Warning over junior doctors

Wellington Hospital has fixed some of the shortfalls highlighted in a coroner's findings, but the rest of the country has not made the same improvements, a doctors' representative says.

Wellington coroner Gary Evans issued his findings yesterday into the death of Cassandra Ann Laurent, 19, who was found dead of pneumonia in her bed by a flatmate on the evening of July 25, 2003.

Her condition had not been diagnosed by junior doctors at Wellington Hospital despite three visits to its emergency department.

In his findings Mr Evans urged the hospital to review its procedures.

Resident Doctors' Association general secretary Deborah Powell said yesterday Capital and Coast District Health Board had improved systems and the level of cover at Wellington Hospital. But despite that, junior staff were still not directly supervised at all times, she said.

"We have eight or nine consultants in Wellington Hospital now, but ... it's still not 24 hours a day, seven days a week."

Nights were the main problem, Ms Powell said.

"That would be the main time of concern for us at the moment.

"I think the sad thing is that whilst Wellington Hospital has improved its systems, that's not the case in the rest of New Zealand," Ms Powell said.

"If you presented to ... many other hospitals in New Zealand, let alone the private ED clinics, there is less supervision of the inexperienced members of staff there than there would be at Wellington Hospital.

"So I think that all of New Zealand can take some lessons from this particular case in Wellington and learn from it."

Ms Laurent had suffered from flu-like symptoms and stiffness in her limbs and neck in the weeks before she died.

She went to the emergency department six days before her death, where a senior doctor ruled out meningitis but suspected pneumonia and ordered a chest x-ray.

With no radiographer on duty, the doctor examined the x-ray, and told Ms Laurent it was likely she had a viral infection.

The chest x-ray was read by a radiologist four days later but a report was not available to emergency department staff until the day Ms Laurent died.

She returned to the hospital twice and was examined separately by three junior doctors. She was kept overnight on July 23 before deciding she was feeling better and was discharged the following morning.

She died the next day.

- NZPA