Inquest points to rural WA health weakness

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The parents of a 21-year-old New Zealander who died in Perth after a regional doctor misdiagnosed her illness have called for better health services in remote Western Australia.

Amanda Tauai died in March 2012 at Royal Perth Hospital after being initially treated in Paraburdoo in the Pilbara, where she worked two jobs while seeking employment in the mining industry.

The WA Coroner’s Court has heard she was diagnosed by Paraburdoo Hospital’s sole doctor Michael Ndubuisi Mbaogu as suffering from gastroenteritis, but a post mortem concluded she died from toxic shock.

Tauai’s parents Toa and Luma, who travelled from Tauranga for the inquest, said the WA Health Department “need to do something for these remote areas”.

“They don’t even bother about it but there’s a lot of people out there paying taxes for this country,” Tauai said.

Tauai said the past two days had been tough – including hearing an apology from Mbaogu.

“We’ve heard some stuff that really confused us today,” she said.

“Amanda’s case won’t bring her back but it will hopefully help someone – some family out there.”

Tauai was admitted to hospital on March 13 with symptoms including fever, vomiting, dizziness, headaches and cramps, and was treated for dehydration and gastroenteritis.

“It is not unusual to see presentation like this in Paraburdoo because of the heat,” Mbaogu told the court on Wednesday.

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“Her presentation was common.”

Her temperature returned to normal for a few hours after spiking at 40C, which indicated to Mbaogu there was no bacterial infection.

“I thought she was improving,” he said.

But he also considered she might have jaundice because the whites of her eyes had yellowed.

Mbaogu said he began to “widen” his search, ordering tests including for hepatitis A and B, which could explain the jaundice.

Her blood pressure then plunged and her heart rate sped up, prompting a nurse to call Dr Mbaogu in the early hours of March 15.

She claimed he’d initially refused to return to the hospital, but he said that was “ludicrous”, adding it didn’t “take a lot to get her knickers in a twist”.

He decided against administering antibiotics as he didn’t want to be “overly enthusiastic” and was concerned about potentially tipping her into a separate, rare condition that he’d never encountered before.

Tauai was airlifted to Perth and was given antibiotics, but it was too late.

Mbaogu said he would now approach a case such as Tauai’s differently, saying he would have “a lower threshold” for administering antibiotics and ordering blood cultures.

Coroner Evelyn Vicker said Tauai’s condition wasn’t diagnosed in time to prevent the outcome, but noted doctors and nurses in remote towns were working in extremely challenging conditions.

They were caring people, providing a service where there previously hadn’t been one, she said.

“Medical treatment in remote areas is horrendous,” Vicker said, flagging her findings would include recommendations to improve it.

 – AAP