Health workers who cared for dying student named

By Martin Johnston

Zachary Gravatt died five hours after being admitted to the hospital where he was training. Photo / Supplied
Zachary Gravatt died five hours after being admitted to the hospital where he was training. Photo / Supplied

The names of four health workers involved in the care of a medical student who died at Auckland City Hospital can now be revealed.

The Auckland District Health Board (ADHB) said this afternoon it would not appeal a High Court ruling that permitted the naming of the health practitioners.

Zachary Gravatt, aged 22, a fourth-year medical student, died in 2009 of blood poisoning and organ failure caused by meningococcal C bacteria. His brief illness and death occurred at the height of the swine flu pandemic.

Coroner Brandt Shortland suppressed the names of three nurses and two doctors, arguing that if they were named, they were at risk of being unfairly criticised in the media.

He faulted the health system, not specifically the individual health workers.

Mr Gravatt's father, Lance Gravatt, formerly the head of drug company AstraZeneca's New Zealand business, asked the High Court to overturn the orders, except one relating to a doctor.

Dr Gravatt told the Herald today that it was not his intention that the health practitioners be publicly named and shamed.

He and Mr Gravatt's mother, Jennifer, felt "it's the last dignity that those who cared for Zachary can give him after he's died - to be prepared to put their hand up and say, 'I was part of the team that looked after Zachary on the day and it didn't work out how we would have wanted it to work out and for that, we are sorry'.

"Whereas, going to extreme lengths, as they seem to be, to hold onto anonymity, to us says that they hold the perception of their own reputation as more important than the fact that Zac died. We just can't accept that.''

There was medical evidence at the inquest that Mr Gravatt's meningococcal infection could have been detected sooner if there had been more regular recording of his vital signs, especially his blood pressure.

The initial diagnosis was suspected influenza; meningococcal disease was suspected only 75 minutes before his death.

Mr Shortland said, "In this case the central and most important issue in my view was the systemic failure to recognise meningococcal disease and treat it appropriately and in a timely fashion.''

"... it is the system and not the individuals that require attention.''

The difficulties and delays in recognising Mr Gravatt's disease were "symptoms of a system under extreme stress. With high workloads and in the context of an influenza epidemic it was going to fall short of [its] purpose.''

Publishing the health workers' names would be a form of punishment, he said, and would discourage other health workers from coming to New Zealand to work, and would undermine confidence in the health system.

Justice Whata reiterated Mr Shortland's view that the faults lay with the health system, not the doctors and nurses. Because of this, he dismissed the coroner's suggestion that the health workers could be subjected to unfair media criticism if their names were not suppressed.

The judge said the coroner's emphasis on systemic failure "strongly mitigates any adverse reputational impact'' on the health practitioners from the facts of the case.

He also dismissed the coroner's deterrence-effect argument. The judge said,'' ... a concern or fear held by other health professionals about being named cannot by itself provide a justifiable basis for limiting freedom of speech.''

ADHB Chief Executive Ailsa Claire said the DHB is disappointed that name suppression has been lifted.

The DHB will continue to be forthright in seeking name suppression for staff when justified, with decisions made on a case-by-case basis, Ms Claire said.

"The current ruling provides clear guidelines so that we can continue to support and protect our staff members, whilst ensuring that our resources are allocated in a pragmatic way to improve the health of the Auckland population.''

The health workers whose names can be revealed are:

* Dr Peter Black (now deceased), consultant in internal medicine,
* Claire Child, emergency department charge nurse
* Emma Hill, assessing nurse/nurse educator
* Evan Gounder, clinical charge nurse, admission

The Auckland DHB decided not to appeal against the decision of Justice Christian Whata overturning coroner Shortland's name suppression orders.

Justice Whata permanently suppressed the name of a fifth health practitioner.

Dr Black's estate also decided not to appeal.

- NZ Herald

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