Steve Szigetvary was left paralysed in a diving accident and has spent a year fighting for answers over his botched rescue and for adequate ACC support. Photo / Supplied
It was supposed to be just another day diving - just like the thousands he'd done over the years.
When Steve Szigetvary left his Auckland home on a Sunday almost a year ago to explore the depths around Great Barrier Island he could never have imagined that by the end of the day a one in 10,000 freak accident would have paralysed him.
To make matters worse Szigetvary's rescue was botched after a call taker mishandled the initial 111 call and in the months that followed he says he has had to fight ACC constantly to get the help and support he needs.
Szigetvary spoke to the Herald about his accident and harrowing year since, frustrated with how he has been treated by health agencies in place to help people just like him - and in a bid to encourage others to fight for themselves in similar positions.
They'd had a great day out in the wild blue-green of the ocean, exploring depths unseen and untouched by most.
Steve Szigetvary and his mate started at the Mokohinau Islands just beyond Great Barrier.
Szigetvary then went for a second plunge on his own around Simpson Rock, a reef not far from "the Mokes".
Soon after he left the boat he realised he was low on oxygen and if he didn't get back to the surface he'd be in trouble.
Szigetvary frantically pushed upwards but lost consciousness.
He managed to surface, came to and knew if he didn't get back to the boat he was a dead man.
Somehow Szigetvary clambered back on deck. And then, inch by inch he started to lose feeling - toes, feet, ankles, calves, knees.
"I've done thousands of dives over 35 years, I dive every second weekend. I am such at one with the water," he said.
"I thought it was going to be a normal dive. Then I lost consciousness."
The 54-year-old recognised decompression sickness and knew from the get-go that his spine was affected.
"I knew I was paralysed, I just felt it creep up my legs, I'm just so lucky it stopped before it got to my heart," he said.
"I was so close to death it wasn't funny, I was in such a bad way that all I could do was try and muster the strength to stay alive, stay awake.
"I didn't even contact my wife Teresa. If I had I would have broken down and lost it and I needed to focus."
At 4.17pm his mate called 111 from the boat.
It was then that the already grim situation became dire.
The first emergency call was botched by an inexperienced operator who miscoded it as "chest pain" rather than a diving accident, did not realise Szigetvary was on a boat despite being given details, and "entered poor clinical notes" into the system.
So the National Air Desk clinical support officer initially allocated the job to a road ambulance crew rather than a rescue helicopter.
At 4.36pm the friend called 111 again - specifically requesting a helicopter for Szigetvary whose condition was worsening.
By 4.43pm the support officer "rapidly ascertained" he had compression sickness and assigned the job to a helicopter.
Szigetvary's accident coincided with an "extremely busy period" when all four northern region rescue helicopters were already on missions.
The next available chopper needed to return to base to refuel before it could get to Szigetvary.
When the Auckland Westpac Rescue Helicopter finally got to the area and made contact with the skipper of the boat it was five minutes from the wharf at Leigh.
It was decided the helicopter would land at Leigh School and Szigetvary would be brought to the aircraft by ambulance.
The helicopter landed at Leigh School at 6pm and a medic "hitched a ride" with a member of the public to the wharf, arriving at 6.15pm to find the ambulance crew "struggling to extricate" Szigetvary whose condition was described as "immediate threat to life".
The medic entered the boat with firefighters to try to get Szigetvary to safety.
"I was saying to my mate 'please, please, how long, how long'… I felt like I was moments away from death - all I knew was I only had a few breaths left in me," he remembered.
"When the medic finally got on board with oxygen, only then did I think I might live."
By 6.46pm Szigetvary had been lifted out of the boat, stretchered to the waiting ambulance and taken to the helicopter, which headed straight for North Shore Hospital.
It landed at 7.05pm and Szigetvary was rushed into the emergency department.
Szigetvary said he was begging to go straight to the hyperbaric chamber for decompression treatment. However he did not get there until 9.20pm - after a full assessment was done.
A further delay in getting him there was because of an "unavoidable unavailability" of a patient transfer ambulance.
Just after 10pm recompression treatment started.
Szigetvary later learned he had spinal decompression sickness - which resulted in complete paralysis from the waist down.
His condition is rare - a complication in about one in 10,000 dives.
It is also potentially reversible with the right treatment.
But almost a year later he is still confined to a wheelchair and waiting for the bulk of his treatment to start after numerous and ongoing delays and errors by ACC.
While navigating that Szigetvary and his wife also faced a lengthy investigation into his rescue - which identified a number of issues and posed recommendations to improve responses to diving incidents.
After a lengthy stint in hospital, Szigetvary was finally able to go home.
He was now in an electric wheelchair, his home needed drastic modifications and he was facing a gruelling physical therapy regime - but he was determined to get better, to walk again.
Three weeks later the Covid-19 Delta variant emerged and the country went into a snap lockdown, halting all face-to-face treatment for the injured diver.
Some people were able to access vital medical services during the lockdown, but Szigetvary was not.
"My condition is Asia B tetraplegia, which is incomplete paralysis and a key part of that is there is an ability to come right - I could stand and walk one day, regain total independence," he said.
"The prognosis is inconclusive, but there is a chance and it is my goal to get back to normal.
"The window of opportunity is now, for rehab to make a real difference."
He acknowledged the country's Covid situation meant less face-to-face contact between Kiwis - but felt more could have been done to help and support him given the severity of his injury.
"I think in this situation there should have been more options for me because the longer you leave this injury without the correct rehab, the harder it will be for me to learn how to walk again," he told the Weekend Herald.
"It seems like the whole system has gone 'it's just too hard, poor old Steve, shit happens'.
"We ask ACC for their support but I don't feel like they are trying to see how they can get me better.
"I am pleading with them to get me into physio, asking them 'please, please help me' - but nothing seems to sink in with them.
"There is no care. People are just left to their own devices."
During lockdown and since Szigetvary has been fighting ACC to get what he needs to live and recover.
He outlined a plethora of issues to the Herald, with the main issues being around incorrect payments and huge delays in getting the equipment he needs for rehab.
Some weeks he was not paid at all, other weeks his payment was short - each time affecting his mortgage and other vital payments.
He has been waiting since November for a pair of orthotics he needs to be able to stand up.
Personal information including his bank details were shared with a third party.
And he says ACC has shown little respect or care towards him at every hurdle and communicated poorly and insensitively.
He has three complaints with the agency at the moment in relation to his treatment.
"We are on this continual merry go round, it's like being a little mouse on a wheel - we've had a lot of stuff-ups," he said.
"I just want to get to the bottom of it, and try to get better and get working and pay my taxes again - that's all I want, I don't want to sit here on my ass in a wheelchair for the rest of my life.
"Am I angry? That's not quite the word for it. How can any of this happen?"
Szigetvary and his wife are now working with advocate Fiona Radford to iron out the ongoing issues.
"If we didn't have Fiona we'd be totally lost and I really feel for people who don't have an advocate like that," he said.
"There are a lot of things along the way have gone wrong. Now I just want to see some compassion, some empathy and for ACC to deliver things in the correct way.
"It's not all about me either, it's about me not wanting this to happen to someone else.
"I don't want anyone else to go through what I have been through, this is just unbelievable, it's a dark, dark place.
"I am open to everything but it feels like ACC are putting me in the 'too hard basket'."
Wife Teresa was furious at how her husband had been treated to date.
"They go on about support but that is absolute rubbish. They talk about kindness and there is absolutely no empathy demonstrated," she said.
"It's inappropriate, unprofessional and unacceptable. Hello, there's a human being on the other side of this, not a robot."
She said it was heartbreaking to see her once active, adventurous and lively husband suffering and struggling - particularly as he wanted so desperately to get his rehab going.
"I want to see Steve have a useful, meaningful, purposeful future - people just need to do better for him," she said.
"Awareness is everything - I don't like to be in the forefront but if I see something unjust I won't stay quiet."
ACC provided a statement from an unnamed spokesperson about Szigetvary's case - parts of which are under review.
It acknowledged "errors" regarding payments but was "confident they are resolved" and would be "correct in future".
It also acknowledged the delay in Szigetvary's rehab but assured the correct equipment had been sourced and would be provided as soon as possible.
It said reviews of other areas of Szigetvary's case were complete and ACC had determined it had not breached his rights.
Szigetvary and Radford were having those decisions independently reviewed.
"Given that the independent review is still in progress we cannot comment further on those matters," said the spokesperson.
"ACC takes privacy seriously and we are investigating the privacy breach complaint from Steve's advocate. We apologise that this occurred and confirm the information has been destroyed.
"We recognise that any injury can have a significant impact on a client's life and always aim to provide service to our clients that is empathetic and compassionate.
"ACC is in regular contact with Steve and his advocate to support him through his recovery.
"To do this effectively, management of Steve's claim has been moved to our Te Ara Tika team where our case managers have additional capacity and skills to deal with clients who may need more intensive case management support."
A review of Szigetvary's rescue and initial care was undertaken by St John Ambulance in conjunction with Northern Rescue Helicopter Limited.
A copy of the final report was provided to the Weekend Herald, outlining in depth the incident, response and how things went so wrong.
The report also contains a public apology to Szigetvary and his family.
The "thorough" review concluded there were no issues with the clinical care provided by first responders who treated Szigetvary but there were "key influential actions, decisions and delays" that had an impact starting with the mistakes by the "inexperienced" initial call taker.
"It is not possible to say with certainty that had Mr Szigetvary received hyperbaric treatment sooner that this would have made a difference to his ultimate clinical outcome," said the final report provided to the Herald.
"The window of opportunity for (almost) guaranteeing a full recovery in spinal DCS [decompression sickness] is measured in minutes, not hours.
"Once the delay for recompression stretches out beyond one hour it becomes a lot less certain how significant further delays are."
The investigation found that the delay to "definitive care" for Szigetvary was "limited by systematic constraints and not the action of any one individual or event".
"In isolation, none of the key actions of delays contributing to this event would have been an issue and none of the individual delays were extreme or outside of normal operations," the brief read.
"However cumulatively, they added up to a significant 6.5-hour delay for Mr Szigetvary to receive definitive treatment for DCS.
"Although diving cases like this are relatively rare, the healthcare system is not configured to manage diving emergencies optimally in the North Island.
"Events like this can undermine the credibility of the system and could not only cause harm to individuals but also potentially harm the diving industry."
The brief said there had been a "significant undertaking at an individual, service and systems-level" on Szigetvary's "life-altering event".
Recommendations included changes to systems and processes to prevent similar incidents in future.
Recommendations for the helicopter services included diving emergency education refreshers for all crew and the formalisation of a policy for dive emergencies in conjunction with the hyperbaric team including calling that team from scenes to activate an "on-call team".
Recommendations for the ambulance sector included amendments to the dive emergencies policy to allow for earlier communications to and activation of dive specialists between the scene and hospital, the addition of a code for rapid dispatch for aeromedical assets for 111 call takers and education on diving emergencies for call takers.
Szigetvary desperately hoped no one else would experience an ordeal like his.
"I feel very failed by the system. It's absolutely crazy. It was an absolute disaster," he said.
"If anything could have gone wrong, it did.
"The 111call response was just so poorly done. It wasn't flash, we made so many calls and they seemed to have no idea about DCS. Obviously the training wasn't there.
"This has changed my life totally. There's nothing normal about my life anymore, it's a whole new life now."
St John Ambulance clinical director Dr Tony Smith - who met Szigetvary personally last year to reiterate the apology in the brief - said any delay was regrettable.
"We extend our thoughts and sympathy to Mr Szigetvary and his family and sincerely apologise for the distress endured," Smith said.
"The combined review concluded there was a series of small delays – some avoidable and some unavoidable – that led to a notable delay, and recognised several opportunities for improvement to the way the call for help was responded to.
"St John Ambulance prides itself on providing the best possible care and takes patient safety and welfare very seriously.
"We sincerely apologise for not meeting the standard of care required in this instance. It fell below the standard we aspire to, and we are taking the opportunity to learn from this."
Smith said St John had identified some opportunities for "possible improvement" in the coordination between services - especially around off-shore incidents.
"And we will continue to improve our processes where we can. St John Ambulance is committed to ongoing quality, health and safety improvements and we reassess our processes to continually improve the service we provide. "
NRHL chief executive Craig Gibbons also apologised to Szigetvary.
"Following this life-changing event for Mr Szigetvary, there has been a significant review at an individual, service and systems-level concerning our response as part of analysing if there was anything we could have done better," he told the Herald.
"We are confident our highly experienced flight crew worked to deliver the best possible standard of patient care to Mr Szigetvary on the day despite the testing and challenging circumstances.
"There were unfortunate but unavoidable delays. As an organisation, we support the decision making of the crew on that day and the clinical care they provided, which in this case was the best possible in the circumstances.
"It is always sad and disappointing when unforeseen events make it challenging to deliver better patient outcomes.
"Like our emergency partners, our number one priority is to ensure and deliver the highest standards of patient care and we are committed to continuous improvement in all parts of our operations.
"Patients like Mr Szigetvary and his loved ones count on us and we take this responsibility extremely seriously. If there are opportunities to improve how we deliver patient outcomes, including better coordination with our emergency partners, we take this on board as part of the continuous improvement and review of our systems."
A Waitemata DHB spokeswoman said Szigetvary received a "thorough emergency trauma assessment that followed a well established standard protocol".
"The patient also had additional post-dive physical injuries that required attention," she said.
"The findings of our assessment – including a full case history and summary of our examinations and investigations - were then discussed with an on-call hyperbaric doctor and a decision was made to transfer to the patient to the Slark Hyperbaric Unit [at the Devonport Naval Base] for recompression therapy.
"The entire process from the arrival of the ambulance at our ED through to the discussion with the hyperbaric doctor took 38 minutes and we consider this to be an appropriate time frame."
The spokeswoman said Szigetvary's case had been reviewed and they were confident he was provided with a "high standard of care".
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