any breaks," he said.
"People who are fatigued will make mistakes (and) when you're a paramedic it's like a doctor, it means patients' lives."
The probe raised several other concerns including:
* Why the case was not Code 1, including the use of lights and sirens.
* Why the patient wasn't taken to hospital when they first called the night before.
* A perceived lack of courtesy towards the patient.
Dr Clarke apologised for any extra stress that may have been caused.
The Courier-Mail obtained the investigation report only after the department's decision to refuse access was overruled by the Office of the Information Commissioner.
But the DCS deleted information showing potential flaws in the emergency services and health system, such as how the patient died, what efforts were made to save the patient and how many hours it took to admit them to hospital.
DCS also refused to name the hospital they were queued at or the one just five minutes from the station that they couldn't get into because it was on bypass.
When asked to comment on the case, a DCS spokeswoman denied any attempt at a cover-up.
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