Coronial inquest begins into hospital sepsis death of Christopher Essery

A coronial inquiry has begun in Cairns investigating whether a man who died in Brisbane’s Princess Alexandra Hospital from sepsis after being transferred from Cairns, received appropriate care.

A coronial inquiry has begun in Cairns investigating whether a man who died in Brisbane’s Princess Alexandra Hospital from sepsis after being transferred from Cairns, received appropriate care.

Christopher Essery, 74, died at Princess Alexandra Hospital in Brisbane on February 20, 2019.

Mr Essery was previously admitted to Cairns Hospital in May 2018, where he was treated for malnourishment and large abdominal abscesses caused by ongoing Crohn’s disease and rectal lymphoma, conditions for which he had received previous surgery and medical treatment to manage.

In August Mr Essery was transferred to the PAH before he was transferred back to Cairns in December before possible surgery.

He was again sent back to the PAH with more abscesses for which he underwent surgery in January and February including the removal of infected mesh used to treat a hernia in 2009.

Princess Alexandra Hospital

During a pre-inquest hearing counsel assisting the coroner Sarah Lio-Willie told the court the discharge summary from Cairns Hospital — which contained his medical history including reference to the 2009 hernia repair — did not appear to have accompanied Mr Essery.

On the first day of the inquest the court heard from Dr Peter Prinsloo, a general surgeon who treated Mr Essery.

Dr Prinsloo began treating Mr Essery in 2015 who had already been diagnosed with Crohn’s disease and presented with an active infection which was treated.

Dr Prinsloo said there was a flare up of the disease in 2017 which revealed a virus related lymphoma.

“The two types of treatment were conflicting in their nature,” Dr Prinsloo said.

Dr Prinsloo said Mr Essery was “very malnourished” and underweight but blood tests showed no sign of “significant infection”.

Dr Prinsloo said at that time Mr Essery’s Crohn’s disease was “out of control” so the option was to divert the fecal stream through an ileostomy — a stoma created by bringing a loop of the small intestine out onto the surface of the skin.

Dr Prinsloo told the court he was aware of the presence of the mesh from the hernia repair.

“I avoided the area of the mesh because of the small risk of introducing infection to the mesh,” he said.

The first day of the coronial inquiry into Mr Essery’s death heard from treating Dr Peter Prinsloo.

Following the ileostomy Dr Prinsloo said Mr Essery was readmitted a number of times due to dehydration with imagery taken on April 6 and 9 showing no signs of infection or complication from the ileostomy.

In May 2018 Mr Essery’s condition deteriorated and scans revealed large fluid collection abscess which was drained.

Dr Prinsloo said further scans on May 23 showed the drains had been successful and there was no indication of any infection in the location of the stoma.

Mr Essery was later transferred to Cairns hospital to undergo total parenteral nutrition to improve his malnourishment and immune system, Dr Prinsloo told the court.

Dr Prinsloo told the court he didn’t believe Mr Essery was fit for major surgery at that time.

He also told the court the removal of the mesh would be a “huge undertaking” which would need to be weighed up with the patient’s condition.

Mr Essery’s cause of death initially cited rectal lymphoma and viral encephalitis as relevant conditions, however a revised certificate issued August 30, 2019 listed sepsis secondary to Crohn’s disease and abdominal sepsis associated with inferior mass as the cause of death.

The inquest will continue until May 22.

Originally published as Coronial inquest begins into hospital sepsis death of Christopher Essery