Flinders Medical Centre doctors fume over ‘week from hell’ in Adelaide emergency department

Two hours ramped with a heart attack and an impossible choice between three desperate patients for a doctor are among some “horrendous” cases.

A patient who a top doctor ordered be taken immediately into Flinders Medical Centre ED was instead left in a ramped ambulance for two hours until suffering a cardiac arrest, in what clinicians have dubbed “the week from hell.”

The doctor was overruled resulting in paramedics later rushing the person into the ED in a life threatening emergency.

SASMOA chief industrial officer, Bernadette Mulholland. Picture: Matt Loxton

In another damning case doctors faced a “impossible” choice where three ambulance patients arrived deemed of equal urgency — burst appendix, anaphylaxis and cardiac issues — but there was only one bed available.

One clinician described the choice of who to prioritise as “a hot mess.”

The cases are contained in a report by SA Salaried Medical Officers Association chief industrial officer Bernadette Mulholland’s authorised inspection of the ED on March 17 following complaints about safety breaches.

Her report to SafeWork SA lists 11 cases where health and safety legislation was allegedly contravened by the PCBU — a SA Health legal entity for the Person Conducting a Business or Undertaking, responsible for ensuring the health and safety of workers.

She arrived on a day where at one stage there had been 116 patients in the 69-bed ED, with five urgent cases ramped.

One medical case had been waiting 46 hours for a ED bed, and a mental health patient had been waiting 41 hours.

The report includes vivid comments from clinicians such as “a week from hell”, “the level of stress is horrendous”, “dangerous to our staff and patients”, “the system was broken”, “the morning ED crew were pretty broken”, and “we are drowning.”

Flinders Medical Centre. Picture: Brett Hartwig

In the cardiac case, Ms Mulholland’s report states: “The senior doctor in the Emergency Department had instructed that a patient needed to be offloaded from the ramp and assessed in FMC ED. The patient was triaged as a Category 2.

“This request was not followed and the patient went into cardiac arrest and was rushed in from the ramp by the paramedics approximately two hours later whilst on the ramp.

“There were no beds … there was no space in the ED including the flex space.”

Ms Mulholland discovered the senior clinician was overruled by the PCBU who reviewed the case and “did not think this Cat 2 was any more urgent than the others.”

The doctor had intended to lodge a high level safety report over the incident but the PCBU downgraded it because the patient “had lived.”

Southern Adelaide Local Health Network chief executive, Kerrie Mahon said the FMC ED experienced high demand on March 17.

“People who present to our ED are always prioritised according to their clinical need, with high acuity cases seen first,” she said. “Patients are continually monitored during this time, with staff responding to patient needs as they progress through triage.

“We work across the system to respond to surges in demand and importantly, plans are in place to help ease the high number of mental health presentations we are currently seeing.”

These include an additional 48 beds at Noarlunga Hospital by the end of the year, while the Margaret Tobin Centre upgrade will deliver a new 12-bed Psychiatric Intensive Care Unit.

“A major expansion and upgrade of Flinders Medical Centre will also deliver 98 new beds as part of the seven-storey Acute Services Building, expected to open in early 2028,” Dr Mahon said.

“We are aware of SASMOA’s inspection and will continue to work with them and SafeWork SA in response to their enquiries.”

She thanked the community for their patience, and staff for their dedication.

Originally published as Flinders Medical Centre doctors fume over ‘week from hell’ in Adelaide emergency department