A man who died after being discharged from a rural hospital on weekend leave was failed by the hospital, the Health and Disability Commissioner has found.
The 66-year-old man was released from the hospital in late 2006 with compromised lung function, but began suffering shortness of breath early the next
morning.
He returned to the hospital, but died two days later of respiratory failure despite being transferred to a larger public hospital where he received intensive treatment.
The rural hospital was run by a health services company contracted by the District Health Board (DHB).
All names and places have been suppressed by the commissioner.
The man should not have been released on weekend leave and a specialist should have been consulted on his return to the rural hospital, Commissioner Ron Paterson said in his recent report.
However, he said the fault was not with the doctor who treated him, but with the lack of policies the hospital had around weekend leave and specialist consultation.
"While such policies (and earlier consultation with a specialist) may not have altered the outcome for [the man], given his complex condition, I consider that the company did not provide [the man] with services with reasonable care and skill, and did not sufficiently facilitate cooperation between its staff and the public hospital specialists to ensure quality of care."
This case highlighted the responsibility of a DHB to monitor the delivery of its services within its district, Mr Paterson said.
"A fundamental prerequisite for the company to provide hospital services at the rural hospital is that adequate systems are in place for consultation with, and referral to, a higher level or service when the severity of complexity of the condition is beyond the technical and clinical capacity of the local service."
The DHB had taken steps to tighten its monitoring of the service at the rural hospital, which was reassuring, Mr Paterson said.
He recommended the rural hospital:
* apologise to the man's wife, who complained to the commission;
* develop formal protocols for its staff to obtain specialist input;
* remind all staff of the importance of consulting with specialists in complex cases.
- NZPA
