A woman whose husband suffered irreversible brain damage when a nurse gave him too much morphine says she's lost her partner and her daughter has been "robbed" of her dad.
Dargaville resident Trevor Flood, 59, was admitted to Auckland City Hospital in February 2019 because he was dehydrated and in pain after receiving radiation therapy for throat cancer.
While he was being treated, he was accidentally given too much morphine which caused brain damage.
On Monday, Deputy Health and Disability Commissioner Dr Vanessa Caldwell found Te Whatu Ora Te Toka Tumai Auckland and the nurse involved breached the Code and failed to provide adequate care.
Along with several recommendations, Dr Caldwell told the nurse and Te Whatu Ora to formally apologise to Trevor and his family. She also referred Te Whatu Ora to the Director of Proceedings.
Trevor's wife Kylie Flood, 46, told Newshub she's glad the mistake has been acknowledged, but it hasn't undone the damage.
"It was to be expected. I guess it's just sad reading it [the HDC report]," Kylie told Newshub.
She's also angry at everything she and her family have lost and will continue to lose for the rest of their lives.
"[I felt] a little bit angry. Especially because of how much my husband has deteriorated since this happened," she said.
"When I first made the complaint, it wasn't as bad but now he has definitely deteriorated over the years and most likely will just keep deteriorating, which is sad."
Before the overdose, Trevor was a hard worker and spent his free time tinkering with cars and motorbikes with their daughter. But now even the simplest tasks are nearly impossible and he relies on Kylie and his carers for everything.
"He was doing real physical work with machinery - stuff where he had to really concentrate… And now he can't change the TV, he can't use his phone, he struggles to remember things, and he can't make decisions. He's just basically, I guess, a shell of his former self really. He's totally reliant on me," she said.
They've recently increased his carer's hours because he was trying to walk to Kylie's work when he was left alone.
Kylie is happy to care for him, but it's completely changed their relationship. She feels more like a carer than his wife.
"You don't go into a relationship or marriage thinking you're going to have to be someone's caregiver. But I guess it's just changing our whole way of life.
"In the mornings, I get up and make sure he's showered and dressed and that everything is in place before I go to work.
"It's all these things I wouldn't normally have to worry about, but now I do. I have to make sure all the bills and everything is paid. I have to do all the cooking. He used to love cooking and doing the gardens and building things."
Kylie said it's also destroyed the life they planned together, including renovating their home and growing old together.
"We planned to do renovations on the house, which is not going to happen now. We really can't afford it and Trevor would have done most of the work.
"So all those things are now gone. It's hugely impacted us. Everything has changed, nothing is the same."
It's taken a toll on their 24-year-old daughter as well. Kylie said she's been "robbed of her dad".
"He was into mechanics and they would go out there and tinker on her car. He would go fishing with her and now all those sorts of things, he just can't do."
Kylie said while she's glad the Health and Disability Commissioner found the hospital and nurse in breach, she wishes it never happened at all.
"I know nurses are really overworked and understaffed and I know from the hospital's investigation, they ended up changing some of their procedures and getting an extra nurse and those sorts of things. I just wish we weren't the crash test dummies or the catalyst for this to change," she said.
"I know the nurse didn't go to work and think, 'Right whose life am I going to ruin today?'. I know it was an accident, but I do wish more care was taken."
It's a sentiment shared by Dr Caldwell who found Te Whatu Ora Te Toka Tumai Auckland breached several parts of the Code of Health and Disability Services Consumer’s Rights.
She said Te Whatu Ora Auckland's policies weren't clear enough to support safe practices.
"This is evident in the practices followed by staff that were not in line with the expected standard of care. Opiates are known to suppress breathing and to affect renal function. The risk for this patient was not monitored adequately."
She also criticised the nurse's lack of monitoring and documentation, in particular, failing to record the Code Red event and for leaving the man on his own while getting assistance, instead of undertaking an immediate assessment and raising the alarm.
Dr Caldwell made several recommendations for Te Whatu Ora including training for nursing staff and considering implementing a quick reference guide for managing opioid overdoses. The nurse was told to have further training on emergency protocol and documentation.
Te Whatu Ora has made several changes in response to the overdose, including improving support for nurses and non-palliative patients, developing appropriate policies and training and expanding access to the Acute Pain Service for oncology ward patients with acute pain.
The nurse has also undertaken basic life support training and developed processes to prevent it from happening again.
