Mackay Hospital and Health Service has undertaken a preliminary review of the care provided in the recent case of a child who swallowed a button battery.
A more extensive review is still ongoing as part of our usual established internal patient safety processes. We will also be communicating with the family as part of this.
I am delighted to hear that Amity continues to improve as she recovers.
Mackay Base Hospital, like all public hospitals, follows the state-wide guideline that provides clinical guidance for all staff involved in the care and management of a child presenting to emergency with a suspected or confirmed ingested foreign body.
The ingested foreign body guideline was developed by senior emergency clinicians and paediatricians across Queensland, with input from specialists at the Queensland Children’s Hospital in Brisbane.
The critical question that has arisen in the Mackay case is about the decision not to initially x-ray.
When a doctor is making that judgement, they will be guided by the history that is given about what the child has eaten.
And if a doctor is given a clear story that they’ve eaten a particular thing, then they won’t want to expose that child to radiation from an x-ray.
In retrospect it is easy to say that an x-ray should have been done to reveal the battery.
The initial information provided to the hospital was that a polystyrene bean had been swallowed and this would not have shown up in an x ray.
We do not routinely perform a CT scan on children who have swallowed a radiotransparent foreign body if their clinical presentation is normal.
From our initial investigation I believe the decision not to x-ray was an appropriate judgement to make based on the information presented and the clinical examination of the child.
However, one thing we will do from now on is to specifically ask the parent if they witnessed the child swallow the object. If they did not, it will influence our decision on whether to x-ray.
