Little comfort for Elise Neville’s father after tragic death exposed Jayant Patel and broken health system
Retired doctor Gerard Neville still bears the burden of a father haunted by a terrible fate that ended the life of his 10-year-old daughter and forever changed his hitherto perfect young family.
Gerard Neville maintains a steely resolve even after all these years. It sits uneasily at times with his gentle nature.
He is no longer single-mindedly obsessed in the way some people are after losing a loved one in an avoidable mishap.
But the now-retired doctor still bears the burden of a father haunted by terrible fate and circumstances. A fate which ended the life of his 10-year-old daughter Elise and fundamentally changed the arc of his hitherto perfect young family.
Gerard’s courage in wanting to share the story of his family’s tragedy made a profound impact on many – and particularly on professionals in the public hospital system in 2004.
It was then, and is still now, the saddest, most gut-wrenching story of a personal catastrophe I’ve researched and reported.
When an experienced and dedicated intensive care unit nurse called Toni Hoffman read it back then, she too was deeply moved.
It was the catalyst for her to risk her job by emailing me to describe grave concerns she held about a dangerously incompetent surgeon called Jayant Patel whom she suspected was killing and maiming patients in Bundaberg’s public hospital.
Two decades later, Gerard knows that many people must have forgotten what happened to Elise. How her death changed so many things.
It is one of the reasons why he acknowledges The Australian’s production of Sick To Death, a podcast series in which Gerard, his wife Lorraine and daughter Elise are integral.
As Gerard told me when we met again several weeks ago, he has been determined for a long time to expose public health failure.
When we first met at the family home in the Brisbane suburb of Toowong in 2004, Gerard’s remarkable wife Lorraine told me: “Elise was just as perfect a child as you could ever have. The last thing she would have remembered was putting her head on Daddy’s shoulder as he carried her in from the car.
“We live with the ongoing trauma. We ask ourselves, ‘What could we have done, what did we miss, how could we have let this happen?’
“It is so cruel for Gerard. He had the very best of intentions. Fate had something else in mind.
“We do not want to be seen to be vindictive and nasty to certain individuals in this. It is more about the bigger picture and how it can be improved.”
Gerard and Lorraine lost Elise days after a January family holiday to the Sunshine Coast went horribly wrong.
The unit in which they usually stayed on visits to Caloundra was unavailable.
Instead, they were shown to a unit with bunk beds. Elise was excited at the prospect of sleeping in the top bunk, and towering over her older sister Laura and their little brother Michael.
But the top bunk had no safety rail to stop a child rolling out while sleeping. Elise rolled the wrong way during the night and fell, striking her head on the tiled floor.
Gerard and Lorraine immediately went to their daughter. She was conscious but distressed. Elise said her head hurt.
They took her into their bed but as Elise’s agitation worsened, they decided to rush her to Caloundra Hospital.
Gerard was a credentialed medical doctor, however, he was not a practising clinician. His work for Queensland Health revolved around policies and high-level planning in the public system’s city offices, not in hospital wards and clinics.
Unforgivably, the Caloundra Hospital had a little-known practice of not admitting children. It had also been deemed an understaffed and unsafe hospital in an internal and confidential report. However, these alarming facts were not known to Gerard and Lorraine when they arrived in the early hours of the morning in January 2002.
The Nevilles received what they would later describe as uncaring and dismissive treatment from the two nurses on duty. The only doctor there looked experienced, but he was relatively junior – he had left his first career to study medicine and become a doctor.
He would later explain that he was exhausted when he did his initial examination of Elise.
Adhering to an inherently dangerous roster and Queensland Health policy that should shame every bureaucrat and executive who endorsed it, the doctor had been assigned to work a 24-hour shift.
When Elise was brought in by her worried parents, the doctor on duty was 19 hours in.
Severe fatigue will impair the judgment of anyone. Strict rules ensure airline pilots get adequate rest and there would be a public outcry if they were rostered to work 24 hours.
The clinical judgment of the doctor at Caloundra Hospital who examined Elise had to be severely impaired after 19 hours of work. Despite their overwhelming concerns, Elise’s parents were effectively turned away and told to keep an eye on their daughter.
If the head injury Elise had suffered had been handled with appropriate concern, she would have been sent to a larger hospital for an immediate CT scan.
There would have been time to relieve the pressure building from the accumulation of blood before her brain’s soft tissue was crushed.
Elise died at 5.45pm on January 9, 2002.
As Gerard noted: “As she died, peace came to her tormented face and her spirit and beauty rained over us all.”
Michael Redmond, a neurosurgeon, stated in a report at the time: “It is considered unacceptable for a patient, following head injury, to ‘talk and die’.
“Elise Neville is one who ‘talked and died’. In a responsible medical system such as we enjoy, with such access to hospitals of ascending levels of sophistication, it is tragic and unacceptable that an event such as this should occur.”
Johannes Wenzel, a specialist in emergency medicine, wrote: “I see it as a system problem that our public hospitals put junior doctors into positions where they have to deal with presentations beyond their expertise … combined with the fact that working long shifts reduces the decision-making ability to a similar level as a person with .05 per cent blood alcohol content.”
The doctor who had seen Elise at Caloundra Hospital when there was still time to diagnose her injury and save her would later be prosecuted and disciplined – with his employer’s blessing – for unprofessional conduct.
In his defence, he wrote: “I would sincerely hope that doctors are not rostered on for any longer than a 12-hour shift. Twenty-four-hour shifts without a break are excessive and dangerous, and no patient or doctor should ever be put through the devastation that both the Nevilles and my family have had to endure.”
Gerard brought his daughter’s case to public attention in 2004, even though he knew it would invite scrutiny of his own role. As he said to me: “I know people look at me and say ‘how did this happen, how did you let this happen?’
“Of course I have blamed myself. I’m a doctor and I’m a father. It’s tragic. It’s a cancer. It eats away at you. I don’t trust Health at all. I don’t respect Health and I work there. It’s a terrible dilemma.
“Now I have a more important job to do. I’m trying to bring the Queensland health system into the 21st century. I want to see some honesty in the health system. If this can put pressure on the system to respond in a learning way, then it is worth it.
“Maybe I have been relentless, but I’m going to stay that way because the truth leads to findings and they will lead to recommendations that can improve things.”
The ensuing lengthy weekend article about Elise Neville’s fate and the mission her father Gerard had embarked upon touched Toni Hoffman. At that time, she and other nurses and doctors were alarmed by Patel but hospital managers were unsupportive.
Toni reflected on Elise and the Neville family when we met again ahead of the release of the Sick To Death podcast.
“The whole story just really broke my heart and I was angry,’’ Toni said.
“I was angry at the lack of resourcing and the lack of accountability for the resourcing.
“I was angry at how dismissive doctors and nurses can be to patients and their families, and how dangerous that can be.
“And I was angry that Queensland Health had expected the doctor to work a 24-hour shift, and then when he made an error, just hung him out to dry.
“It really struck a nerve with me and I read it and then I contacted you to say ‘I’m working at a hospital in regional Queensland where we’re encountering some serious issues’.”
Gerard lost his stoic wife Lorraine earlier this year.
When he and I caught up recently, he too reflected on the events of the early 2000s.
How his daughter’s death was the start of a chain of events that culminated in the unmasking of a dangerous surgeon, Patel, then a public inquiry with far-reaching reforms and a multibillion-dollar boost in funds for Queensland Health.
Gerard knows it started with Elise. She lit something. But it’s no consolation. He has only ever wanted his daughter back.
Do you know more? Contact Hedley Thomas and the team at sicktodeath@theaustralian.com.au
The Australian’s podcast series Sick To Death, based on the book by Hedley Thomas, is available on all platforms.
Subscribers hear new episodes of Sick to Death first. Listen at sicktodeathpodcast.com, in The Australian’s app or search for “Sick to Death” on Apple Podcasts to connect your subscription.
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