Source : Perth Now news
A senior emergency nurse bypassed attending doctors to rush a rapidly-deteriorating toddler into resuscitation, moments before he suffered a cardiac arrest, a coronial inquest has been told.
Senior registered nurse Felicity Melville held back tears as she gave evidence at an inquest examining the final hours of Joe Massa’s life on Thursday.
Ms Melville said she recalled taking over the two-year-old’s care at Northern Beaches Hospital at 10am on September 14, 2024.
She described finding the toddler with “dark and sunken” eyes and mottled skin.
Ms Melville told the inquiry, before Judge O’Sullivan, that attending doctors were waiting for ultrasound results at the time.
She gave evidence she felt waiting for an ultrasound was the wrong approach.
The inquest was told Ms Melville took matters into her own hands, phoning resuscitation staff herself to request an emergency bed.
“Joe was very unwell, he was lying on the bed,” Ms Melville told the court.
“Mrs Massa … she spoke to me about a rash on his back and I checked that, and he didn’t have a rash but he was quite mottled on the back.”
During questioning, Ms Melville said neither attending doctor accompanied her down the hospital corridors.
Hospital policy requires that doctors remain with patients during a resuscitation transfer.
Footage from 10.42am allegedly showed Ms Melville leaving the pediatric department unescorted and reaching the resuscitation bay after pushing the heavy 300kg hospital bed through a crowded triage area.
Moments later, at 10.47am Joe suffered a cardiac arrest.
“I picked Joseph up and Mrs Massa said to me ‘my son is very sick’ and I said ‘yes he is’ and ‘I’m getting help’ and I popped him down onto the emergency trolley which are much smaller in order to not waste time,” Ms Melville said.
“I was able to see Joe where I was standing, and that’s when Sam said that he had arrested.
“It was very quick”.
The inquiry was also told missing and faulty equipment delayed vital observations and monitoring in the time leading up to Joe’s death.
Ms Melville testified she was forced to leave Joe’s bedside three separate times, once for cables, once for stickers and once to make the call to resuscitation.
She said monitoring cables across the department were frequently broken or missing, forcing her to leave the bedside to search for functional ones.
She also faced difficulty when attempting observations on Joe’s heart rate, after changing the sticker.
“Sometimes it’s perfusion of the child,” Ms Melville said.
Unable to obtain a heart rate, she said she recorded his respiratory rate of 57 and moved to escalate his care to resuscitation.
In a deeply emotional moment, Ms Melville addressed Joe’s grieving family directly in the courtroom.
“I am so deeply sorry for your loss,” Ms Melville said through tears.
“Joseph mattered, and he matters now, and he will not be forgotten.”
Ms Melville hugged Joe’s mother Elouise Massa, crying as she said she was “so sorry”.
The account follows testimony earlier in the week from Ms Massa, who told the court hospital staff showed a “complete lack of urgency” as her son’s health plummeted.
She described watching an attending doctor stand back with his arms folded looking “out of his depth” and “relaxed” as she asked staff to intervene.
The “happy and healthy” boy had returned from a family holiday in Bali shortly before falling ill, where he began vomiting and struggling to breathe.
Joe passed away on September 16, 2024 – two days after entering the emergency department.
Though his exact cause of death is unconfirmed, the inquest was told Joe died from bowel complications caused by a build-up of faecal matter, which hospital staff initially misdiagnosed as rudimentary gastroenteritis.
At the time of Joe’s death, Northern Beaches Hospital was operated under a controversial public-private partnership between the NSW Government and private provider Healthscope.
Following widespread outrage and campaigning by the Massa family, the state government returned the hospital to a full public administration, and overhauled clinical reporting policies across the public health system.
The inquest continues.
