Serious concerns raised at Flinders Medical Centre, Royal Adelaide Hospital ahead of expected COVID wave

A woman suffering an ectopic pregnancy was turned away from an Adelaide hospital stretched to the limit last week, a report from the doctors union has found, as the state braces for another COVID wave.

The alarming situation was one of multiple failings identified by South Australian Salaried Medical Officers Association (SASMOA) at the over-capacity emergency departments of Flinders Medical Centre, in Adelaide’s southern suburbs, as well as at the Royal Adelaide Hospital in the CBD.

A June 15 safety report of the Flinders Medical Centre’s emergency department stated that a person experiencing an ectopic pregnancy was sent away “for fear the patient would not receive timely care”, and a patient with a severe abscess was monitored in the waiting room.

A doctor described the situation that day as “the worst I’ve seen it”.

Bernadette Mulholland from SASMOA said the pressure to transfer people out of ambulances to reduce ramping outside meant clinicians were making tough choices in triaging patients.

“Do I see people on the ramp who are in desperate need, and those ambulances need to be desperately out there [in the community], or do I see someone in the waiting area who probably requires more urgent care from that position?” she said.

“But unfortunately there’s a real need to get those people off the ramp and those ambulances out.”

Health Minister Chris Picton said he would investigate the claims made in the reviews.

A green and white ambulance with a blurred street behind it
Staff are feeling pressured to get patients out of ambulances and into the hospital.(Che Chorley)

He acknowledged people were having tests done in waiting room chairs of emergency departments, something he said had been happening for some time.

“It’s absolutely not ideal but it’s a factor of the fact we don’t have enough beds,” he said.

Mr Picton, who spent a shift with emergency crews in the southern suburbs on Tuesday night, said the government had opened “every single bed we can” .

“It is very, very difficult right now,” he said.

“Our clinicians are working their guts off.”

Ms Mulholland said an “enormous” amount of admitted patients were taking up beds in emergency departments while they waited for a spot on the wards.

A white hospital building with blue and green windows, with green trees in front of it
A report found the RAH failed to prepare for a recent hotel fire.(ABC News: Che Chorley)

She said 53 of the 65 beds at the Royal Adelaide Hospital’s emergency department were taken up by admitted patients waiting to go to a ward on Monday, describing it as “the worst day” she had seen in her decade with SASMOA.

Ms Mulholland said she had “real concerns” regarding staffing and bed capacity going into winter.

The reviews found emergency staff were burnt out and fatigued, including one doctor who had worked 11 days straight and had not taken leave in more than three years.

Other concerning findings in the reviews included an elderly woman with a perforated bowel who was ramped at the Royal Adelaide Hospital for more than an hour in April, and a patient at Flinders who had rapidly declined the evening before in an ambulance and was admitted to intensive care after waiting for eight hours.

Concerns were also raised over diaster processes after it emerged that no-one at the Royal Adelaide Hospital’s emergency department saw a message advising of a catastrophe regarding a fire at a hotel, and the message was only sent after patients had already arrived at the hospital.

SA reports four COVID-related deaths

The findings come as health authorities warned of another wave in COVID cases after the BA.5 subvariant was detected in the state.

Chief Public Health Officer Professor Nicola Spurrier told ABC Radio Adelaide this morning the new subvariant made it difficult to predict case numbers.

“What we are fairly certain of is we will have this wave, but we don’t know the size of it,” she said.

South Australia recorded 2,686 new cases of COVID-19 today and four deaths of people aged from their 60s to their 80s.

The hospital system is currently caring for 223 people with COVID, including seven in intensive care.

Professor Spurrier said while BA.5 was not expected to be more severe than other subvariants, the rising case numbers would still put additional pressure on the already struggling hospital system.

“If we have a wave and we’ve got more cases, then there’s going to be more people as a percentage that are going to require hospitalisation,” she said.

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