Mum who lost eye granted treatment injury cover by ACC

Perata Atutahi lost her sight following a rare corneal transplant defect in her eye that haemorrhaged after she vomited in hospital. ACC has agreed she suffered a treatment injury. Photo / Alan Gibson

A mother who lost her eye following a treatment injury at Waikato Hospital felt an "explosion" in her head after vomiting when doctors gave her strong pain medication on an empty stomach.

Perata Atutahi, 32, was rushed to the hospital on Queen's Birthday Weekend after waking with a "hole" in her right eye.

Atutahi was administered significant pain relief medication on an empty stomach that left her nauseous as she waited for assessment by an eye specialist.

The Te Kūiti mother-of-three later reported feeling an "explosion" in her head when she vomited, and permanently lost the sight in her right eye that day.

Less than a week later she had to have the right eye removed because of excruciating pain, and has limited vision in her remaining eye.

After the Weekend Herald revealed her story ACC fast-tracked Atutahi's claim for treatment injury, which was accepted this week.

Now she is wondering whether her eyesight could have been saved if she'd received emergency surgery earlier.

On arrival at the emergency department Perata Atutahi was given three types of pain medication on an empty stomach that made her feel sick and she vomited an hour later. Photo / Alan Gibson

Atutahi was diagnosed with keratoconus at 16, a genetic eye condition where the normally round cornea becomes thinned, distorted and cone-shaped.

She had a full thickness graft - a corneal transplant - on her right eye in December 2018, performed by an ophthalmologist at Waikato Hospital.

In early May the eye became inflamed and itchy. Steroid eye drops did not improve the condition but before she could visit a specialist again, Atutahi woke up on May 30 unable to see out of the eye.

She called out to her partner of 13 years, Uriah Taylor, for help.

"All I could really see was a black circle. He [Taylor] was like 'Oh my God, there's a hole in your eye'."

Atutahi had suffered a graft dehiscence - the surgical wound had reopened at the sutures.

She was rushed to Waikato Hospital in an ambulance and, according to the ophthalmologist's report for ACC, was given a significant amount of pain relief medication on arrival including codeine, Nurofen and Panadol on an empty stomach.

"She had not eaten that day and became quite nauseous and later vomited approximately one hour after taking the medications despite having a sausage roll to try to settle her stomach," the specialist's report stated.

Atutahi said she felt an "explosion" inside her head as she was sick.

"I was screaming on the floor. I couldn't see or find where the emergency buzzer was. I crawled out of the bathroom on the floor.

"I told the doctors it felt like my head just exploded and that's when the immense pain started."

Perata Atutahi must use enlarged print close up to read her phone. Her remaining vision is so blurry she can no longer see the faces of her children, aged 10, 6 and 5. Photo / Alan Gibson

Later that day she had surgery to resuture the graft but the damage was already done and after several days in agony the eye was removed.

The ophthalmologist said graft dehiscence was relatively rare and usually caused by trauma but noted no documented sign of bruising or swelling around the eye that day.

He believed an underlying structural defect in the graft led to the wound reopening.

He said in many cases graft dehiscence can be repaired and typically would result in a good visual outcome, but not when there has been a haemorrhage.

The ACC treatment injury report said Atutahi was given the analgesia on arrival at the emergency department due to severe pain, "which unfortunately resulted in vomiting".

"As a result of vomiting this caused the traumatic dislocation of the intraocular [implanted] lens and subsequent suprachoroidal haemorrhage in the right eye.

"Emergency surgery was undertaken. However, due to the additional damage sustained your eye was not able to be repaired."

It concluded the graft dehiscence was caused by an underlying structural defect in the graft, an extremely rare complication of corneal graft surgery, which met the criteria for treatment injury cover.

Uriah Taylor and partner Perata Atutahi plan to lodge complaints about her treatment with Waikato DHB and the Health and Disability Commissioner. Photo / Alan Gibson

Atutahi, who was studying towards becoming a small business owner before the injury, said it was upsetting to learn her eyesight potentially could have been saved.

"Reading that in the report gave me the impression that maybe if I had been seen sooner or at least had some guidance to what I was meant to do in the time of waiting ...

"It's pretty gutting. Things need to change. There needs to be better systems.

"I'll probably never see my children's faces again."

A Waikato District Health Board spokesman said this was a complex case and the DHB was not able to disclose the patient's personal health information.

"Our sympathies remain with this person who has experienced a traumatic injury.

"Our staff work hard to minimise the wait times within our Emergency Department taking into account the complexity and volumes of patients who present to our ED.

"In this case the patient presented on a weekend and was seen promptly by ED staff, however, ophthalmology staff were attending an urgent case within the operating theatre at the time."

He said the DHB had not viewed the ACC report yet.

Atutahi and Taylor plan to lodge complaints about her treatment with the DHB and the Health and Disability Commissioner.