Christine Toms, with a picture of husband Arthur, says she's in limbo while she waits for answers about his death. Photo: RNZ / Jimmy Ellingham
More than two years after the sudden death of her husband at Palmerston North Hospital, a Manawatū woman is still waiting for answers about what happened.
Christine Toms says she is in a state of limbo and doesn't even feel up to scattering husband Arthur's ashes until a Health and Disability Commissioner's investigation is concluded.
But there's no indication how long that will take.
On the afternoon of Wednesday 16 September, 2020, Arthur and Christine Toms received a call from Arthur's kidney specialist saying tests showed he had virtually no kidney function and he needed to get to hospital for urgent dialysis.
They called an ambulance, but Arthur, aged 75, would never return to their Tokomaru home.
Despite a period of ill-health, Christine said his death was sudden and unexpected, and the subsequent long wait for the commissioner's findings was draining.
"I just feel I can't have closure on Arthur's life, as such, because of his, basically, appalling death," she said.
"There's no resolution to any of this at all. At this stage, in fact, as time goes by it actually gets worse."
When she reached him in the hospital emergency department after following by car, Christine said her husband's condition had deteriorated.
He was sitting in a wheelchair holding discharge notes from a previous hospital admission, unsuccessfully trying to get someone to notice him when he couldn't speak, she said.
Convinced he'd suffered a stroke, she tried to get someone to see him, but was told he'd already been triaged. Eventually a nurse took a look.
"She went with me back to the wheelchair and Arthur's feet were caught underneath. She reluctantly tried to wheel him through to the triage room, and she couldn't, so she tried to run over his feet.
"I said, 'His feet are stuck under the plate, you'll have to move it,' which she did," Christine said.
"She took him into the triage room and very shortly afterwards an alarm sounded."
Arthur received treatment and was taken for a head X-ray and a CT scan.
Arthur Toms waits in the Palmerston North Hospital emergency department on 16 September, 2020. Photo: Supplied
Christine said shortly afterwards it was confirmed her husband had suffered a stroke, probably due to the anti-clotting drug Warfarin he had been taking.
She was told he needed a risky reverse procedure and the barely conscious man was shaken awake to nod consent.
He was rushed to intensive care, where he suffered another stroke, from which he never recovered.
He was then taken to another ward, where he died on the morning of 18 September, 2020.
"He regained consciousness just a fraction on that Thursday night and I said to him, 'If you love me, squeeze my hand,' and he did.
"That's when I asked to see a doctor or somebody to see if he was regaining consciousness. [A nurse] came and said, 'No, he's not. It's just something that happens'."
Among Christine's unanswered questions are why her husband wasn't rushed straight to intensive care for dialysis as directed by the specialist in notes to the hospital emergency department; when did he suffer his first stroke and why wasn't it noticed; and why she wasn't asked for consent to the anti-Warfarin treatment when her husband was incapable of giving informed consent.
She also wonders why she never saw a doctor when Arthur was moved to the hospice ward, and why no end-of-life care plan for him was made.
Te Whatu Ora MidCentral chief operating officer Lyn Horgan said it sympathised with the Toms family, but couldn't comment on specific cases.
"Our clinicians met regularly with the whānau to offer support after Mr Toms passed, and agreed that they would take the matter to the Health and Disability Commissioner as a third party.
"We are working with the commissioner who is reviewing the case and we are currently awaiting an independent clinical haematologist adviser report."
Hato Hone St John general manager, clinical effectiveness, Jon Moores said after an internal investigation the organisation found it had provided Arthur Toms with appropriate care.
"The call was appropriately prioritised for the dispatch of an ambulance non-urgently, without lights and sirens, within 10 minutes, and arrived 15 minutes after being dispatched.
"On arrival, Mr Toms was assessed as conscious, alert and self-mobile. The ambulance was on scene for eight minutes before commencing transport to Palmerston North emergency department," Moores said.
"During transport to hospital, it was noted Mr Toms was communicative and non-distressed. Upon arrival at hospital, he was transferred into the emergency department for triage by hospital staff.
"Hato Hone St John ambulance officers do not transfer patients directly to a ward without standard triage and admission processes being enacted."
Christine said the transfer to hospital should have been classed as urgent given the need for her husband to receive dialysis immediately.
She has plans to scatter her husband's ashes in Wellington, as was his wish, but won't do that until she has answers about the death of a man who desperately wanted to live.
The pair were married for 18 years, but had met long before, in 1976, at the Titirangi Folk Music Club in Auckland.
Arthur was a man of music, and a former RNZ radio announcer.
Christine fondly recalls his many talents.
"He was very much involved in radio. He used to say, 'I've got a face for radio.' He wrote jingles and advertising copy, and all sorts of things, which he was really good at.
"Of course, he was such a brilliant musician. He was one of the foremost folk musicians in New Zealand in the 1970s."
Christine made a complaint to the Health and Disability Commissioner in 2020.
A spokesperson there confirmed it had received the complaint, but said they couldn't comment further to protect the privacy of people involved.
As RNZ has recently reported, a significant increase in complaints has affected the time it takes to issue findings.