This article was first published by Stuff.
Janelle Te Purei, a mother of three, was found dead at home the morning after her second hospital visit in as many days. A report has found that staff at the hospital failed her. Senior journalist Nick Truebridge reports.
Gathered in the living room of her parents’ rural Taranaki home, Janelle Te Purei’s loved ones remember a young mum of three who was “so full of life”.
“She was my soulmate,” husband Marley Te Purei says.
“She was just the friendliest person you’d ever meet.”
Janelle’s mother, Beverley Ingram, recalls how much her daughter “loved her little girls”.
Brian Ingram, Janelle’s father, talks of his “vibrant, energetic” daughter.
“Now she’s gone,” he says.
Janelle died at home on July 19. She was found by her eldest daughter, who still struggles to sleep as a result.
A coroner has found the “fit, young” 38-year-old died of pneumonia, due to a Type A influenza infection and beta haemolytic streptococcus infection, which can cause pharyngitis.
But an internal Te Whatu Ora Report shows her death was preceded by a litany of failures by staff working at Hāwera Hospital’s Emergency Department.
Brian Ingram blames Janelle’s passing on “blatant negligence” by those working the morning of July 18, the second time in two days his daughter had presented to the emergency department.
“A life was lost that shouldn’t have been lost, just through their negligence, and the community needs to know,” Ingram says.
“She had so much good in her and they took her life - not acceptable.”
‘WE TRUSTED THEM’
Brian Ingram told Stuff the family knew at the time of Janelle’s death she had been “let down” by staff at Hāwera’s Emergency Department.
“But this report, it’s so much worse - she never had a chance,” he says.
The report is a Te Whatu Ora Serious Incident Review. It shows Janelle presented to the emergency department on the night of July 16 and the morning of July 18, when three other patients were present.
Janelle tested positive for Influenza A on July 16. By July 18, her parents say she’d been experiencing symptoms for about four days. The report adds she had developed diarrhoea and vomiting.
It goes on to reveal a series of failures in relation to Janelle’s care, specifically a failure to recognise she was deteriorating, not appreciating the gravity of her illness and a failure to escalate her care.
Documentation reviewed by the report’s authors did not describe Janelle’s response to the “limited treatment she received”, the report shows. It goes on to note a “significant lack of documentation” in relation to her care.
Janelle would have required further emergency department management that may have carried onto inpatient management, the report adds.
It also states further investigations would have been “advisable”, including consideration of an antibiotic, investigations to rule out sepsis, a chest x-ray, a blood test and a urine test. Additionally, no oxygen was given in response to low levels.
Brian Ingram, after reading the report, says he is “devastated that this could happen in 2024″.
“She never had a chance and we trusted them,” he adds.
“We took her there for help, twice.”
The report also reveals an initial primary assessment was not completed, incomplete risk assessments and adds Janelle was not reassessed by medical staff at the time she was discharged.
Her Early Warning Score (EWS), a tool used to assess deterioration, was six prior to being discharged, but the report suggests this was inaccurate.
“It is likely that this would have been a higher score but her temperature was not taken and so was not included in the calculation,” it found.
“It would have been advisable to keep her in for further observations and tests as opposed to discharge.”
Elsewhere, the report questions the anti-nausea medication Janelle received, stating “it is not usual practice to give both of these together”.
The doctor working on July 18 documented Janelle was feeling “significantly better” and was “happy to go home”.
However, according to the report, Janelle’s family disputed this documentation.
The review also covers what happened after she was discharged.
“On July 19 at approximately 2.30am, it is reported by Janelle’s mother that she expressed to Janelle that she wanted her to go back to [Hāwera ED] as she was still very unwell,” it states.
Beverley Ingram remembers that morning well.
“I wanted to ring the ambulance again and [Janelle] said: ‘I’ve been twice, what are they going to do? They don’t f...ing care’,” she recalls.
After reading the report, the family have laid a complaint with the Health & Disability Commissioner over Janelle’s treatment.
Beverley says “a doctor in their right mind” would not have sent her daughter home “as sick as she was”.
“I just can’t believe it,” she says.
‘HEADS HAVE TO ROLL’
Brian Ingram says his family has gone public for one key reason: “It’s that bad, the community need to know just what’s gone on.”
Beverley Ingram says the report shows Janelle was failed “by multiple people, multiple times”.
“We’re all human, we all make mistakes, but [this is] not just once, twice, [it’s] multiple times,” she says.
Stuff requested an interview with Te Whatu Ora in relation to Janelle’s care, but was emailed a brief, written statement instead.
“We would like to recognise the death of Janelle Te Purei and the deep impact this has had on her whānau and friends,” Taranaki Acting Group Director of Operations Wendy Langlands said.
“This case is the subject of a Coroner’s inquest, and it would not be appropriate for us to comment further.
“We always encourage patients and whānau to contact us directly if they have concerns about their own or their loved one’s care, as the family have done in this instance.”
In the report, Te Whatu Ora extended its “sincere condolences” to Janelle’s family.
“It is evident that there are deficits in the care that was provided for Janelle when she attended the Emergency Department for which we are very sorry,” the report reads.
“Although we cannot make up for your loss, please know that we are putting in considerable work to ensure that a tragedy like this does not occur again.”
Brian Ingram says “heads have to roll” in the wake of his daughter’s death.
“It’s got to be something so no family has to go through this ever again,” he says.
Brian says the doctor in question is still working at the hospital, which to him feels like a “kick in the guts”.
Beverley Ingram says her family is “broken, broken, absolutely broken” months on from Janelle’s death.
“She didn’t deserve this at all,” she says.
“Marley’s lost his wife and three little girls have lost their mum, and we’ve lost our treasured daughter.”
‘COULD’VE BEEN AVOIDED’
Marley Te Purei was away for work when his wife fell ill and was taken to Hāwera ED.
Several months on, sitting in her parents’ living room, he explains how life has changed for him and his three daughters.
“We’ll get there but now I’m working half my hours, I have to stop the mortgage payments - it’s just terrible,” he says.
“It’s something that could’ve been avoided if they’d just done their job.”
He believes the staff responsible “should be held accountable”.
“We knew it was bad, but reading the report it was worse,” he says.
“I mean, the things on there, they can’t do their job - it’s just disgusting.”
For now, his focus is on looking after the couple’s three children.
“The eldest one’s struggling a bit as she found mum,” Marley says.
“She’s struggling with sleep, struggling to go to school, and it just puts a lot of pressure on me as well, but I’ve just got to do it for them, do it for Janelle.
“The oldest one’s scared to sleep because she’s just scared that she won’t wake up, or I won’t wake up.”
Why has he decided to speak out?
“I just don’t want it to happen to anyone else and the staff at ED need to be held accountable,” Marley says.
“There’s got to be some sort of consequence happen to them - I lost my life.”
- Stuff
