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Indigenous man's agonising pain misdiagnosed in days leading up to his death

Dechlan Brennan -

A junior doctor had limited knowledge of the syndrome with which an Indigenous man was wrongly diagnosed at a NSW hospital whilst in significant pain, an inquest has heard.

Dr Lisa Hu was a resident medical officer at Dubbo Hospital in 2021 when Kamilaroi-Dunghutti man, Ricky 'Dougie' Hampson Jr, presented to the hospital in severe pain, reporting a "popping" sound in his stomach.

Dr Hu, along with her senior colleague, who cannot be named, incorrectly diagnosed Mr Hampson Jr with cannabinoid hyperemesis syndrome (CHS). Side-effects of CHS are vomiting and nausea - both of which Mr Hampson Jr was not suffering or displaying - along with abdominal pain.

He had previously recalled smoking cannabis in the previous 24 hours.

The inquest is examining if prejudice played a role in the treatment of the 36-year-old after he arrived at Dubbo hospital on August 14, 2021, with "ten out of ten" pain.

He died on a friend's couch from ruptured duodenal ulcers on August 16, less than 24 hours after being discharged from the hospital with over-the-counter painkillers.

Counsel assisting the coroner, Simeon Beckett SC, told the inquest on Tuesday a review by a medical expert said the symptoms displayed by Mr Hampson Jr showed a significant problem.

"If there had been an abrupt onset of severe pain, never experienced before, accompanied by tearing, a serious diagnosis should have been considered and excluded," the expert said, according to Mr Beckett.

Dr Hu said she passed on information Mr Hampson Jr had experienced a "popping or tearing" sensation to her senior colleague. The colleague then mentioned CHS, of which Dr Hu had limited knowledge.

"I would have only heard of it in passing," she said when asked about her knowledge of CHS.

"I have never really thought about it in a diagnosis."

Dr Hu said she "didn't take a detailed history on his longer-term use" of cannabis use by Mr Hampson Jr, but believed she told her senior colleague he did consume the drug in the recent past.

"I think I would have talked about the fact that he smoked marijuana…that's just a part of the drug and alcohol history," Dr Hu said.

"I would usually report everything that was documented."

CHS became the "working diagnosis" for Mr Hampson Jr, and a plan was formulated to give him droperidol - an intravenous drug used to reduce vomiting and nausea - along with morphine.

Both her and her senior colleague had a 'review' at 7pm where she was told the administering of droperidol had occurred. Dr Hu said Mr Hampson Jr began yelling in pain when she visited him in his room at around 7pm.

She said both CT scans and X-rays were available at the hospital, acknowledging a lack of clarity on who could order them.

"For an abdominal image it's a little bit grey…for CT scan it's something that definitely should be discussed."

Asked by solicitor advocate Holly Fitzsimmons, on behalf of Mr Hampson Jr's de-facto partner, if she thought at the time an X-ray should have been called, Dr Hu said: "I can't remember now, but it's likely."

She said the plan for Mr Hampson Jr was for him to be discharged when he was more alert, however he was kept overnight after both Dr Hu and her senior colleague checked on him.

Mr Hampson Jr was eventually discharged on the 15th and previous evidence submitted to the inquest noted he was in "obvious discomfort. Dr Hu said she assumed a "senior [employee] would see him at some point" before being discharged.

Asked what she could have changed anything from the treatment, Dr Hu said: "I think I could have…considered the differentials more and perhaps [been] more assertive in asking for more rationale and suggested some investigations."

The inquest continues.

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