Western Australia’s deputy coroner has indicated she will not be making adverse findings against medical staff who treated a woman at a remote hospital before she died from toxic shock syndrome.
Coroner Evelyn Vicker had been examining the death of 21-year-old Amanda Tauai after she was flown to Perth from the mining town of Paraburdoo in March 2012.
Ms Tauai was treated in the town’s hospital for two days after Doctor Michael Mbaogu diagnosed her with gastroenteritis.
She was given intravenous fluids and anti-nausea medication, but after her condition deteriorated she was flown to Royal Perth Hospital where she died as a result of “multiple organ failure due to undefined sepsis”.
In his evidence, Dr Mbaogu said the woman presented with symptoms including a fever and lethargy which were “not unusual” for Paraburdoo because of the region’s hot temperatures.
He said when her condition deteriorated about a day and a half later, he considered giving her antibiotics but decided against it, mainly because her temperature had been in a normal range for about the previous 10 hours.
“I didn’t want to be overly enthusiastic in administering antibiotics in order not to precipitate a condition where antibiotics are given inappropriately,” he said.
“It can cause a very serious condition.”
Dr Mbaogu said he believed Ms Tauai may have been suffering hypotension due to fluid loss because she had been vomiting.
He said his main focus at that time was to resuscitate Ms Tauai by giving her fluids and getting her blood pressure up.
Doctor ‘alone and working 24/7 365 days a year’
Dr Mbaogu rejected evidence by a nurse that he had refused to attend the hospital when Ms Tauia got worse, describing the claim as “ludicrous.”
He also testified about the difficulty of working in a remote location, and said one of the main challenges was that he “was alone and working 24/7 365 days a year”.
“Being alone and having to work all the time was very difficult,” he said.
“Before I arrived they’d had no permanent doctor for three years.”
The nearest major medical facility was at South Hedland which was a 45-minute plane trip or a six-hour drive away, Dr Mbaogu said.
At the conclusion of the hearing, Ms Vicker said it was likely she would find Ms Tauai died from natural causes.
She said the coronial inquest system was “not fault-finding” but rather “fact-finding”.
“It’s not as though anybody did anything that caused Ms Tauai’s death,” she said
“The situation in these remote areas is that five years ago I don’t think they even had a doctor at all, and it’s very difficult situation for doctors and nurses.
“All these clinicians are trying to provide a service that previously wasn’t there.
“They are caring people exercising their professional judgement.
“I don’t see any point in making adverse comments.”
‘Somebody has got to be responsible’, parents say
Ms Tauai’s parents flew from New Zealand for the inquest.
After the hearing they said they had attended to try to get some closure.
“We do understand somebody has got to be responsible for her passing. She’s a healthy young girl, only 21,” her father Luma Tauai said.
“It might be no good for our daughter Amanda but it may be good for somebody out there.
“The Western Australian health board – they need to do something for these remote areas out there.”