News Video | Policy | GPs | Hospitals | Medical | Mental Health | Welfare | Search


Emergency Department Fails In Its Care Of A Girl Who Developed Septic Arthritis

Health and Disability Commissioner Morag McDowell today released a report finding Hutt Valley District Health Board (HVDHB) in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failures in its care of a teenage girl suffering from a rare infection.

The girl went to an Emergency Department (ED) with increasing knee pain on multiple occasions. After participating in physical training several days earlier, she visited ED twice on the same day with pain in her right knee. She was diagnosed with a knee injury and given morphine on her second visit.

The girl returned to ED three days later, at which stage the pain had spread to her left knee. An X-ray was performed and she was diagnosed with Osgood-Schlatter disease, an overuse injury that often occurs in growing adolescents. But a few days later she returned to ED significantly unwell and was finally diagnosed with a bacterial joint infection, known as septic arthritis, in both knees.

The Commissioner acknowledged that the illness the girl had developed was rare, and accepted that the signs and symptoms of the diagnosis may have been subtle. However, she considered that there were a number of shortcomings in the care the girl received at ED and that ultimately HVDHB was responsible for the inadequacies in the services provided.

Ms McDowell said key symptoms were not documented when the girl was triaged on her first visit to ED. At the second visit, the possibility of a more serious pathology was not recognised, and at the third visit more critical thinking was needed.

In the report, Ms McDowell commented on "the need for Emergency Department staff to think critically, having regard for the wider clinical picture, and to consider alternative explanations when someone presents to ED multiple times with increasing pain."

The Commissioner recommended that HVDHB train clinical staff on the importance of routinely checking vital signs on ED presentations, unless it is clearly not clinically indicated, and the importance of considering possible serious pathologies. She recommended using the anonymised report as a case study.

She also recommended HVDHB perform a random audit of 30 ED presentations to assess the recording of vital signs, discharge instructions given, and whether Senior Medical Officer reviews were completed as appropriate; consider whether a review of its ED staffing levels is warranted; and provide a written apology to the girl and her family.

The full report on case 19HDC02034 is available on the HDC website.

© Scoop Media

Culture Headlines | Health Headlines | Education Headlines


Howard Davis: Emerald Fennell's Promising Young Woman'

The Guardian needed not one, but three reviews to do justice to Fennell's unsettling approach, which indicates exactly how ambiguous and controversial its message really is. More>>

Howard Davis: Jill Trevelyan's Rita Angus

Although Angus has become one of Aotearoa’s best-loved painters, the story of her life remained little known and poorly understood before Jill Trevelyan's acclaimed and revelatory biography, which won the Non Fiction Award at the Montana New Zealand Book Awards in 2009, and has now been republished by Te Papa press. More>>

Howard Davis: The Back of the Painting

Painting conservators are the forensic pathologists of the art world. While they cannot bring their subjects back to life, they do provide fascinating insights into the precise circumstances of a painting's creation, its material authenticity, and constructive methodology. More>>

Howard Davis: Black Panthers on the Prowl

A passionate and gripping political drama from Shaka King, this is an informative and instructive tale of human frailty that centers around the charismatic Chicago Black Panther leader Fred Hampton, who was murdered at the age of twenty-one during a police raid. More>>

Howard Davis: Controlling the High Ground

Stephen Johnson's raw and angry film not only poses important questions with scrupulous authenticity, but also provides a timely reminder of the genocidal consequences of casual bigotry and xenophobia. More>>

Howard Davis: Dryzabone - Robert Conolly's The Dry

After the terrible devastation caused by last year’s bushfires, which prompted hundreds of Australians to shelter in the ocean to escape incineration and destroyed uncountable amounts of wildlife, The Dry has been released during a totally different kind of dry spell. More>>

Howard Davis: Hit the Road, Jack - Chloé Zhao's Nomadland

Nomadland is perhaps the ultimately 'road' movie as it follows a group of dispossessed and disenfranchised vagabonds who find a form of communal refuge in camp sites and trailer parks after the economic contraction of 2008. More>>



  • Wellington
  • Christchurch
  • Auckland