Mr Dooley death in custody: Inquest explores 37yo’s treatment in NT prison before falling ill
A nurse who missed a possible opportunity to rush a dying prisoner to hospital while he was suffering a heart attack has vowed to ‘be a better clinician’. Latest from the inquest.
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An ambulance should have been called within 15 minutes of a Darwin prisoner presenting with dangerously low blood pressure, but he was instead taken to intensive care three hours later, a court has heard.
An ambulance should have been called within 15 minutes of a Darwin prisoner presenting with dangerously low blood pressure, but he was instead taken to intensive care three hours later, a court has heard.
The Maiyali man, referred to as Mr Dooley for cultural reasons, died in palliative care at Royal Darwin Hospital in October 2022, after suffering a massive heart attack at Holtze Prison.
On Wednesday, a nurse told Coroner Elisabeth Armitage he recognised Mr Dooley’s blood pressure reading of 80/40 as “very low” but followed a doctor’s instructions to treat it by giving him fluid.
“It was low but I had a sense that I felt confident what we were doing was right, that the treatment was correct, that by giving him the fluid he was going to improve,” the nurse said.
But the nurse said while he believed the doctor had done a “thorough assessment” prior to him seeing Mr Dooley, he now understood his other vital signs had not been checked.
“Going back and looking at the doctor’s notes I’ve been made aware that there was only a blood pressure recorded, there wasn’t other observations,” he said.
The court heard it wasn’t until three hours later that the nurse finally called an ambulance, after hearing Mr Dooley calling out for help and rushing to his bedside.
“He was yelling out ‘Please help me, I’m having trouble breathing’,” he said.
“I heard it several times and I went straight to his cell and yelled out to the officers and asked them to please open the door quickly.”
After hearing the nurse’s evidence, Ms Armitage read from an expert cardiologist’s report that found “an ambulance should have been called within 15 minutes of arrival at the medical clinic”.
“It would be my opinion that referral to a medical facility with intensive care capabilities should have been carried out immediately because the blood pressure was so low,” she read.
The nurse responded that that was something “I’ve spent a lot of time going back and reflecting on” and if another patient presented with the same blood pressure reading he “just wouldn’t leave them”.
“I’d monitor them a lot (more) closely than what I did and personally, that’s something that’s been hard for me to accept and it’s something that I’ve spent a lot of time thinking about and reflecting on,” he said.
“It’s something that I have to take away from this and learn from and be a better clinician, I simply have to be.”
The inquest continues.
Prisoner told to ‘relax and keep water up’ while having heart attack
January 16, latest: A Darwin prisoner was told to “relax and keep the water up” after complaining of feeling sick a day before he was rushed to hospital suffering a massive heart attack, a court has heard.
The Maiyali man, referred to as Mr Dooley for cultural reasons, died in palliative care at Royal Darwin Hospital in October 2022 after being rushed to Adelaide for unsuccessful emergency surgery.
On Tuesday, prison guard Peter Talbot told Coroner Elisabeth Armitage he reported Mr Dooley’s symptoms to the prison nurse after the 37-year-old’s nephew rang the alarm bell on September 25.
“I said ‘I’ve got a prisoner here, Dooley, he says he’s feeling dizzy, crook, and apparently he’s been vomiting, do you want me to send him up?’,” he said.
“The nurse said to me ‘He’s on new medication’ but he didn’t tell me what it was, he said ‘He’s most probably feeling sick and dizzy because his new medication’s kicking in, so just tell him don’t do anything strenuous just relax and keep the water up’.”
Mr Talbot said he relayed the advice to Mr Dooley and his nephew and fellow inmate, Bartholomas Dooley, who also testified at the inquest on Tuesday.
“I walked out and told him the nurse said ‘You’re on new medication that’s probably kicking in, that’s making you crook and dizzy so just relax and keep the water up to you’,” he said.
Mr Talbot agreed that he didn’t think the situation was an emergency but if Mr Dooley had complained of chest pains “it would have been different” and he would have escalated it “off my own bat”.
The next day Mr Dooley was rushed to hospital where it was revealed he had effectively been suffering from a heart attack for the past two days, and he died less than a month later.
The inquest continues in the Darwin Local Court until Thursday.
Prisoner suffered heart attack for two days before death: Inquest
January 16, update: A Darwin prisoner who died of a cardiac arrest aged just 37 had effectively been suffering heart failure for two days before he was rushed into emergency surgery, a court has heard.
The Maiyali man, referred to as Mr Dooley for cultural reasons, died in palliative care at Royal Darwin Hospital on October 22, 2022 — almost six weeks after an electrocardiogram conducted as part of a routine health check returned an “abnormal” result.
On Tuesday, the first day of a Coronial inquest into his death heard that despite a doctor requesting Mr Dooley be recalled for a possible cardiologist referral, a “high priority recall box” was not ticked and he was sent back to his room.
Mr Dooley’s nephew Bartholomas Dooley, who was sharing accommodation with his uncle in the low security section of Holtze Prison at the time, told the court the man he called his “young father” began to fall ill 12 days later.
“We went to get our lunch on Sunday and then I came back, I saw my young father coming back and he was starting to feel dizzy, I asked him what happened and I told him to sit down,” he said.
“I got his mattress and told him to lay down in the lounge room, he told me to get a plastic bag because he had started vomiting.
“I went back to the office and told the officer my young father is vomiting, he needs to go to the clinic for a check-up.”
But Bartholomas Dooley said prison staff told him “it wasn’t an emergency” and would have to wait until the following day as it was a weekend.
Counsel assisting Coroner Elisabeth Armitage, Sandra Wendlandt, told the court Mr Dooley was finally seen by a doctor the next day, who diagnosed “a gastrointestinal and dehydration issue, notwithstanding the outstanding ECG, his high cardiac risk and his severely hypotensive state”.
Ms Wendlandt said Mr Dooley was then moved to a medical housing unit where he was placed on a drip, but it wasn’t until three hours later that he was rushed to Royal Darwin Hospital after reporting having trouble breathing.
“An angiogram revealed what is called severe triple vessel disease and cardiogenic shock,” she said.
“He had in effect, been suffering from the effects of a heart attack for two days.”
Mr Dooley was then placed into an induced coma and intubated to be flown to Flinders Medical Centre in Adelaide shortly after midnight, by which time “his prospects of survival were extremely limited”.
Ms Wendlandt said emergency heart surgery was unsuccessful and Mr Dooley was woken from his coma so he could say his final goodbyes before he was flown back to Darwin where he died surrounded by family.
The inquest continues.
Inquest to probe man’s final days in Holtze prison
Initial: A smiling young man, a talented artist, a son and a friend — this is how the loved ones of a 37-year-old Territory man want him to be remembered.
Yet for the next three days the Territory coroner will also explore how the man, known for cultural reasons as Mr Dooley, also became known as a violent offender, a sentenced prisoner, and one of 63 people who have passed away inside the Territory’s prison system.
On Tuesday Coroner Elisabeth Armitage is expected to open the three day mandatory death in custody inquest to explore the factors that contributed to the Indigenous man passing away on October 22, 2022.
The NT News understands Mr Dooley suffered from a medical incident, and was brought to Royal Darwin Hospital before he passed away.
It is also understood his family were able to be by his hospital bedside to say their farewells, bringing Mr Dooley and his loved ones together after four months of being separated by prison walls.
Mr Dooley was two months out from his release date when he fell ill.
The coroner is expected to particularly focus on the 37-year-old’s care, supervision and treatment while at Darwin Correctional Centre in the days before he was taken to Royal Darwin Hospital.
Court records show that on June 20, 2022 Mr Dooley was sentenced in the Katherine Local Court for an aggravated assault.
Judge Stephen Geary heard the attack was aggravated as Mr Dooley assaulted a woman and she suffered harm, and sentenced him to six months in prison.
According to the Australian Institute of Criminology, there have been 63 deaths in custody in the Territory’s prisons since 1979 — 75 per cent of whom were Indigenous Territorians.
Family members have shared photos of the 37-year-old, along with pictures of a hand painted buffalo skull, one of Mr Dooley’s artworks, which currently hangs at a school in Manyallaluk, Eva Valley, 105km east of Katherine.
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