This decision out of the District Court of Western Australia provides substantial precedence for medical negligence and reasonable care, as regards instances of personal injury resulting from mental harms to patients.
Issue
The question in this case was whether or not it was reasonably foreseeable to the hospital that a patient would experience a psychological trauma, due to a medical error and subsequent lack of reassurance, as to incur a breach of the duty to take reasonable care.
Overview
This case concerned the plaintiff, Ms Stanton, who was admitted to King Edward Memorial Hospital in 2017 after being alerted that she was going into early labour. The plaintiff was informed by hospital staff that she would need to be administered with a magnesium sulphate infusion, which could cause possible side effects including feeling unwell or getting a hot flush. These were symptoms she had experienced before when medicated for previous pregnancies. The purpose of this medicine was to protect the brain and central nervous system of the baby, in the event of a premature birth. Due to being given the incorrect dosage, the plaintiff entered a stress-induced early labour which required an emergency caesarean section in the following hours. The baby was delivered safely, however the mother experienced various mental harms during the ordeal, that later led to a diagnosis of ongoing psychiatric disorders including PTSD.
Background and Facts
In the court proceedings, the plaintiff argued that the hospital had breached their duty of care which extended to not impairing the mental condition of the patient under s 5S of the Civil Liability Act 2002.
This medical error occurred as follows. During a nurse hand-over, the plaintiff was mistakenly administered a dose of 8 grams of magnesium sulphate in the span of 38 minutes by Midwife Wissemann, when hospital protocol instructed that the dosage be slowly administered over a 4.5-hour period.
The patient began to experience rapid symptoms that did not match her past experienced and grew severe, including hot flushes, dizziness, a slow heart rate, inability to move her hands and feet, and floating in and out of consciousness. She recalled that her calls for attention were met with ‘passive’ comments from nurses passing her off. The plaintiff described how one midwife, unaware of the excess dosage, verbally reassured the plaintiff that everything was ‘normal’ without attending her bedside to check, despite the plaintiff’s insistence that something was wrong, and she was worried her baby might die. Her major symptoms went ignored as she passed in and out of consciousness, until she signalled to her husband, Mr Moffatt, to take the cannula out of her wrist and turn off the dosage dispenser. Per Mr Moffatt’s testimony, it was only after he alerted Midwife Wright of the empty bag that any action was taken, and his wife’s symptoms acknowledged.
Evidence given by the defendant’s witnesses claimed otherwise. The testimony of the midwife who discovered the overdose, Midwife Wright, contended that he had been attentive to a normal extent and was simply providing standard reassurances, until he realised by himself that the wrong dosage had been given. He then quickly alerted other staff of the emergency. Midwife Wissemann, who was suspected to have made the error and was present in the room at various times, provided vague recall that the hospital staff stepped into action quickly and diligently once the mistake was discovered.
Hospital liability and Duty of Care
While the dosage mix-up was an honest mistake, the court found that the hospital had breached its duty of care to not invoke mental harm upon its patients. The Court favoured the plaintiff’s recollection of events, that the hospital staff had indeed not adequately reassured her that she and the baby were safe under their care. The plaintiff suffered psychiatric trauma as a result of the consequential mental harm, worsened by her impending early labour, and accentuated by medical staff who failed to pay attention to her symptoms and concerns. The Court found that expert maternity staff in an experienced position should have been able to adequately address the patient’s psychological needs. Further, it was foreseeable to the staff that a patient of normal fortitude might suffer psychiatric illness if reasonable care in the stress-inducing and traumatic event was not taken.
Result
Thus, the defendant did owe a duty of care to limit mental harms to the patient under the Civil Liability Act. The plaintiff was awarded damages for both past and future medical losses and loss of earning capacity, in the total sum of $177,836.41.
This decision provides strong precedence supporting the legal reality that hospitals and healthcare providers can be held liable for breaches of care for mental harm resulting from inadequate responses and communication.
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