Patient Travel Incidents

“We’re sorry, but we don’t know when the plane is coming”

Katherine West Health Board Aboriginal Corporation (KWHB) is again calling for the Northern Territory Government to increase capacity with regard to patient air evacuation and to provide certainty around patient evacuation protocols, in the wake of another seriously injured patient being forced to wait overnight (18 hours) for evacuation from a remote community.

On Thursday evening (May 12, 2011), one of our remote health professionals was forced to utter the woefully inadequate line “we’re sorry, but we don’t know when the plane is coming” to a seriously injured patient in the remote community of Yarralin, 420km south west of Katherine.


 “This is exactly what we said three years ago after a patient died waiting for a plane in Lajamanu, we are concerned that if this issue is not urgently addressed, it is only a matter of time before there is another avoidable death of a client in a remote community due to a delay in transfer to hospital" said KWHB Chief Executive Officer Sean Heffernan.


“This time, it’s happened only 48 hours after we received a written assurance from the Minister for Health that patients could be evacuated from Yarralin airstrip at night”.


The patient in question fell from his horse at the Humbert River station, near Yarralin, and was knocked unconscious for up to five minutes. He was stabilized at the accident scene by station workers and taken by vehicle to Yarralin Health Centre, which is managed by KWHB.


KWHB staff determined at 430pm that the patient required urgent air transport to Royal Darwin Hospital for treatment, categorized as a High Priority Level 2 retrieval.

KWHB staff then followed the established procedure for requesting urgent air evacuation for the injured patient. Established air evacuation protocol states that Priority 2 patients should be evacuated where possible within two hours.

 

From the time of the fall in the afternoon, through until 9pm when staff were finally advised that the plane would not be arriving in Yarralin overnight, the patient did not receive anesthesia for his injuries, as patients are required to be alert upon their arrival to Royal Darwin Hospital. 

The evacuation plane didn’t arrive in Yarralin until the next morning, a painful, highly stressful and medically dangerous 18 hours later.

 

The Minister said the plane would come, that patients could be medically evacuated from Yarralin at night. His promise was proved wrong, in this case, a mere 48 hours after him making this commitment.

 

KWHB calls on the Department of Health to directly to work with CareFlight and other relevant authorities to rectify the issues of poor communication, confusion and most importantly, air evacuation capacity. 


This continues to be an incredibly unsafe situation that must receive attention at the highest levels.

The NT Government and Careflight must make sure that there are enough aircraft to provide this serious and important service to the bush.

Mixed Messages on Yarralin Airstrip

Only 48 hours prior to this incident, KWHB received a response letter from the Hon. Minister Vatskalis (NT Minister for Health) regarding previous patient travel concerns raised by KWHB about air evacuation response times in our region.


On the specific issue of the Yarralin air strip, the letter from Minister, dated Monday May 9, 2011 stated:

 
The CareFlight Chief Pilot, in conjunction with Civil Aviation Safety Authority (CASA) Airstrip Assessor and Department of Lands and Planning personnel, completed an audit of the Yarralin Airstrip in January 2011. As a result of the audit, the Yarralin Airstrip opened to night flying in February 2011.


In direct contradiction to this clear statement, KWHB were advised only 48 hours after receiving the letter, on the evening of May 12, 2011 by CareFlight that the pilot would not land in Yarralin at night due to safety issues.


The following morning, contradicting the advice given the previous evening, KWHB were told by CareFlight that the 18 hour delay was caused by higher priority cases elsewhere, and not because the airstrip in Yarralin wasn’t safe to operate on at night.

This creates great confusion and raises serious questions on two fronts.


Inconsistency of retrieval priorities

In the letter from the minister dated May 9, 2011, he wrote:

 
Priority 1 retrievals must be responded to within 30 minutes of the call from the District Medical Officer (DMO); and Priority 2 retrievals must be responded to within 2 hours.


The letter goes on to add:

 
Priority 2 patients are retrieved at night if it is clinically required. On a clinical basis, Priority 3, 4 and 5 patients do not require night retrieval. However, Priority 3 patients will be retrieved at night if the Community Health Centre has no capacity to support the patient overnight. 


In the documented Yarralin incident of May 12, 2011, the DMO was notified by Yarralin staff that the Community Health Centre did not have the capacity to support the patient overnight, and that the patient was requested to be transported via air evacuation as a High Level Priority 2 patient.

In essence, KWHB were assured that Priority 2 patients would be evacuated within two hours, and that all effort would be made to evacuate patients when it was determined that the Community Health Centre could not support the patient overnight.


This did not happen, and must be urgently looked at.

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For any further enquiries on patient travel matters, we encourage you to contact:

KWHB Chief Executive Officer Sean Heffernan on Mobile 0429 671 062

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If you are interested in reading further about KWHB's recent history in fighting for better patient retrieval services in the Northern Territory, please read the following supporting documents:

1. April 2008 KWHB Letter to Health Minister Burns - Concerns relating to NT aero medical services and PATS
(PDF 57Kb)

2. August 2008 - NT man dies awaiting hospital transfer
Archive web link, Sydney Morning Herald website, First published August 19, 2008, Retrieved May 17, 2011

3. May 2011 - Letter from Health Minister Vatskalis to KWHB – RE: KWHB Listing of Patient Travel Incidents Feb-Mar 2011
(PDF 166Kb)