A pneumonia patient who died after being discharged from an Adelaide Hills hospital in 2018 arrived on a night that was "frantically busy" and chaotic, South Australia's Coroners Court has been told.
Lynne Patricia Fisher — who had five children and six grandchildren — died at home from sepsis due to pneumonia after she was discharged from Mount Barker District Soldiers' Memorial Hospital in September 2018.
Doctor Fenella Livesey initially treated Ms Fisher and told the court she tried to persuade the 60-year-old to stay in hospital before her shift ended.
"In hindsight, I should have been more insistent," Dr Livesey said.
The court heard Ms Fisher arrived looking very unwell, and was struggling to breathe and answer questions by medical staff.
Dr Livesey told the court Ms Fisher had been administered medication and her condition improved once she received oxygen.
"She was speaking full sentences, her colour looked good, she had something to eat and drink," she said.
Dr Livesey said she wanted to keep observing the patient to see if she was stable once she was weaned off the oxygen.
"Before I went home at 11pm, I ducked my head in, but she was still on oxygen. I was quite frustrated the nurses hadn't done anything with the oxygen," she said.
'Hurried' note on busy night
Dr Livesey admitted her written handover note to the overnight doctor was "totally inadequate".
The note said "discharge home [with medication], bed rest, GP follow-up the following day or next 24 hours return to the ED".
"That's unfortunately a hurried note that I wrote. I did have full intentions of going back and doing a progress note," Dr Livesey said.
"It was just so frantically busy."
The doctor disagreed the note was a discharge plan to be followed through by the overnight doctor, Mei Leng.
"It's not what was verbally handed over, that was the whole point of her remaining in the department — to see how she coped without oxygen," Dr Livesey said.
"I told Dr Leng that my plan had been that I wanted to admit this lady, but she refused — and so we agreed to see what would happen as we weaned her off oxygen."
The court will next hear evidence from emergency physician Anne-Marie Kelly.
