Ambulance delays 'unlikely to have caused deaths'
Three elderly people whose ambulances broke down before they could be taken to hospital would almost certainly have died even if the vehicles had been in working order, doctors have said.
The doctors were testifying yesterday at an inquest at the Coroner's Court into the deaths of Chung Tak-shing, 60, Hui Ching, 86, and Loh Tchen-tong, 79, who died after the ambulances that were called to transport them broke down. The three cases occurred within weeks of one another, on July 20 and 28, and August 15 last year, respectively.
Each of the patients had to wait about 10 minutes for a replacement ambulance after the first one experienced problems. Chung's and Hui's ambulances failed to start, while Loh's could not drive up a slope.
One of the medical witnesses said that had Hui arrived at hospital 10 minutes earlier, her chances of surviving would still have been near zero, while another said Loh's delay in reaching a hospital was not the determining factor in whether he would have survived. Another doctor had said earlier it would have been impossible to save Chung had the first ambulance been able to start.
Chung was a diabetic with heart problems who regularly underwent dialysis. Hui had high blood pressure, diabetes and other high-risk conditions. She also had atrial fibrillation, or abnormal heart rhythm. Loh had high blood pressure and wore a pacemaker. The court had earlier heard how Chung's and Hui's ambulances were delayed. Yesterday, it heard Loh's case.
Loh was taking a walk in Por Lo Shan in Tuen Mun at about 6am when other pedestrians found he had collapsed. An ambulance was called. Ambulance crew found him lying face down, and when they turned him over, found his face blue and bleeding. They performed cardiopulmonary resuscitation on him, the court heard.
Driver Lam Pok-man said that after starting the ambulance, he drove uphill along the steep, single-lane road to find a place to turn around and leave. However, when he reached a right turn, the vehicle would not budge, even when he stepped hard on the accelerator and shifted gears.
The ambulance supervisor called for another ambulance. In the meantime, Lam managed to retreat downhill by reversing for 450 metres until he could drive forward again, so the supervisor radioed that they no longer needed another ambulance. The reversing took seven to eight minutes, Lam estimated. An incident log showed a lapse of 10 minutes between the request for reinforcement at 6.30am and the release of the second ambulance.
The ambulance reached Tuen Mun Hospital at 6.52am and Loh was declared dead on arrival. A pathologist's report read in court said he died of coronary occlusion by atheroma, in which blood flow in a coronary artery is blocked.
The most important thing to do when the condition caused a patient's heart to slow or stop, leading him to lose consciousness, was to perform CPR or to use an automated external defibrillator, Dr Lam Yat-yin told the court.
These steps, rather than whether the ambulance was able to leave, were the important factors determining Loh's death, the doctor said. The ambulance crew performed CPR and determined the defibrillator to be unsuitable for him, Lam noted.
In Hui's case, she felt unwell at home in Wong Tai Sin. Dr Chan Hon-wah told the court that Hui's condition resembled a sudden cardiac death. Chung fainted after taking a shower at home in Sau Mau Ping. A pathologist said he likely died of end-stage renal failure, while a doctor said she died of coronary heart disease.
The inquest, which is heard without a jury, continues before Coroner Michael Chan Pik-kiu.
