The Queensland coronial inquest has been told Omid Masoumali, with burns to 50 per cent of his body, had zero chance of survival in Nauru’s hospital.
Evidence included multiple witnesses detailing unhygenic conditions, broken and antiquated equipment, and under-trained staff.
A statement issued by Nauru’s government in response to evidence at the inquest said “medical staff acted properly, immediately and with great care and professionalism” but did not address the state of the Ron Hospital.
In April 2016, Omid Masoumali set himself on fire in front of a visiting UN refugee agency officials in protest at conditions in Australian off-shore processing.
The 24-year-old was taken to Nauru’s hospital at about 10am on 26 April but the plane did not arrive to medically evacuate, or medivac, him until the next morning.
His fiancée “Pari” in evidence said she believes he did not intend to kill himself.
The inquest was shown graphic video filmed by a bystander of Mr Masoumali’s protest.
Professor Michael Muller treated Mr Masoumali at the Royal Brisbane and Women’s Hospital (RBWH) and told the court if he had been admitted in under ten hours it is “highly unlikely he would have died”.
He added it “remains his opinion” there was no chance of survival when Mr Masoumali was admitted to his care in Brisbane 30 hours after setting himself on fire.
“Please pass on (to the family) that we couldn’t do more (to save him), and I mean that sincerely,” he said.
Under-cross examination the witness identified a ventilator used at Nauru’s hospital was the same model as one he had used in 1979.
In earlier evidence, RBWH burns specialist Jason Miller testified Mr Masoumali would have had a 95 per cent survival rate under his care in Brisbane.
“A major burn on a Pacific island like his, I would expect to be lethal 100 per cent of the time,” he said.
“The only chance he had was to have more effective care in an earlier time frame. It needs to be dealt with very quickly locally.”
Mr Miller was shown photos of Mr Masoumali in Nauru’s hospital and said conditions were “wholly unacceptable from a clinical point of view”.
CareFlight (now known as LifeFlight) doctor Angus McDonell helped transfer Mr Masoumali to Brisbane from Nauru and told the inquest the hospital was unclean and equipment old or broken.
He recalled finding Mr Masoumali being treated on what appeared to be a child’s cot, adding there was “obviously mould on the wall, that’s obviously not ideal for a patient that is ventilated”.
CareFlight nurse Tracey Griffiths, who also helped transfer Mr Masoumali, said it was her first visit to Nauru and she was shocked by hospital conditions, highlighting the only soap to wash hands was dishwashing liquid.
Both Ms Griffiths and Dr McDonell said Nauru hospital staff did the best they could treat Mr Masoumali.
In a statement issued on Friday, the Nauru government said it was “saddened” by the death and defended staff at its hospital.
“(Mr Masoumali) arrived in ER at 10:20am and doctors immediately inserted IVs and he was given pain relief by an anaesthetist,” the statement said.
“The burns protocol was implemented and he was intubated and ventilated. An urgent medevac was requested at 10:40am.”
“His partner was focused on filming the incident on her phone and actions by those close to the victim made treatment more difficult.
“Despite this, medical staff acted properly, immediately and with great care and professionalism.”
The International SOS regional assistant manager Clive Gillard, who organised the CareFlight, said the time to medivac Mr Masoumali could not have been “meaningfully improved” because Nauru airport has no lights for night landing.
He added that for any incident after 11:30pm on Nauru, no air ambulance could arrive before first light the next morning.
Mr Gillard said International SOS was notified at 10:12 on the day of the incident, but no air ambulance with crew and medical staff were available before 11:30.
The inquest heard Mr Masoumali was due for a mental health examination on 2 May, a week after he set himself on fire, but records relating to the booking were missing.
Lawyers for the family have applied for an extension of the inquest to consider the mental health care provided to Mr Masoumali.
Parties have until Wednesday to make submissions to the coroner by Wednesday after which a decision will be made.
Queensland coroner Terry Ryan will scrutinise if more could have been done to prevent the death, along with the health and medical evacuation services provided, but will not examine Australia’s obligations to or treatment of refugees.
Mr Masoumali is one of twelve people to die since off-shore processing resumed on Manus and Nauru in 2012.
– with AAP
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