Sydney hospital under fire over death of two-year-old boy

A Sydney family is grieving the loss of their two-year-old son who was left in an emergency department chair for 2½ hours despite showing clear signs of a life-threatening condition, in a tragedy that has shocked Sydney and led the state’s health minister to question the government’s controversial agreement with the public hospital’s private operator.

Elouise and Danny Massa will directly ask NSW Premier Chris Minns for an extraordinary coronial inquest and an independent review of Northern Beaches Hospital, after an internal investigation into their son Joe’s shock death found serious individual and systemic failures in the hospital’s management of his rapidly deteriorating condition.

Elouise and Danny Massa at their North Balgowlah home with a picture of their son Joe, whose shock death at Northern Beaches Hospital in September has left the family demanding answers.Credit: Kate Geraghty

“Bright and loving” Joe, two months shy of his 2nd birthday, was taken to Northern Beaches emergency department on the morning of September 14 after he had spent the night violently vomiting and dry retching at their home in North Balgowlah.

He was suffering from significant hypovolemia, a condition that occurs when the body loses too much fluid.

A nurse about to finish their night shift triaged the toddler as “category 3”, having a potentially life-threatening condition requiring treatment within 30 minutes.

But his heart rate, which was above 180 beats per minute, and “pale and flat” appearance indicated his condition was life-threatening and should have triggered an immediate and serious response, independent medical staff said in a review into his death.

The review recommended urgent changes to the hospital’s electronic medical record system and triage processes after finding the hospital failed to respond urgently to a heart rate in the “red zone” and failed to respond to serious concerns from clinicians and the boy’s parents.

The hospital has accepted the recommendations and apologised to the family.

Elouise Massa said her son’s death did not meet the threshold for a coronial inquest but, in a meeting next week, she would push the premier and the Health Minister Ryan Park to ask the coroner to investigate.

“A few minor policy tweaks actually isn’t enough,” she said. “We need real, meaningful change, and that’s in the form of a coronal inquest and, with the help of the premier and the health minister, an independent review into the emergency department at Northern Beaches Hospital.”

The couple will also ask Minns and Park to ensure every parent knows their rights to escalate concerns when their child is deteriorating, through a statewide education program and enforcement of NSW Health’s “REACH” (Recognise, Engage, Act, Call, Help) protocols.

“I want change so that the hospital is safe for our local community, and I want no other family to feel as hopeless and lost [as we felt] in an emergency department,” said Joe’s father, Danny Massa.

The couple said hospital staff denied their repeated requests for intravenous fluid drip, and they were frequently left alone with their son in the resuscitation room without medical staff.

Despite the department having paediatric beds available and adequate staffing levels at the time, Joe was not given a bed for two-and-a-half hours as his condition continued to deteriorate rapidly.

The review was critical of the nursing staff’s initial decision to treat his condition as gastro. It was also critical of a trainee doctor’s decision to perform an initial physical assessment while the toddler was fully clothed and sitting in his mother’s lap on an emergency department chair rather than in a bed.

Joe was not given a bed until two-and-a-half hours later when his mother said she screamed, “My son has gone blind”, and his eyes were rolling in the back of his head.

At 10.47am, Joe went into cardiac arrest in the resuscitation room. Emergency staff delivered CPR for 29 minutes, and Joe was transferred to the paediatric intensive care unit at Sydney Children’s Hospital. He suffered irreversible brain damage, and his life support was withdrawn two days later.

Danny Massa told 2GB’s Ben Fordham on Thursday that he arrived at the hospital just as Joe entered cardiac arrest.

“I ran from the car park to the ED admission, and then from around the back, I entered the resuscitation room ... and there was [Elouise] and Joe by themselves in the [resuscitation] bay ... [with Elouise] screaming on the phone to get Joe better care out of that hospital,” he said.

Park said the tragedy highlighted grave concerns about the state government’s agreement with private provider Healthscope to run the hospital until 2038 under a controversial public-private partnership entered into by the former Coalition government.

“This incident raises serious questions about privatisation and this type of model,” he said.

The NSW auditor-general is currently investigating the performance of Northern Beaches Hospital, which recently came under fire after 14-year-old Joshua Gill died just days after being discharged from mental health treatment at the hospital in 2021.

Local politicians Michael Regan, state MP for Wakehurst, and Sophie Scamps, federal MP for Mackellar, had previously called for an independent inquiry into the Northern Beaches Hospital. They said they were devastated by today’s news.

Scamps, who has previously met with the hospital’s auditor to discuss her concerns, said she was confident the auditor-general’s investigation would be “thorough” and would result in positive outcomes for the community.

She supported the family’s call for a “full and public review” into Northern Beaches Hospital’s delivery of care and called for the NSW government to re-evaluate its contract with Healthscope.

Regan, who has received treatment at the hospital for a foot injury, said he was cautious to not denigrate the work of medical staff, but said the community had “started to lose confidence” in Northern Beaches Hospital, with many people travelling to the Royal North Shore or Hornsby Ku-ring-gai hospitals to receive care, rather than use their local hospital.

Healthscope operates 38 hospitals across Australia and is owned by Canadian private equity giant Brookfield.

In a statement, a Healthscope spokesperson said it recognised Joe’s death had “caused unimaginable heartache and grief for the family”.

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