'Not surprising' Rozalia Spadafora waited hours in Canberra Hospital ED, Dr Tze Hoa Wong agrees

Dr Tze Hoa Wong was the paediatric emergency department registrar on the night shift, and the first doctor to treat Rozalia, who died at Canberra Hospital on July 5, 2022.

Dr Wong agreed that patients like Rozalia, who was triaged as category three, an urgent patient, should have been seen within "30 to 45 minutes".

When asked by counsel assisting Michael Fordham SC, "you weren't particularly surprised" that an urgently sick patient would wait that long to see a doctor, Dr Wong said "no."

Dr Wong was a paediatric emergency doctor, the only one responsible for six beds and two consultation rooms for children within the emergency department.

He agreed he could have been called to another more urgent patient. This did not appear to happen on the night Rozalia was Dr Wong's patient.

His evidence appeared to reveal poor communication between the paediatric and emergency departments within the hospital.

Despite Rozalia also being treated by paediatric consultant Dr Callum Jarvis, there was no joint handover between the paediatric and emergency staff in the morning, Dr Wong said.

A few hours before the morning handover, Rozalia had been moved from a paediatric emergency bed to a resuscitation bed.

When she moved, she was being cared for by Dr Kate Watson, Dr Wong said.

Dr Wong said when his shift finished at 8am, he handed over Rozalia to a morning doctor, Dr Kirsty Dunn, who was responsible for the resuscitation beds.

Because there was no plan to move her, Dr Wong did not discuss her with the morning paediatric emergency doctor.

However, she would soon be sent back to that paediatric ward, to a doctor who had not been briefed on her condition overnight.

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Dr Wong also agreed he was not aware of a guideline or document which prescribes how handover should happen in the morning.

Dr Jarvis, a locum doctor from Queensland who works in different hospitals, said it was not custom in other hospitals for a speciality team to join an emergency department handover.

He said any plan to transfer a patient would require a "phone call" between the paediatrician and emergency department.

After an initial consultation with Rozalia, Dr Wong contacted the paediatric registrar on shift that night, Dr Jarvis.

Dr Wong said he was not aware that Dr Jarvis had ordered a blood test on the morning of July 5.

These blood test results confirmed Rozalia had Influenza A. She is ultimately believed to have died from myocarditis, a complication of the flu.

Dr Wong said when he initially saw Rozalia after midnight on July 5, he thought "she looked like a child that had a viral infection".

"She looked like a child that was dehydrated."

Mr Fordham repeatedly questioned whether Dr Wong had adequately explored the possibility of Rozalia having the flu, and whether he communicated that suspicion to other clinicians.

Dr Wong said he did not make comprehensive notes about Rozalia's vital signs or the possibility she had a viral illness because the retrospective notes were supposed to provide a summary.

However, he did agree his concerns that Rozalia may have had a viral illness would have been relevant for the next clinician, and it would have been helpful to record that in the retrospective notes.

He said he thought Rozalia was probably dehydrated and did not consider taking her blood pressure. He said results from vitals did not raise concerns from him, or make him think she had the flu.

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