Coronial Inquest told hospital faced equipment shortage
A SHORTAGE of medical equipment meant a man had to be airlifted for treatment from Grafton to a better-equipped Lismore Hospital, where he later died, the New South Wales Coroner has been told.
A coronial inquest in Sydney heard John Gibson, 63, was admitted to Grafton Hospital's emergency department in June 2011, with an obstructed bowel - a potentially fatal condition exacerbated by his long-term alcohol and tobacco addictions.
Taking the witness stand on Monday, surgeon Dr Alison Duchow said the procedure had been uneventful, but Mr Gibson's rapid post-operative deterioration demanded emergency measures be taken.
"I felt that if we didn't (do the surgery immediately), there was a risk of his bowel rupturing due to being over-distended, leading to peritonitis and possibly death," she said.
Dr Duchow told the inquiry Mr Gibson smoked 50-60 cigarettes a day and seemed to become delirious due to alcohol withdrawal following the surgery.
She said in her home country, the United States, alcoholics undergoing surgery were often allowed to consume alcohol to stave off the effects of withdrawal, but that it was illegal to do so in NSW.
Instead, Mr Gibson was given doses of valium, which may have contributed to further degradation of his already-hampered breathing capacity.
His breathing became dangerously shallow in the following days and he developed pneumonia due to his lungs' inability to clear themselves, the inquiry heard.
Grafton Hospital staff put Mr Gibson on a respirator, but they were in short supply.
The inquiry was told only one BiPAP respirator was available in his ward, and it was already being used on another patient.
"I would say he wasn't starved of oxygen for more than half an hour, but his condition certainly did continue to deteriorate after initially responding to the BiPAP. It wasn't enough," Dr Duchow said.
Nurse Jane Pinkowski said she requested a second respirator be brought down from the emergency department, but it took about half an hour to arrive.
She said she did not know why it took so long to be delivered.
"I rang her (the emergency ward nurse) back to say I need it... yesterday," she said.
Dr Duchow said any patient who needed a ventilator for more than a few hours, at that time, had to be transferred to another hospital, as Grafton lacked the facilities to maintain the treatment for a prolonged period.
She said it was no longer such a big issue.
"There's definitely more availability at this point," Dr Duchow said.
Mr Gibson was airlifted by helicopter to Lismore Hospital, where he later died.
The coronial inquest has been allocated a five-day hearing and is due to wind up on Friday.