Staff at Port Moresby’s Pacific International hospital appeared not to comprehend that Hamid Kehazaei was critically ill and dying, leaving him unattended even as the life-saving machines he was attached to were “alarming”, an inquest into his death has heard.
Kehazaei died in Brisbane in 2014 after a treatable infection in his leg deteriorated to a sepsis that caused him to go into cardiac arrest.
The inquest, now in its third week of evidence, has heard of a chaotic scene at Port Moresby’s premier hospital.
Two days after falling ill on Manus Island, and having declined precipitously, Kehazaei was flown by air ambulance to Port Moresby on the evening of 26 August, in defiance of doctors’ recommendations he be taken straight to Brisbane.
Kehazaei was critically ill, unconscious and with dangerously low oxygen saturation in his blood, but it was more than two hours before he was intubated at the hospital, the inquest heard.
“The doctors at PIH appeared unaware that a critically ill patient was arriving – it took about two hours to rally the senior staff and intubate the patient. This should have occurred virtually on arrival,” a reviewing doctor told the coroner.
The Pacific International Hospital has declined to cooperate with the coronial inquest, being held in Brisbane.
The coroner heard on Monday that Kehazaei’s conditioned worsened dramatically at PIH. In an extraordinary intervention, an International SOS specialist emergency medical team – in Port Moresby to treat Australian federal police officers, not asylum seekers – was called to the hospital to care for Kehazaei.
A member of that team, nurse Robert Miazek, recalled walking into the room to see Kehazaei “in serious distress”.
“When I went into the room, I saw the patient in a bed on left-hand side. I immediately noticed alarms going off, both the ventilator was alarming and the monitor with patient’s vital signs was alarming. There was a nurse stood on the other side of the bed, not attending the patient, and there was a female – either a nurse or doctor – local national, standing at the foot of the bed.”
Miazek told the court neither of the two staff members was attending the patient. He said he went into “life-preservation mode”.
The ventilator was found to be broken and was not giving Kehazaei sufficient oxygen – as a result Kehazaei was turning blue. Miazek said when he reached for the “ambu-bag” – a bag-valve mask used to manually ventilate a patient – it had a hole in it.
“There was a tear in the ambu-bag, basically it was useless to me. The bag was broken.”
Kehazaei went into cardiac arrest and required more than an hour’s resuscitation to keep him alive.
One of the health professionals who helped resuscitate Kehazaei was nurse Cher McIntyre, who was employed by International Health and Medical Services, not in a clinical role, but in a coordinating logistical role for the detention health services provider.
She told the coroner she was so concerned by the lack of care being provided to Kehazaei that she and a colleague went to a nearby hotel looking for the AFP emergency medical team so that they could take over his care.
She told the coroner the staff at Pacific International Hospital left Kehazaei unattended for significant periods of time. “They did not seem to understand the seriousness of the condition.”
Counsel for Doctors for Refugees, Gerard Mullins, put to McIntyre that Kehazaei’s care was “woefully inadequate and endangering his life”.
“That is correct,” McIntyre said.
Late last year, two weeks of evidence before Queensland state coroner Terry Ryan heard Kehazaei suffered from inadequate treatment on Manus Island because crucial clinical machines were broken, there were insufficient medicines to treat him and orders from doctors to nurses were ignored.
Much of the coronial inquest has focused on the systemic bureaucratic delays in moving asylum seekers from offshore detention to hospital. Kehazaei was not moved off Manus Island for more than 60 hours after he first presented as unwell at the detention centre clinic, and more than 36 hours after his urgent transfer was first requested by doctors.
Kehazaei’s medical transfer was delayed because bureaucrats in Canberra resisted doctors’ recommendations to transfer him, and because emails seeking approval for his flight were not read for more than five hours.
Several doctors have told the coroner they faced political pressure not to remove patients from PNG to higher-level care.
The Australian government maintains that asylum seeekers and refugees in offshore immigration detention receive healthcare “broadly comparable to the Australian community”. The immigration minister at the time of his death, Scott Morrison, said Kehazaei received “outstanding” healthcare.
Kehazaei’s name is more accurately translated to the spelling Khazaei, but he is referred to in government and court documents by the former spelling.
Kehazaei fled Iran in April 2013, after facing increasing repression from that country’s theocratic regime. He arrived on Christmas Island by boat in August 2013, and was forcibly removed to Manus Island in September.
