The Mackay Base Hospital is investigating two cases of children presenting to its emergency department and ending up in induced comas.
The hospital has been criticised by parents of the children for failing to detect a button battery in a one-year-old girl's throat and misdiagnosing pneumonia as gastro in a three-year-old girl.
The one-year-old's parents have also called the hospital into question for turning them away due to a lack of beds.
An online fundraising campaign was set up by the three-year-old's aunty on behalf of her mother, Michelle Doran.
It stated the child, Poppy, had "been in an induced coma for the past 12 days in Townsville due to being misdiagnosed initially with gastro and sent home, when in fact she had pneumonia and para-influenza in both lungs".
The hospital is internally investigating its handling of both cases.
But Chief Medical Officer Charles Pain said he had no reason to believe the judgement of the doctors involved in the two paediatric cases was inappropriate.
Decision not to X-ray
Speaking to the media on Thursday, Dr Pain said there had been an initial investigation into Poppy's case.
"We know most the facts ... we are still further investigating and we won't draw a conclusion about that," he said.
However, Dr Pain said he wanted to address the care provided in the case of one-year-old Amity Buchanan, who went more than 28 hours with a button battery burning in her throat before it was diagnosed on her second presentation to the emergency department.
On Monday, March 13, Amity was taken to the Mackay Base Hospital via ambulance and was seen by a doctor who sent the family home.
On Tuesday, her parents Daniel Buchanan and Jemma Lang took her to a private GP, who told them Amity needed an X-ray.
The family said after receiving an X-ray, which discovered the button battery, they were sent back to the waiting room.
That night, Amity Buchanan was flown to Townsville for emergency surgery, before being taken to a Brisbane hospital where she spent two nights in an induced coma.
She was released from hospital two days ago but the family has stayed in Brisbane for check-ups.
"Apart from a three-centimetre ulcer … it's looking really good — no feeding tubes or anything, which is great," Mr Buchanan said.
But he said his little girl was still struggling to eat.
Dr Pain said "the critical question that has arisen" was around the hospital's initial decision not to do an X-ray.
"Queensland-wide guidelines are developed by experts," he said.
"[When] interpreting those guidelines, we will make sure that whenever history is taken of the ingestion of a foreign body, we will have witness evidence as to what was actually taken.
"One thing we will do from now on is to specifically ask the parent if they witnessed the child swallow the object.
"If they did not, it will influence our decision on whether to X-ray."
In the case of Amity Buchanan, it was initially suspected by her parents that she may have swallowed a polystyrene bean.
However, they did not know this for certain.
"If we X-rayed every child that came in who had swallowed something … it would mean exposing a lot of children to X-rays which are unnecessary," Dr Pain said.
"Most foreign bodies are innocuous and pass through.
"The judgement at the time and the decision-making at the time is not really in question in my view.
"I think it's a good lesson for all of us that having absolute witness evidence of what has actually been swallowed is important."
Community concern
Dr Pain said he was aware there was a bed shortage but wanted to reassure the Mackay community there would be care available.
"That's why we're building a new wing and we'll have [an additional] 128 beds," he said.
"The shortage of beds will never be a reason for not getting good care … we will always find somewhere to treat someone if they need admission.
"There are some concerns that people are not being listened to, and we as an organisation have taken that extremely seriously.
"The best thing we can do is listen and make sure we're learning from those and make sure we respond appropriately and I hope we're doing that."
