Latest news with #internalbleeding
RNZ News
21-07-2025
- Health
- RNZ News
Man sent home without doctors checking for potentially fatal condition
The junior surgical registrar who assessed the man who came to hospital with signs of internal bleeding was not aware they needed to investigate the possibility of an aorto-enteric fistula, the commissioner said. Photo: 123RF A man was sent home from hospital without doctors checking for a potentially fatal condition due to a communication breakdown, the Health and Disability Commissioner has found. The man died the following day of unrelated causes. The man, aged in his 60s, had undergone major surgery on his abdominal aorta - the main artery from the heart - two years before going to hospital in Health NZ's Southern region in 2019 with signs of internal bleeding. In findings released on Monday, the commissioner said the junior surgical registrar who assessed him was not aware they needed to investigate the possibility of an aorto-enteric fistula (AEF) - a serious and sometimes fatal complication after that type of surgery. Commissioner Morag McDowell said the doctor did not consult a senior vascular surgeon for advice. Later, the doctor told other medics there was "no evidence of aortic pathology", which a gastroenterologist mistakenly took to mean the condition had been ruled out. The gastroenterologist did not verify that against the man's medical records before discharging him, the commissioner said. The man died at home the following day. His son complained his father was discharged when still unwell with unidentified internal bleeding. While the cause of death was unrelated to an AEF, the commissioner said Health NZ Southern had failed to provide services with reasonable care and skill. "Given that an AEF is a life-threatening diagnosis that needs to be investigated urgently, there was a concerning lack of responsibility taken by anyone to ensure that this had been done," she said. "Staff failed to communicate effectively, deferred to others, and passed on the responsibility without using critical thinking or making individual assessments." McDowell said she accepted the junior surgical registrar would not have known about the possibility of an AEF. But it was concerning he documented "no evidence of aortic pathology" - mistakenly leading others to false conclusions - without seeking advice from a vascular surgeon, she said. Overall, McDowell found the doctor was not in breach of the Code of Health and Disability Services Consumers' Rights, but had reflected on these events and made changes to the way he documented in clinical notes. Hearing about the case had affected the junior surgical registrar deeply, McDowell said. "He has spent considerable time reflecting on the events. He believes that he practises very differently now," she said. The gastroenterologist "should have confirmed, by review of the clinical record, that the appropriate investigations had been completed", McDowell said. "I am critical of his lack of critical thinking and diligence." He had also "reflected on how he accepts information from other providers", she said. "I consider this to be appropriate and to serve to minimise the risk of such an event happening in the future." Health NZ Southern had updated its registrar orientation programme following the man's death to ensure on-call surgical registrars discussed any subspecialty questions with an appropriate specialist, McDowell said. In her recommendations, she advised sharing the findings with staff as a "learning resource to highlight the importance of critical thinking at each stage of care". She also recommended providing ongoing refresher training on AEF and outlining the expected process for identifying and ruling it out. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
The Sun
02-07-2025
- Health
- The Sun
Man, 24, breaks out in horror rash and nearly bleeds to death after taking petrol station ‘Viagra'
A YOUNG man faced the terrifying risk of internal bleeding after taking a 'Viagra' pill bought from a petrol station. The 24-year-old ended up in a US hospital after developing unusual symptoms, including a purple rash, persistent gum bleeding and nosebleeds. Blood tests revealed dangerously low platelet levels, leading to a diagnosis of immune thrombocytopenia (ITP). ITP is a rare but serious condition where the immune system attacks the body's own blood cells, specifically the platelets. These are tiny cells that help the blood clot, without enough of them, even minor bumps or cuts can lead to dangerous internal bleeding. Symptoms can include easy bruising, petechiae (small red or purple spots on the skin), nosebleeds, and bleeding gums. Last year, A Place in the Sun presenter Laura Hamilton revealed she's suffered the same condition. The 43-year-old shared images with fans showing the outbreak of bruises on her legs, caused by her ITP. A healthy person typically has 150,000 to 450,000 platelets per microlitre of blood. The man mentioned in the new case report had just 1,000, putting him at extreme risk of random, potentially fatal bleeding inside the brain or gut. He later admitted he had been taking Rhino 69 Platinum 1000 for two weeks, which he had bought from a petrol station while on holiday in Mexico. Doctors from Kern Medical Center, in Bakersfield, believe the unregulated sex pill triggered the condition, marking the first known case of a supplement being linked to ITP. The drug contains sildenafil, the same active ingredient as prescription Viagra used to treat erectile dysfunction. "Our case suggests that sildenafil-containing supplements such as 'Rhino 69 Platinum 1000' may represent a previously unrecognised cause of ITP," the medics wrote in Cureus. Unlike Viagra, Rhino 69 is unlicensed, it's sold online and in some shops without proper safety checks. This is because supplements in many countries are not subject to the same rigorous safety or quality checks that prescription medicines are. This means contaminated, counterfeit, or mislabeled products can make it to store shelves and websites. The US Food and Drug Administration (FDA) has repeatedly warned that it may be contaminated with hidden ingredients or cause serious side effects. TP is usually caused by viral infections, autoimmune diseases, or certain prescription medicines, including antibiotics, anti-seizure drugs, and chemotherapy. The man was treated with high-dose steroids and a blood product called IVIG (intravenous immunoglobulin), which calms the immune system. His platelet count returned to normal within a week.
ABC News
02-07-2025
- Health
- ABC News
Man who died after leaving NSW hospital 'overlooked' by public guardian, inquest hears
A man who died from internal bleeding after discharging himself from a New South Wales hospital was "overlooked" by the public guardian, an inquest has heard. Raymond Wheatley was found dead in his Wagga Wagga home on December 6, 2021, a week after he was admitted to the local hospital with low haemoglobin levels, anaemia and internal bleeding. The 54-year-old was given three blood transfusions before he felt better and wanted to go home to get cigarettes and a jacket. The three-day inquest heard that in 2020 Mr Wheatley was put under a public guardianship appointed by the NSW Civil and Administrative Tribunal (NCAT) to make lifestyle, health and medical decisions for him. On Wednesday the inquest heard from Vicky Elliott, who was the NSW Public Guardian's southern regional manager at the time of Mr Wheatley's death. She told the inquest that Mr Wheatley had been assigned a guardian in 2020, but when that person changed roles a year later his case was not reassigned and was instead managed by the team as a whole. Counsel assisting the coroner, Gillian Mahony, told the inquest the public guardian made key decisions about Mr Wheatley's life, including consenting to a key-box and key being outside his home and NDIS requests, without consulting him "in respect to any of those decisions". Ms Mahony asked Ms Elliot if there was a communication breakdown with Mr Wheatley, given the "minimum attention" he received. "It's possible his file could have been overlooked or there was some miscommunication," Ms Elliot responded. Earlier the inquest heard from Louise Gabauer, who was the emergency registrar at Wagga Wagga Base Hospital at the time. She told the inquest she called the public guardian to discuss whether the hospital had "any provision to detain" Mr Wheatley. Dr Gabauer was told that the public guardian and hospital staff did not have the right to keep him there without his consent. The inquest also heard that hospital staff contacted NCAT for a review of Mr Wheatley's public guardianship, but that did not happen. Dr Gabauer said she conducted what she called a "capacity assessment" while speaking to Mr Wheatley outside the hospital. She told the inquest she believed he was "lucid" and "logical", but told Mr Wheatley it was essential he return to hospital. "There's a chance that you could die if you leave," the inquest heard she told him. The public guardian formerly assigned directly to Mr Wheatley and two other witnesses were expected at the inquest today. Family statements were also expected to be tendered, but Ms Mahony told the inquest more time was needed before other witnesses were heard from. The inquest has adjourned until August.
