Queenstown’s hospital – servicing the country’s adventure tourism capital – suffers an alarming lack of staff, space and expertise for mass casualty emergencies, a formerly censored debrief reveals.
The Lakes District Hospital debrief highlights major shortcomings, which became apparent following a Kawarau Jet boat’s fatal flip in September 2008.
Chinese tourist Yan Wang, 42, died and six of the 22 passengers on board were rushed to hospital.
The fuller version of the debrief – which Mountain Scene has finally managed to prise loose from Southland District Health Board – says hospital staff were never trained for a full-on emergency, “other than the table-top [exercise] in March ”.
The shortcoming is admitted by senior SDHB official Ian Winwood, who emails LDH manager Norman Gray promising “whatever support I can to ensure [LDH] is better prepared for the next mass casualty”.
LDH’s sole duty doctor couldn’t deal with all seven victims – two GPs from Queenstown Medical Centre came to help, with another on standby.
The newly uncensored material also reveals confusion between LDH and St John during the Kawarau Jet aftermath.
“Ambulance crew were taking casualties straight into beds in ED rather than waiting on them to be triaged – [they] just wanted to ‘drop and go’.”
Poor facilities at Queenstown’s hospital are also dramatically evident. The first three patients – one of whom later “deteriorated” – had to be admitted to the physio unit and general ward to keep LDH’s tiny emergency room free for “more severe casualties”.
A maternity clinic was being held as victims arrived “so the delivery suite was not available as a back-up resuscitation area” – one victim was resuscitated in physio. The report says LDH staff must be “educated” to “halt and reschedule” outpatient clinics when future emergencies occur.
And there was “poor accessibility” to LDH “emergency cupboards” because “this area is always packed with beds, cots and other items that have nowhere else to be stored”.
With all victims being Chinese, LDH staff were also critical of the “non-availability” of an interpreter.
SDHB spent months trying to persuade the Ombudsman not to lift the veil on censored content.
Lifting the lid
An earlier version released to Mountain Scene in February 2009 had about 30 per cent of content deleted. The new material has been released after an investigation by Ombudsman David McGee. McGee found much of the content is “factual information” and shouldn’t have been censored – but he also agreed “opinion information” could stay under wraps, particularly with a coroner’s inquiry pending.
SDHB deputy-boss Lexie O’Shea wrote: “Such debriefs invariably evoke emotive reactions and opinions from employees, both with regards to what went well and also as to what did not.
“It’s important staff are able to hear and work through those reactions without prejudice, favour or fear of reprisal. That’s unlikely to be possible when conducted publicly through the media as employees will need to be mindful of how their opinions may be perceived by the public and their colleagues.
“If either the free or frank expression of opinion is inhibited by the fear of undue publicity, that will most certainly be detrimental to the effective conduct of public affairs.”
The debrief was apparently compiled and penned by SDHB “major incident emergency planner” Sandra Miller.