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The day before,he was found in the playground of his Broken Hill primary school,clutching his chest and screaming in pain.
He suffered two cardiac arrests but was revived by paramedics who rushed him to Broken Hill Base Hospital about midday.
There,it was agreed that he was suffering from a life-threatening irregular heart rhythm.
Even though his condition improved to the point at which he was talking and laughing,it was agreed he couldn’t stay in Broken Hill.
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“There was no doubt in anyone’s mind that Austin needed transfer to a higher needs hospital,” Ryan said.
About midnight,as Austin was giggling,watchingSpongebob Squarepants videos while he was being readied for the plane trip,he collapsed and could not be revived.
The inquest was unable to arrive at a definitive cause of death for Austin.
However,Ryan concluded that,on the balance of probabilities,Austin died as a result of cardiopulmonary arrest on a background of earlier cardiac arrests and resuscitations while he was at school.
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“The evidence at inquest strongly supports the submission … that a timely transfer to a tertiary hospital had the potential to improve Austin’s chances of survival,” she said.
“Whether Austin’s death could have been prevented depended on what medical investigations at Adelaide might have revealed.”
Ryan condemned the “agonising wait” that Austin’s parents were subjected to while staff discussed whether he would be transferred to Sydney,Adelaide or Melbourne.
“Worst still,the evidence at inquest established that,for the most part,these delays were avoidable,” she said.
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It was originally planned Austin would be flown to Adelaide,the closest geographic centre to Broken Hill,but the plan did not proceed.
There were concerns that Adelaide might not be an appropriate destination for Austin because life-saving technology known as ECMO – an extracorporeal membrane oxygenator – was not available.
“I accept the submission that,even without the benefit of hindsight,Adelaide was an appropriate and reasonable destination for Austin,” Ryan found.
“The pressing need for him to be taken to the nearest tertiary hospital outweighed the speculative nature of any concern that he might need facilities not available for him in Adelaide.”
Ryan made three recommendations,including that mutually agreed guidelines be established as soon as possible for the retrieval of critically ill paediatric patients from Broken Hill to the Women and Children’s Hospital in Adelaide.
“Patients in remote areas like Broken Hill who are in need of urgent transfer deserve to have the earliest possible access to full hospital services,like patients elsewhere in NSW,” she said.
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