Hospital apologises for death of student

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

Auckland health authorities have publicly apologised to the family of a 22-year-old man who died in hospital from meningococcal disease.

Zachary Gravatt, a fourth-year medical student, died in Auckland City Hospital in July 2009 from blood poisoning and organ damage caused by meningococcal C strain bacteria.

He was a popular, hard-working student who had had to struggle with dyslexia, a learning disability.

His mother, Jennifer Gravatt, told coroner Brandt Shortland yesterday that her son was "strong in body and mind", a keen rower and a fine son and brother.

"Zac was the very best son a mother could want."

He died five hours after being admitted to the hospital where he had been learning to care for patients in the general surgery wards. His father, Dr Lance Gravatt, was at the coroner's hearing in Auckland yesterday with other family and a number of Zac's friends.

Auckland District Health Board's chief medical officer Dr Margaret Wilsher offered them its apologies for "shortcomings" in its care of Mr Gravatt that had been identified in an external investigation into the case. No details of that investigation were made public, nor any other evidence.

Dr Gravatt has previously questioned whether the correct diagnosis of his son's infection with meningococcal disease was at first missed - despite evidence of kidney, liver and blood abnormalities - because of a focus on influenza. Mr Gravatt's death occurred during the 2009 swine flu pandemic.

The coroner said he would assemble a draft summary of the facts of the case to circulate to the parties and he intended to issue his findings on July 29.

But the DHB and the Gravatt family have already agreed on recommendations they would like the coroner to make. They are aimed largely at avoiding misdiagnosis of meningococcal disease, an illness Dr Wilsher said doctors were all terrified of.

The recommendations urge that the Ministry of Health's public advice and medical guidelines on influenza-like illness include the caution that other illnesses, notably bacterial sepsis, Mr Gravatt's condition, may cause symptoms that look like the flu.

"Furthermore, in the absence of cough or sore throat a differential diagnosis of influenza-like illness should also include possible bacterial sepsis until proven otherwise."

The formation of a working group is proposed to write guidelines on giving pre-hospital injections of antibiotics in cases of suspected bacterial blood poisoning.

The recommendations also ask the ministry to review, soon, the costs and benefits of undertaking a publicly funded vaccination programme against meningococcal C.

Although the resulting diseases' effects are the same, the C strain differs from the B strain against which the Government offered state-funded vaccination to young people after a prolonged epidemic.

Dr Gravatt wrote in the New Zealand Medical Journal two months after his son's death that although student doctors were required to be immunised with the publicly funded vaccines against diseases like measles, polio and hepatitis B, information and advice were not provided regarding the $40 meningococcal C vaccine.

Dr Wilsher said information was now provided about the C vaccine, a result of Zac Gravatt's case.