Inquiry into Patient Death

Report for the Bunbury Regional Hospital’s quality and safety committee into the death of Josephine Wilma Troy

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Introduction

This report has been prepared for the Bunbury Regional Hospital’s quality and safety committee, following the death of Josephine Wilma Troy on 14 February 2006. Mrs. Troy was a 63 year old lady who had been diagnosed with leukemia in 2004 and was treated with chemotherapy initially. The diagnosis was later refined to prolymphocytic leukemia, a rare chronic leukemia, as Mrs. Troy’s leukemia persisted in her bone marrow after an initial course of chemotherapy. Disease together with chemotherapy compromised her blood production capacity. She had low white blood count, low platelet count and low hemoglobin and was susceptible to infection and febrile neutropenia. Mrs. Troy had been issued with febrile neutropenia card to warn health care workers regarding her susceptibility to febrile neutropenia.

On 12/02/2006, Mrs. Troy had a temperature of 38°C and attended Bunbury Regional Hospital with her card. She was started on antibiotic and a full blood screen was ordered in view of her susceptibility to febrile neutropenia. She recorded a very low platelet count (3), which required a platelet transfusion. She was admitted to St. John of God Hospital, Bunbury for treatment of neutropenia sepsis. The following day her platelet count dropped even lower (1). An order was placed for platelet from Australian Red Cross Blood services. She was transfused with two units of blood. There was apparent improvement in her condition after the blood transfusion. In the early hours of 14/02/2006, Mrs. Troy suffered a significant deterioration in her condition. The platelets were transfused in the morning of 14/02/2006. However Mrs. Troy suffered a catastrophic intracranial bleed and did not recover from it.

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Objectives

This report will look in to the events that lead to death of Mrs. Troy and critically evaluate the key findings. Finally it will make recommendations to reduce the reoccurrence of similar adverse event. It is expected that the recommendations will be examined and will be included in to clinical guide lines and policies by this hospital and other hospitals.

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