Reprimand for nurse present at Christian community death

Medical Observer, Australia/May 22, 2013

A nurse based on a remote Christian community where a woman died following a doctor's refusal to send her to hospital has been ordered to take courses in ethics and clinical decision making.

The order came after the NSW Medical Tribunal cleared Dr Christopher Maendel, the community doctor at Danthonia near Inverell, of professional misconduct despite his refusal to refer his mother Irene Maendel, 70, to hospital after her collapse in 2010.

Dr Maendel was the religious group's medical officer when his mother, who was staying on the community grounds while on a visit from the US, was found unconscious and vomiting in a bathroom.

After she regained consciousness, Dr Maendel diagnosed his mother with a subarachnoid haemorrhage from an aneurysm. But instead of sending her to hospital for a CT scan to confirm the diagnosis he treated her with morphine until she died six days later on the property.

The NSW Health Care Complaints Commission (HCCC) had called for a professional misconduct finding for Dr Maendel, which could have led to his registration being suspended. But instead the tribunal accepted his lesser plea of unsatisfactory professional conduct, saying his actions "must be seen as a sincere attempt to act in the best wishes of his mother".

This week the Nursing and Midwifery Professional Standards Committee (PSC) said the HCCC had also prosecuted two nurses based on the property – Anthony Peter Fischli and Andrew Blough.

The HCCC had said the nurses "failed to question Dr Maendel about his decisions not call an ambulance, to provide palliative care in the absence of appropriate investigations and to treat his own mother".

This week the PSC ruled the complaint against Mr Blough, the more junior of the nurses, was unproven but found Mr Fischli, who had a directing role in Ms Maendel's care, guilty of unsatisfactory professional conduct.

The committee noted "the nurses worked quickly and effectively to stabilise the patient" but cautioned Mr Fischli and put conditions on his registration including that he must complete courses in ethics and clinical decision making regarding deteriorating patients.

To see more documents/articles regarding this group/organization/subject click here.