Conditions in a major western NSW hospital have been slammed as “Third World” over allegations an elderly man went without food or water for three days because it was too expensive to roster staff on, in a ward that "ran out" of morphine and paracetamol.
Family have given an alarming account of Allan Wells' treatment late last year in Dubbo Base Hospital, the flagship facility within the Western NSW Local Health District.
Allan Wells died after he was discharged from Cobar District Hospital against his family's wishes.
Mr Wells died in December only days after he was transferred to Cobar District Hospital and discharged against his family's wishes.
The Western NSW Local Health district rejected allegations of resourcing issues at either hospital and said it was committed to providing the best care for patients.
A Herald investigation has also uncovered a series of troubling near misses at both the Dubbo and Cobar hospitals.
They include a man forced to have a toe amputated after months pleading for treatment of an infected blister and a man who had to have most of his bowel removed after being sent away from emergency three times.
Allan celebrates at home with his daughter Jamelle on his last birthday on March 18, 2019.
"What happened to my father was heartbreaking at the end of his life and I don’t want it to happen to any other person," said Mr Wells’ daughter Jamelle Wells, who works as a journalist in Sydney.
Mr Wells' great loves were his wife Cecilia and his home town of Cobar, 700 kilometres north-west of Sydney.
After Cecilia passed away in 2016 Mr Wells visited her grave twice daily, and otherwise occupied himself doing laps of Cobar’s main street, stopping to shoot the breeze with whoever he spotted from his ute.
According to locals, the 85-year-old “cared about everyone except himself”, working tirelessly on local volunteer projects. But family say health services in the town Mr Wells loved let him down.
Allan Wells and his wife Cecilia in 1959.
"My dad died feeling he wasn't good enough for a hospital bed," Ms Wells said.
Her father’s ordeal began last September when he broke his hip in a fall and was flown to Dubbo Base Hospital. Following emergency surgery, the wound was oozing and doctors ordered a second operation.
"I nearly had a heart attack, I said he's 85 he can't have a second surgery. I wondered if something had gone wrong with the first surgery," Ms Wells recalled.
Following the second surgery, Mr Wells appeared "really unwell", but hospital staff sought to have him discharged to a private hospital.
They "grudgingly" allowed Mr Wells to stay an additional night. Hours later, he went into cardiac arrest.
"They said we don't recommend resuscitating him because of his age," Ms Wells said. "My brother said no, dad is a fighter, he would want to live."
It’s believed the cardiac arrest was due to a pulmonary embolism, the blood clot lodging in Mr Wells' lungs after his anti-clotting medication was stopped.
Mr Wells survived and was transferred from intensive care back to the ward. But because it was a long weekend, it would be three days before a dietician was available to assess whether he could swallow properly.
"Here's this old man lying there having died and been brought back to life," Ms Wells recalled.
"And for three days my dad lay there just begging me going, 'Jamelle, why can't I eat and drink?' It was heart-wrenching.”
Ms Wells confronted a manager.
"She said we can’t afford to roster someone [a dietician] on a weekend and a public holiday so you have to wait," Ms Wells recalled. “That’s like Third World stuff."
Allan Wells served in the army when he was 18.
A nurse told the family "not to be surprised" if Mr Wells' hands were tied to the bed to stop him pulling out his intubation tube. The family refused to allow it, pointing out he was too weak to move and had his full faculties.
A junior doctor tried unsuccessfully three times to force a feeding tube through Mr Wells' nose and family said untouched meals would be taken away within 30 minutes if they were not there to feed him.
“It was about that point that my brother and I decided we could not leave dad on his own,” Ms Wells said.
On one occasion Ms Wells witnessed her father "screaming out in pain" as staff attempted to roll him over. She later queried the pain management available in the surgical ward.
"The nurse said to me we've got no morphine and Panadol here at the moment, we’re waiting for it to come for the pharmacy," Ms Wells said. "I couldn’t believe it."
One day when the fire alarms were going off Ms Wells discovered her father lying alone grabbing his blankets in terror, telling her "I don’t want to burn".
The hospital declined the family’s request that Mr Wells be transferred to Dubbo Private Hospital and he was instead sent back to Cobar Hospital to recuperate.
It was there the family discovered at Dubbo Mr Wells had been treated with a controversial antipsychotic drug, Haloperidol.
On his hospital records it was noted Mr Wells had dementia, to the amazement of his family who say he had never been diagnosed with the condition and had passed a mental alertness test.
On November 4 an aged care assessor told Mr Wells' family he was too unwell to go anywhere for a week. The next day Cobar hospital staff insisted he be discharged to a nursing home, even though Ms Wells said there were only a handful of patients in the hospital at the time.
Her father wept.
Allan Wells used to pass the time doing "laps" of Cobar's main street.
"He said love, they're giving up on me, they're sending me off there to die aren't they?"
Mr Wells passed away five days later. After her father’s death, Ms Wells was charged over $600 by Dubbo Base Hospital to access his medical records.
She discovered that the doctor whose name was written on Mr Wells' bed and medical records had never performed the surgery.
"That seemed odd because my father was a private patient and they billed his health fund $12,000," she said.
According to the Bureau of Health Information, Dubbo Base Hospital had a 7.6 per cent mortality rate following hip fracture surgery between 2015 and 2018, higher than the NSW average of 6.4 per cent.
Some 70 per cent of those patients died after they were discharged, compared to 60 per cent for the rest of NSW.
A spokesperson for the Western NSW Local Health district denied the allegations and said the hospital was committed to providing the best care.
The spokesperson insisted the hospital always had staff available on weekends and public holidays to assess if patients could swallow following intubation.
"Nursing staff undergo training to perform 'sip tests' with patients," she said. "These tests can be performed at any time."
The spokesperson denied the hospital had ever suffered Panadol or Morphine shortages.
"All clinical areas in the hospital have 24-hour access to pharmacy stores," she said.
The spokesperson said end-of-life decisions were made collaboratively between patients, families and clinicians and in accordance with NSW Health policy, "irrespective of a patient's age"
Nurses assisted patients during meal times, she said, and meals remained with a patient for 60 minutes on average.
While there were situations where restraint was necessary to ensure patient and staff safety, staff worked to use the "least restrictive method".
Lorraine Long from the Medical Error Action group branded Mr Wells' care "utterly appalling".