Couple deny delaying antibiotics after elderly man’s pneumonia

By David Clarkson, Open Justice reporter of NZ Herald

A couple has challenged police allegations that they failed to provide prescribed antibiotics to a 90-year-old dementia sufferer after his discharge from hospital after a bout of pneumonia.

Christchurch District Court

Photo: RNZ / Nate McKinnon

* Warning: This story contains some disturbing content.

The police called medical evidence about the condition of the elderly man with advanced dementia – the father of the man now on trial in the Christchurch District Court – and the effects of not giving him the antibiotics prescribed for him after his discharge.

The police allegations amount to one charge of neglect of the old man in the trial which is expected to go on for more than two weeks.

The other neglect allegations are that he was locked in a room for up to 16 hours a day, clad in an adult nappy and wetsuit, without access to light, ventilation, or water.

Further charges against the son allege he stole $275,239 from the man’s bank account and the family trust account when he had enduring power of attorney, to buy items for himself, including a car.

The couple has interim name suppression because the two are indicating they will appeal against the decision of Judge Mark Callaghan at the start of the judge-alone trial to refuse suppression. Suppression would normally continue until the appeal is heard.

The trial has been shown a series of closed-circuit videos from the old man’s bedroom, when he knocked and called for help for more than an hour after soiling himself, and his efforts to clean himself up.

The police allege he had been left with no means of cleaning himself, and the son called him a “filthy animal” and threatened to assault him after one of the times when he soiled himself.

Dr Jennifer Butler, a senior medical officer at Christchurch Hospital, said the man was assessed as having a moderate risk from aspirational pneumonia when he was admitted to hospital in June 2020.

Dementia suffers sometimes contracted pneumonia because they had difficulty co-ordinating their swallowing and may inhale oral secretions or vomit.

The police case was that a prescription for antibiotics issued when he was discharged was not filled at a pharmacy for several days and then only half the prescribed pills were given to the man.

Butler said it could cause a recurrence of pneumonia symptoms if antibiotics were discontinued or not used.

Clayton Williams, counsel for the man, asked about whether the antibiotics supplied could cause diarrhoea as a side effect. She said it could happen.

Williams asked if she was aware of a practice where the nurse, at the time of discharge, could tell a carer that if the side effects were too severe the medication should be stopped.

“That is not standard practice,” she said. Nurses and doctors would tell patients to continue with all the medication, but see their doctor if there were side effects.

He also asked her about nurses giving patients some antibiotics from the ward supplies to tide them over until they could get the prescription filled. She said that would normally have been recorded in the case notes, but was not mentioned.

Giving medication might be done if a patient were discharged after hours or at the weekend. But she said a discharge at 4.24pm on a Friday – as in this case – would not be classed as after-hours because most pharmacies were open till 6pm.

The trial is continuing.

* This story originally appeared in the New Zealand Herald.

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