An intensive care doctor who saw Rozalia Spadafora on the morning she died said he would have properly reviewed her if he had known the full picture of her health.
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Dr Abhinesh Dhital said he spoke briefly to some other medical officers about Rozalia at the end of his shift on July 5, 2022.
Rozalia died that evening, with doctors believing it was from heart condition myocarditis following an Influenza A infection.
Not a review, doc says
The court has previously heard from paediatrician Dr Callum Jarvis that he asked intensive care doctors to review Rozalia on the morning of July 5.
Dr Dhital decided to accompany his more junior colleague, Dr Conan Hall, to see Rozalia because she was a child.
"Because it was a child involved ... I did want to get a more clearer picture [to hand over to the day team]," he said.
Dr Dhital said because it was the end of their shift, the intention was not to formally review Rozalia but get a picture of her situation to pass on to the day ICU team.
Dr Dhital said he and Dr Hall talked to Dr Jarvis and resident medical officer Dr Kevin Tee.
Fluid overload concerns
Dr Dhital said he understood the doctors wanted ICU input because the amount of fluid Rozalia had been given was a "trigger" for an ICU review.
On Monday, Dr Hall also told the court he understood doctors were concerned of fluid overload.
Dr Dhital admitted he wasn't aware of an official protocol requiring that, and he did think she might need ICU support down the line.
He said that because the intensive care unit was for adults only, he did not know the normal ranges of things like heart rate, blood pressure or white cell count for children.
Neither Dr Dhital nor Dr Hall reviewed Rozalia's notes, charts or physically examined her. Dr Dhital said he was not told that Rozalia might need support for her heart.
There were no notes recorded of this interaction. Dr Dhital agreed that in hindsight, that would have been useful for other clinicians.
Miscommunication
He said he believed a senior paediatrician, Dr Anne Mitchell, was on her way to review Rozalia. He was not aware that she was the person who had ordered an ICU review.
A morning ICU doctor, Dr Mitchell Wilcox, said he understood that Dr Dhital and Dr Hall had been called to an emergency, which is why they didn't take notes.
Dr Wilcox also said he did not formally review Rozalia because he thought his night-shift colleagues had already done so, despite not seeing any notes to that effect.
"I was under the impression they had reviewed Rozalia ... I wasn't sure to what extent ... I was under the impression that she had been reviewed to an extent," he said.
Dr Wilcox said he was told by emergency staff that paediatric consultant Dr Anne Mitchell was happy for Rozalia to be transferred from the higher care emergency ward to a paediatric ward.
Because of that, he believed she did not require another ICU review.
"In hindsight I should have called directly to confirm that [and asked if the paediatric team] required more ICU input," Dr Wilcox said.
Handover
Dr Dhital was asked what he would have done if he was aware of observations and pathology results that suggested Rozalia was not improving.
He said he would have reviewed Rozalia's notes, examined records and trends over time, physically examined her and consulted with an ICU consultant.
He said he was not at the night-to-day-shift handover, but told Dr Hall to ask the ICU day team - including Dr Wilcox - to properly review Rozalia.
"What I wanted to happen is somebody goes down [to see her] even if we are not called [just] to be aware of what's happening," Dr Dhital said.
He said sometimes patients would deteriorate and end up in the ICU, so it was better for the team to be familiar with the patient in case that happens.
The inquest continues on Tuesday afternoon.
Lanie Tindale
I am City reporter at The Canberra Times. I previously covered health for the masthead, and was a trainee before that. I have written on courts, federal politics, breaking news, features and opinion. lanie.tindale@canberratimes.com.au.
I am City reporter at The Canberra Times. I previously covered health for the masthead, and was a trainee before that. I have written on courts, federal politics, breaking news, features and opinion. lanie.tindale@canberratimes.com.au.
