A matter of life and death

Vanessa Casey with 8-year-old Patrick, who has twice had his life-saving brain operation put off. Picture / Greg Bowker

Hospital staff shortages mean brain surgery for 8-year-old Patrick Casey has twice been delayed.

Last night his mother, Vanessa, was preparing for the heartbreaking consequence of going public about the delays - telling him the operation was potentially fatal.

Patrick has a malformed artery in his brain which caused an aneurism to form when he had a seizure last year.

He has had the condition - an arteriovenous malformation (AVM) - since birth and each year there is a 2 to 3 per cent chance of a rupture that could cause brain damage, a major stroke or death.

His Auckland City Hospital neurosurgeon, Dr Andrew Law, recommended surgery to remove the lesion, which if untreated would probably result in a rupture at some stage.

The surgery itself is high-risk, carrying a 10 per cent chance of leaving Patrick unable to talk, giving him a stroke or killing him.

But his parents decided that the surgery was the lesser risk.

Ms Casey said she and her husband recently sat Patrick down "and told him he was going to have this surgery on his brain and he was absolutely horrified".

But they didn't discuss the possibility that the operation could have fatal consequences.

Instead there were pre-hospital presents, new pyjamas and a series of "exciting little trips".

Ms Casey, who lives in Howick, was told in mid-March that Patrick was to be admitted for surgery on April 1, but the date was then moved to April 10 as no consultant was available. About a week later, she was told there was a shortage of theatre nurses and the hospital was now unable to give her a date as it could only do emergency operations.

Beside herself with worry, she wrote to her MP, Judith Collins, who forwarded the letter to Health Minister Pete Hodgson.

National Party health spokesman Tony Ryall raised the issue in Parliament yesterday, asking: "Why is it taking so long for kids like this to get vitally needed surgery?"

He did not use any names and Mr Hodgson refused to discuss the case then, saying he would not do so unless the people involved went public, which Ms Casey later did.

She said of her decision: "I'm so angry and feeling so desperate that I'm more protective of his life than his privacy."

That was before she had to find the dreaded words to explain the risks to her son, which she planned to do last night. "I haven't gone that far as to think about what my exact words will be, but think he's going to be a very upset little boy. This sort of information is pretty mind-blowing."

Dr Law said: "We just don't have the nurses to get it into theatre. The only cases getting into theatre at the moment are those with immediate life-threatening conditions where they are deteriorating now."

It was hugely frustrating for everyone involved, the neurosurgeon said.

The hospital was hoping to give Patrick his operation in May or June "but we can't given them certainty".

Dr Law added: "I think that is the last straw for the Casey family. I can understand it. They feel neglected and strung out and worried."