The "tragic reality" of the death of an Indigenous woman at Royal Darwin Hospital (RDH) was that even if her rare heart condition had been detected earlier, she could not have been saved because the hospital lacked the surgical treatment she required, the Northern Territory (NT) coroner has heard.
WARNING: Aboriginal and Torres Strait Islander readers are advised that this article contains the name of an Indigenous woman who has died.
Janelle Pamkal, 35, died of a rare aortic dissection seven hours after she was rushed to RDH from the remote community of Bulman, 300 kilometres north-east of Katherine, in July 2021.
At an inquest into her death, NT Coroner Elisabeth Armitage today heard Janelle – as her family requested she be called — had been taken to hospital suffering mental health issues and later complained of chest pain.
Doctors noted she had a high heart rate and abnormal blood test results, so she was closely monitored as medical staff worked to find a diagnosis.
However, her condition declined so quickly that she passed away several hours later.
"She went into cardiac arrest and despite doctors' best efforts to resuscitate her, she could not be saved," counsel assisting the coroner, Chrissy McConnel, said.
"It is not submitted that the level of care received by Janelle was sub-standard or anything less than satisfactory."
An autopsy three days after Janelle's death showed she died of an uncommon heart condition, known as aortic dissection with associated secondary suppurative inflammation, which was not picked up in the series of tests medical staff performed.
Doctor Nicolas Forget told the coroner the condition was so rare, diagnosing it would have required so many tests, that the hospital would have ground to a halt.
He said that even with the benefit of hindsight he would not change the approach medical staff had taken to her care.
"The tragic reality though, is that even if an earlier diagnosis of aortic dissection had been made, Janelle could not have been saved as RDH does not have a cardiothoracic surgery service and therefore, she could not have received the urgent surgical treatment required," Ms McConnel said.
The coroner also heard that if the condition had been picked up, Janelle would have been transferred to Adelaide – a trip that would have likely taken at least 10 hours, or "in the most miraculous of situations", around six hours.
Dr Forget said by the time Janelle's condition had taken hold, it was unlikely she would have survived at all, given how quickly she deteriorated.
The inquest into Janelle's death is mandatory, as she had been sectioned under the Mental Health Act and was technically in care at the time of her death.
It will continue on Wednesday.
