CT scan may have changed treatment - doctor

Photo / iStock
Photo / iStock

A Queenstown doctor believes had a CT scanner been in place at Lakes District Hospital, the treatment of a tourist who later died of severe traumatic brain injuries last year may have differed.

Corey Richard Docherty, 23, of Massachusetts, United States, died in Dunedin Hospital on February 10 last year, having fallen from a fire escape at Base Backpackers in Queenstown early on February 6.

His inquest was held on papers by Coroner David Crerar.

In his formal written findings, released today, Mr Crerar said Mr Docherty was found in the alleyway beside the Shotover St backpackers at 8.30am on February 6.

It appears he fell from a first-floor fire escape earlier that morning, having exited the building through a fire door, which locked behind him.

He was cold and covered in blood and vomit when he was found.

An ambulance was called and Mr Docherty was transferred to Lakes District Hospital. His Patient Report Form documented him as suffering from concussion and hypothermia.

He was admitted to LDH at 10.10am - 'on admission' observations made by Dr Morne Pienaar noted Mr Docherty was intoxicated and had possibly taken Ecstasy.

However, blood samples taken ante-mortem gave no evidence of Mr Docherty having consumed either Ecstasy or cannabis, and his blood alcohol level was 89mg per 100 millilitres of blood.

Mr Crerar estimated his blood alcohol level at the time of his fall was about 150mg of alcohol per 100 millilitres of blood.

Mr Docherty's initial presentation at LDH was consistent with spinal and head injuries, and arrangements were made to transfer him by helicopter to Dunedin Hospital where a comprehensive CT scan was carried out.

Mr Crerar said that identified multiple areas of parenchymal haemorrhage in both frontal lobes and small petechial haemorrhages in the occipital lobes.

He had a right occipital bone fracture of the skull and a spinal fracture.

A small lung laceration was noted, but there appeared to be no abnormality in the abdomen.

Mr Crerar said a care plan was agreed, but unfortunately his condition continued to deteriorate and he died at 9.30am on February 10.

His cause of death was determined to be severe traumatic brain injury.

"There is no evidence provided to my inquiry to the effect that the medical care given by either Queenstown Lakes Hospital or Dunedin Hospital fell below the standard of best practice," Mr Crear said.

"All clinicians giving aid to [Mr] Docherty, including the crew of the St John Ambulance, have done their best to ensure his safety and survival.

"It is a matter of regret that his injuries were so severe.''

However, in a submission to Mr Crerar's inquiry, Dr Pienaar said appropriate support equipment in Queenstown would have made a "substantial and significant difference'' with regard to how doctors could have treated Mr Docherty.

"The basis of this submission is that if the hospital had been equipped with a CT scanner, this would have enabled early diagnosis of the existence of any brain injury and the extent of the injury and the clinicians may have altered their approach to the care they provided,'' Mr Crerar said.

"Dr Pienaar and his team were faced with a dilemma in that Corey Docherty was hypothermic on admission.

"They were required to re-warm him, although such re-warming may have been conducted differently if they had known the extent of the brain injuries.

"It may have been preferable to cool a patient who had a brain injury.''

In response to that submission, the Southern District Health Board advised it was "impractical'' for the board to fund and supply a CT scanner to all of the tertiary hospitals within its jurisdiction.

It cost about $2 million to establish a scanner, and the annual running costs were about $800,000.

At present Lakes District Hospital and Dunstan Hospital, at Clyde, combine to share a CT scanner. Mr Crerar said it was estimated that was operating for "only approximately two-and-a-half days per week''.

While Mr Crerar forwarded a copy of his findings to the DHB, he made no comment or recommendation on the submissions received.

- Otago Daily Times

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