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RNZ News
25 minutes ago
- RNZ News
Two-month-old Bellamere Arwyn Duncan's death 'must be a turning point', says pharmacist
Bellamere Duncan died at Starship Hospital on 19 July. Photo: Supplied The death of a two-month-old baby who died after being given medication that was more than 13 times the prescribed dose is a "symptom of a much deeper, systemic issue," a member of the national executive of the Pharmaceutical Society says. RNZ earlier revealed Bellamere Arwyn Duncan died at Starship Hospital on 19 July. A Manawatū pharmacy dispensed an adult dosage of phosphate to the two-month-old's parents. A provisional post mortem report said she died from phosphate toxicity. The revelations have prompted the Ministry of Health and Health New Zealand to "urgently" undertake a joint review into the incident with MedSafe visiting the pharmacy to ensure it was safe to continue operating. The Pharmacy Council, which is also investigating, said it was "clear that an awful error has occurred". On Friday, the owner of the pharmacy emailed Bellamere's parents and told them an intern pharmacist misread the prescribed dosage of medication. Afterwards, a trainee technician, who was handling a phosphate product for the first time, did not notice the dosage error. Then a registered pharmacist who carried out the final check did not pick up that the prescription was for an infant and that it was new medication. The intern pharmacist has since been suspended, and the registered pharmacist has resigned. Do you know more? Email Lanny Wong a pharmacist, director of Mangawhai Pharmacy and a member of the national executive of the Pharmaceutical Society, told RNZ on Tuesday Bellamere's death was "not simply a one-off mistake". "It's a symptom of a much deeper, systemic issue. The current model prioritises volume over value, this incentivises speed at the expense of safety. "For years, community pharmacies have grappled with operating under this fundamentally flawed funding system, marked by chronic underinvestment and relentless workload pressures. Skilled staff are increasingly difficult to retain, and experienced pharmacists are burning out or leaving the profession altogether. The very people relied upon to be the final checkpoint before a medicine reaches a patient are now overstretched, under-resourced, and unsupported." CAPTION: Bellamere Duncan's parents were given an adult dosage of phosphate by the pharmacy. Photo: Supplied Wong said in healthcare there were multiple layers of safeguards that were meant to save an error from happening. "But when there are gaps in every layer, caused by workload pressures, fatigue, underinvestment or broken systems and those gaps align, the error breaks through." Pharmacists were being asked to interpret complex prescriptions, perform clinical calculations, and provide personalised counselling, often while working under intense pressure and tight deadlines, she said. "In Bellamere's case, it appears the pharmacist had to calculate a specialised paediatric dose and explain a precise paediatric-dosing schedule to the whānau. This is work that requires expertise, care, and time, and yet the pharmacy was reimbursed less than the cost of a cup of coffee. That's not just unsustainable. It's unsafe." She said Bellamere's death "must be a turning point". "It's not just about fixing one pharmacy or one process, it's about fixing the system around pharmacy. "That means investing in safety, funding time to think, check and counsel, and designing a workforce strategy that ensures every community has access to skilled, supported pharmacists." [h ]The medication error In their email to Bellamere's parents the owner of the Manawatū Pharmacy included a summary of what happened. The owner said the pharmacy's standard dispensing process involved intern pharmacists entering each prescription into the dispensary computer. The pharmacy used a dispensing system called Toniq. A technician would then use the information in Toniq and the prescription to identify the medication and put the correct amounts in containers. The labels were then printed out and placed in a basket with the original prescription and the medication. A registered pharmacist would then check the prescription, the labels and the medication itself before it was given to the patient. The owner said the pharmacy received the prescription by email on 1 July from Palmerston North Hospital. The prescription was entered into Toniq by an intern pharmacist. "This person unfortunately misread the prescribed dosage and entered the prescription dose as '1 tablet twice daily' rather than '1.2 mmol twice daily'," the owner said. The Toniq system then generated an original label for the prescription. "This includes a warning label with the patient's age, if they are under 18 years old, and if the patient has not been prescribed the medication before. "The second warning prompts the checking pharmacist to counsel (speak with) the patient or their caregiver about how to take the medication." The product was supplied in tubes of 20 tablets. The trainee technician printed out three further labels. They were to be placed on the three tubes that were being dispensed. "This was the trainee technician's first time handling a phosphate product. She was also unfamiliar with the mmol dosage. She did not notice the dosage error as a result. She put the original prescription, labels and the medication in a basket on the dispensing bench for the registered pharmacist to check. "Unfortunately, the original label and the warning label was not kept with other items." The registered pharmacist who carried out the final check did not pick up that the medication was for an infant, the owner said. "In addition, it was not identified that this was a new medication. The fact that the warning label was not retained contributed to this error." The owner said the intern pharmacist had been suspended by the Pharmacy Council. The registered pharmacist had taken leave and then resigned. "This person does not intend to return to work in the immediate future," the owner said. The pharmacy was "urgently re-evaluating our dispensing and checking protocols and reinforcing safety checks at every stage". "We are actively recruiting additional staff to help manage our workloads. In addition, we are engaging an independent pharmacist from outside the Manawatū region to conduct a full review of our dispensing procedures and provide further guidance on system improvements." The owner said the pharmacy was "fully co-operating" with investigations being carried out by MedSafe, the Pharmacy Council and the police on behalf of the coroner. The owner signed off the email with "heartfelt apologies and regret". Bellamere's parents Tempest Puklowski and Tristan Duncan said after reading the email they did not blame the intern pharmacist for what happened. "My first initial reaction after reading it was I felt really bad for the intern," Puklowski said. "I don't blame him for the mistakes. I blame whoever was meant to be looking over his shoulder, whoever put him in that responsibility and just left him to it." Puklowski said it should have been picked up that the medication was for a baby. "It just seems like there's something lacking there that could have avoided it being missed or messed up," she said. Duncan said the system "needs to be better". Tempest said she remained "frustrated and angry" about her daughter's death. "It's just an endless sort of questioning of how and where it went wrong, to the point of, yeah, how could it have been avoided? "Obviously, those questions don't do much now, which then brings on the sadness of just knowing that she could still be here if these things were pulled up on initially, if maybe the intern wasn't left just to do the job by themselves. Or if you know something else is put in place, we would've never even gotten it and then we wouldn't be beating ourselves up for giving it to her." Duncan said the past two weeks since Bellamere's death had been "really hard". "Just empty is the only word that really comes to mind," he said. "It's unfair. Just stolen away by a singular document. That's what it comes down to." Puklowski said the couple "don't really know what to do with ourselves really". They were now waiting to see what happened with the multiple investigations that are under way. "I want things to change," Duncan said.
RNZ News
2 hours ago
- RNZ News
Midday Report Essentials for Tuesday 5th August 2025
money technology 6 minutes ago In today's episode, Doctors are being warned to be on alert for people with symptoms of Dengue Fever as the number of cases in New Zealand doubles; Dairies say they are having to act like banks as more and more customers ask to get cash-out with their purchases, and local banks reduce services and access to cash; and a new report shows an urgent need for policy around the use of AI in primary schools.
RNZ News
3 hours ago
- RNZ News
Doctors on alert as dengue fever cases surge among people returning from overseas
The Asian tiger mosquito is one of the vectors responsible for transmitting dengue fever. Photo: SCIENCE PHOTO LIBRARY Doctors are being warned to be on alert for people with symptoms of dengue fever as the number of cases in New Zealand surges. National Public Health Service physician Dr Sharon Sime told Midday Report public health teams are also seeing a surge in cases among people returning home after picking up the illness overseas. Dengue cases in the Pacific are at their highest level in almost a decade, with Samoa particularly affected with more than 2000 cases reported and multiple deaths since an outbreak was declared in April. In New Zealand, there have been 208 cases of dengue nationally in the year to date. Of those, 103 cases were recorded in Auckland this year, double the amount recorded for all of 2024. Around a third of the cases so far this year have also ended up being hospitalised. "What's different with dengue fever is many people with dengue don't have symptoms," Dr Sime said. "So, the ones that we diagnose is likely an under representation of the number of cases." New Zealand does not have mosquitoes able to transmit dengue, so you can't get the disease in New Zealand, Dr Sime said. While you cannot catch dengue fever from another person, you can get it from infected mosquitoes in an area or region that has dengue, and there is no available vaccine in New Zealand. "At the moment, our climate wouldn't work for the particular type of mosquito that carries dengue. We do also have a monitoring programme at our airports and our ports where we are constantly monitoring for any imported mosquito, just so that we would get an early warning of any chance of these mosquitoes surviving in New Zealand," Dr Sime said. Symptoms of dengue fever include a sudden high fever, intense headache, pain behind the eyes, muscle and joint pain, tiredness, nausea, vomiting and a fine rash, which may be itchy and usually begins on the extremities, but spares the palms and soles of the feet. Many people infected with dengue will only have mild symptoms, but a small number of people may get severe dengue and require hospital care. Dr Susan Jack, National Clinical Director for National Public Health Service, said people over 60 years old and children aged 10 and under are also at greater risk of severe illness from dengue. Dr Jack said if you're travelling outside Aotearoa New Zealand to an area with dengue, protect yourself by: Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
