An Indigenous man who died after being misdiagnosed with a drug-induced syndrome had previously told a relative he was "really scared" of going to hospitals, an inquest has heard.
Kamilaroi-Dunghutti man Ricky 'Dougie' Hampson Jr, 36, presented to the emergency department at Dubbo hospital in regional NSW on August 14, 2021, with "ten out of ten" pain and feeling a "popping" sensation in his stomach.
He died on his friend's couch from two perforated duodenal ulcers on August 16, less than 24 hours after being discharged from the hospital with over-the-counter painkillers.
Emergency doctor Sokol Nushaj previously told the inquest he misdiagnosed Mr Hampson Jr with cannabinoid hyperemesis syndrome (CHS), which he blamed on "cognitive bias."
The condition can be seen in cannabis users and displays a variety of symptoms, including vomiting, abdominal pain and nausea. Mr Hampson Jr did not display symptoms of nausea or vomiting.
One doctor previously said she hadn't much experience with the diagnosis outside of Dubbo and the inquest has heard the diagnosis of CHS was not uncommon amongst Indigenous patients who presented to Dubbo hospital.
Mr Hampson Jr was given droperidol - an intravenous drug used to reduce vomiting and nausea - along with morphine.
Deputy State Coroner Erin Kennedy is being asked to consider whether factors such as bias and racism played a role in the medical treatment Mr Hampson Jr received.
On Thursday, the inquest heard from an Indigenous doctor who was the overnight emergency registrar at the hospital on the evening of August 14.
Jamee McBride, who said his role often involved seeing up to 65 patients during the height of the Covid-19 pandemic, told the inquest his senior colleague, Dr Nushaj, had mentioned the CHS diagnosis around midnight during their handover.
He said he wasn't aware Mr Hampson Jr was Indigenous and that would have led to a different approach to treatment had he known.
"We're all taught and aware that Indigenous people are a more vulnerable population," Dr McBride said.
"I understand the complexities of being an Indigenous person seeking healthcare."
The barrister for some members of the Hampson family, Callan O'Neill, told the inquest of a time Mr Hampson Jr wrote to a sick relative in 2017 apologising for not visiting them in the hospital due to being "scared" of hospitals.
Asked if he was aware of this response from the Indigenous population towards healthcare, Dr McBride replied: "Yes, absolutely."
"It is a well-known fear that lives in the community; of presenting to hospital or seeking healthcare," he said.
The doctor said it was vital for medical staff to be aware of patients being Indigenous in order to treat them accordingly. Mr Hampson Jr had a box ticked on his medical form identifying that he was Indigenous, but now a small icon has been introduced, alerting staff to a patient's Indigenous status on their computerised records.
Dr McBride said challenges remain for Aboriginal people receiving healthcare, arguing there maintained a lack of understanding and awareness by medical professionals of what it means when an Indigenous person presented to a hospital.
"That level of fear that exists in our community: the mistrust, the lack of trust - or no trust - in the hospital system [is] quite a complex topic," Dr McBride said.
"I don't think our culture is completely understood by non-Indigenous people.
"The understanding of culture; the basics of it, the nuances of it…to feel culturally safe".
On Wednesday, some members of Mr Hampson Jr's family walked out of the court house when Dr Nushaj apologised at the end of his appearance at the inquest. On Thursday, Mr Hampson Jr's father, Rick Hampson, said they didn't want an apology in a speech outside of the courthouse.
"I've been hearing "sorry" my whole life. It's time to move past sorry. We want change," he said.
The inquest continues.
13YARN 13 92 76
Aboriginal Counselling Services 0410 539 905
