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| Hamid Kehazaei inquest: asylum seeker needed urgent transfer, medical staff agreed Hamid Kehazaei inquest: asylum seeker needed urgent transfer, medical staff agreed | |
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| Within 36 hours of Hamid Kehazaei presenting to the Manus Island detention centre medical clinic with an unrelenting fever, there was “general consensus” among medical staff that he was “very very sick”, suffering from sepsis and “needed to be treated quite urgently at a higher level”. | Within 36 hours of Hamid Kehazaei presenting to the Manus Island detention centre medical clinic with an unrelenting fever, there was “general consensus” among medical staff that he was “very very sick”, suffering from sepsis and “needed to be treated quite urgently at a higher level”. |
| “We were trying to get him out,” Rafael Cruz, the paramedic who was treating Kehzaei, told a coronial inquiry into the asylum seeker’s death. “He was not improving, he was actually deteriorating. He was only getting worse.” | “We were trying to get him out,” Rafael Cruz, the paramedic who was treating Kehzaei, told a coronial inquiry into the asylum seeker’s death. “He was not improving, he was actually deteriorating. He was only getting worse.” |
| It was, however, a further 36 hours before Kehazaei was flown from Manus by air ambulance for advanced care – first to Port Moresby and finally to Brisbane. | It was, however, a further 36 hours before Kehazaei was flown from Manus by air ambulance for advanced care – first to Port Moresby and finally to Brisbane. |
| Kehazaei – a 24-year-old Iranian asylum seeker whose name is also spelled Khazaei – died in Brisbane’s Mater hospital on 5 September 2014. | Kehazaei – a 24-year-old Iranian asylum seeker whose name is also spelled Khazaei – died in Brisbane’s Mater hospital on 5 September 2014. |
| A coronial inquest into his death began on Monday in Brisbane before the coroner, Terry Ryan. | A coronial inquest into his death began on Monday in Brisbane before the coroner, Terry Ryan. |
| Counsel assisting Emily Cooper told the inquest an auotpsy found Kehazaei’s death was caused by a lack of oxygen to his brain as a consequence of cardiorespiratory arrest, caused by sepsis which developed from an infection which began in a sore on his leg in the Manus Island detention centre. | Counsel assisting Emily Cooper told the inquest an auotpsy found Kehazaei’s death was caused by a lack of oxygen to his brain as a consequence of cardiorespiratory arrest, caused by sepsis which developed from an infection which began in a sore on his leg in the Manus Island detention centre. |
| The inquest will address the “adequacy and appropriateness of medical care” provided to Kehazaei, Cooper said, including the “procedures and processes for the escalation of urgent medical treatment and to provide for urgent evacuation out of Manus Island”. | The inquest will address the “adequacy and appropriateness of medical care” provided to Kehazaei, Cooper said, including the “procedures and processes for the escalation of urgent medical treatment and to provide for urgent evacuation out of Manus Island”. |
| The inquest heard Kehazaei presented to the then-rudimentary medical clinic within the Manus Island detention centre at about 5.30pm on the evening of 23 August. | The inquest heard Kehazaei presented to the then-rudimentary medical clinic within the Manus Island detention centre at about 5.30pm on the evening of 23 August. |
| At the time, the medical centre in the detention camp consisted of four converted shipping containers, with a roof covering the space in between them. The internal covered area, and the containers, were air-conditioned. The medical clinic has since been upgraded. | At the time, the medical centre in the detention camp consisted of four converted shipping containers, with a roof covering the space in between them. The internal covered area, and the containers, were air-conditioned. The medical clinic has since been upgraded. |
| Cruz was one of two paramedics rostered on on the night of 23 August. Kehazaei presented shivering, with his hands held inside his shirt, complaining of a fever, chills, body aches, a runny nose and sore throat. He had been unwell for two days, he said. | Cruz was one of two paramedics rostered on on the night of 23 August. Kehazaei presented shivering, with his hands held inside his shirt, complaining of a fever, chills, body aches, a runny nose and sore throat. He had been unwell for two days, he said. |
| Kehazaei was prescribed intravenous paracetamol, saline solution and a broad spectrum antibiotic ceftriaxone. But his condition continued to deteriorate. | Kehazaei was prescribed intravenous paracetamol, saline solution and a broad spectrum antibiotic ceftriaxone. But his condition continued to deteriorate. |
| “The fever was not responding to anything we did,” Cruz said. “It just remained high throughout the whole night. Nothing touched the fever … He was very, very sick.” | “The fever was not responding to anything we did,” Cruz said. “It just remained high throughout the whole night. Nothing touched the fever … He was very, very sick.” |
| Fevers were common inside the Manus detention centre, Cruz said, but Kehazaei’s case quickly emerged as unusual and “very concerning”. His temperature touched 40C and was resistant to all treatments. | Fevers were common inside the Manus detention centre, Cruz said, but Kehazaei’s case quickly emerged as unusual and “very concerning”. His temperature touched 40C and was resistant to all treatments. |
| “It [Manus] is a very remote location, we have very high humidity, [it is] very hot, it rains every day, infections are abundant,” Cruz said. “The risk for any type of infection is quite great. | “It [Manus] is a very remote location, we have very high humidity, [it is] very hot, it rains every day, infections are abundant,” Cruz said. “The risk for any type of infection is quite great. |
| “But even if antibiotics were not working, even giving him Panadol should relieve the fever for a few hours. But we didn’t see a change at all.” | “But even if antibiotics were not working, even giving him Panadol should relieve the fever for a few hours. But we didn’t see a change at all.” |
| Cruz treated Kehazaei again the following night – 24 August into 25 August – and said the patient had a temperature of 40C that could not be relieved. He was also suffering hypertension and a high heartbeat, followed by low blood pressure. | Cruz treated Kehazaei again the following night – 24 August into 25 August – and said the patient had a temperature of 40C that could not be relieved. He was also suffering hypertension and a high heartbeat, followed by low blood pressure. |
| “It’s a good indication the patient is septic and that the patient needs to be treated quite urgently and at a higher level.” | “It’s a good indication the patient is septic and that the patient needs to be treated quite urgently and at a higher level.” |
| By 7.30am on the morning of 25 August, Cruz said, medical staff on the island agreed they could not adequately treat him there. | By 7.30am on the morning of 25 August, Cruz said, medical staff on the island agreed they could not adequately treat him there. |
| “There was a general consensus on day two that he needed to be moved to a place of higher care,” Cruz said. “We were trying to get him out.” | “There was a general consensus on day two that he needed to be moved to a place of higher care,” Cruz said. “We were trying to get him out.” |
| However, Kehazaei was not flown out of Manus until lunchtime on 26 August, 36 hours after doctors on the island requested his urgent transfer from the island and some 68 hours after he first presented unwell. | However, Kehazaei was not flown out of Manus until lunchtime on 26 August, 36 hours after doctors on the island requested his urgent transfer from the island and some 68 hours after he first presented unwell. |
| The inquest heard that the turnaround for an emergency medical evacuation was typically 12 hours. It also heard that the air ambulance could not fly to Momote airfield on Manus at night because the airport was not equipped for night landings. | The inquest heard that the turnaround for an emergency medical evacuation was typically 12 hours. It also heard that the air ambulance could not fly to Momote airfield on Manus at night because the airport was not equipped for night landings. |
| The coronial inquiry, set down for two weeks, is expected to hear from more doctors and Manus Island staff on Kehazaei’s specific treatment and the general standard of care in detention, as well as procedures for acutely-ill patients. | The coronial inquiry, set down for two weeks, is expected to hear from more doctors and Manus Island staff on Kehazaei’s specific treatment and the general standard of care in detention, as well as procedures for acutely-ill patients. |
| The Pacific International Hospital in Port Moresby, where Kehazaei was initially taken before being moved to Brisbane, has refused to co-operate with the inquest and will not make any of its staff available to appear before it for questioning. | The Pacific International Hospital in Port Moresby, where Kehazaei was initially taken before being moved to Brisbane, has refused to co-operate with the inquest and will not make any of its staff available to appear before it for questioning. |