Boyd Katans died of a rare form of meningitis in March 2012. Photo / Otago Daily Times, file
A couple of weeks after his arrest, Boyd Katans told the nurse that his head was “killing him”.
Unfortunately, he was almost right.
More precisely, the problem was what was in his head – a rare meningitis caused by an invasive soil fungal infection, which was most likely discovered during his work in kindergarten.
Katans’ imprisonment lasted the last two and a half years, but the debilitating headaches that plagued him for several weeks before his imprisonment continued.
After 48 days in Otago penitentiary and 27 conversations with medical staff, the 44-year-old man was taken to Dunedin Hospital.
For 72 days, doctors desperately tried to uncover the source of Katans ’disease, but only when he died on March 28, 2012, was the secret revealed.
His mother Elizabeth, a trained nurse, visited him the day he was hospitalized and found him weak, vomiting, his speech “all mixed and slurred”.
She was surprised that he had not been transferred before.
“He was so seriously ill that I could not believe that no steps had been taken to send him to the hospital. I believe that only after my intervention were the measures taken,” Elizabeth Catanz wrote to Coroner David Carrer after as he published his previous findings in 2013.
In a written decision in 2015, the coroner was critical of the assistance the prisoner received.
“Evidence shows that Boyd Katans has been very ill since joining the OCF. He was terminally ill. His headaches were severe, and these headaches led to physical symptoms, more than the usual headaches that could or should have been noticed by a healthcare professional.
“While it must be acknowledged that the causes of Boyd Kathans’ illness were unclear, the severity of his symptoms and the significant number of manifestations should have been a warning to those responsible for his medical care … blood tests, neurological tests, monitoring, symptom reporting and headache relief are appropriate medical care. “
Elizabeth Catanz was upset that Corrections continued to defend her nursing staff and general practitioner, who evaluated her son, and she believed they minimized the symptoms Boyd Catann was exhibiting to absolve himself of guilt.
The coroner’s opinion was not sufficiently justifiable.
Last September, Elizabeth Katans took the fight to Dunedin District Court.
Because her lawsuit was filed more than six years after her son’s death, the Prescription Act prevented the award of pecuniary damage.
That didn’t stop her.
She sought a number of statements, essentially urging the court to recognize that those entrusted with Boyd Cattans ’medical care were negligent.
“The degree of negligence of the prison medical staff who dealt with Boyd was outrageous and constituted subjective recklessness. The staff would have been aware that unresponsiveness to Boyd’s symptoms and complaints posed a serious risk to his health and possibly to his life.” said Elizabeth Catanz in a statement of claim.
Judge Paul Keller, whose written decision was recently published in the Otago Daily Times, immediately dismissed some parts of the lawsuit.
The essence of the case hung at one point.
“The main question is whether there should have been prison medical staff, and Dr. X in particular should refer Boyd to a specialist much earlier than he was hospitalized on January 15, 2012.”
The question was not whether the medical care was below the standards of best practice, but whether it was below the threshold of a “reasonable standard of care”.
From 1987 to 2006, Boyd Katans handed down a number of convictions, mostly related to alcohol use.
However, after that the drinking slowed down and he turned the corner.
He worked in the horticultural industry and his life was more structured.
Then the headaches began.
By early 2011, they had deteriorated. Boyd Cuttans has increased alcohol consumption just to sleep and relax from nagging pain.
While he was in trouble with police, his mother said what happened on June 18, 2011, was completely “inappropriate.”
He was denied entry to the cafe and bar Lake Waihola, and after an argument with the manager he was forcibly taken to the parking lot.
He then took out a container of petrol from his car and walked along a number of vehicles near the restaurant, doused nine of them with petrol before setting fire to the last one in line.
Boyd Kattans left the parking lot and stopped 200 meters away, and those who were on the scene used a fire extinguisher to put out the fire.
After extinguishing the fire, the head of the bar called the arsonist, who returned to the scene with two containers of gasoline.
Boyd Katans in response sprayed fuel on the man and flicked a lighter.
He was knocked to the ground and detained until police arrived.
Boyd Katans was pledged, and his headaches intensified.
During one week in October 2011, he visited Dunedin Hospital three times, reporting severe pain and, on final appearance, vomiting, tingling in the limbs and blurred vision.
A CT scan revealed an infected sinus and he was prescribed painkillers, anti-inflammatory and antibiotics.
A month later, he appeared in Dunedin District Court, where he was sentenced to two and a half years in prison.
His mother was so concerned about his physical condition that she called the jail the next day to make sure he would have access to the right medication.
On the same day, Boyd Katans saw a therapist who contracted. Three of his consultations with the doctor took place under a microscope during last year’s hearing.
Despite Elizabeth Cathans ’opposition, the doctor’s name was withheld by Judge Keller because there was a“ real risk of significant damage ”to her professional reputation.
At their first meeting, Dr. X noted that Boyd Catanz’s respiratory rate and blood pressure were normal and he did not feel aversion to light.
She was prescribed panadol and nurofen and continued to take the anxiety medication he had been taking before.
The woman told the court at last year’s hearing that Boyd Katans called the pain “much better” and she believed he may have had tension headaches.
Everything seemed to be fine for a couple of weeks, but the symptoms didn’t go away for long.
One nurse noted that Boyd Katans said “his head is killing,” and the next day it was reported that he was crying in a hole.
“I feel terrible, the pain in my whole head, as before, is getting worse today. I usually go to the intensive care unit, where I am moisturized. I think I need anti-inflammatory, I’m dizzy, ”the prisoner said. them the next day.
Dr. X’s second consultation took place the next day, December 20, 2011, and during it Boyd Katans said the pain can sometimes be “unbearably painful and constant.”
Dr. X specifically tested the usual signs of meningism – neck stiffness, aversion to light, nausea, and headaches – but noted in her notes that he looked good and had “relaxed demeanor.”
Their third meeting took place on January 6, 2012, after Boyd Katans again sent a flurry of complaints to prison nurses.
He could not sleep, he had tingling of the lips, numbness, was vomiting; at one point he was asked to go to the hospital and said he did not believe in the OCF medical team.
Dr. X believed that the headaches could have been caused by anti-anxiety drugs, and Boyd Katans told her that Panadol could relieve the pain for a few hours.
She underwent a neurological examination and a complete physical examination and found no abnormalities, the court heard.
A plan was drawn up for Boyd Katans to visit a physiotherapist.
But nine days later he was taken to hospital and did not survive.
During cross-examination, Dr. X agreed that it is not customary to review nurses ’notes before assessing a patient.
Dr Colin Lewis, called in as an expert to testify against Elizabeth Catanz, highlighted this as a critical failure.
She said there was no indication that the doctor knew about how many times the prisoner had complained of headaches or various symptoms.
This, she said, was a significant departure from a reasonable standard of service.
Another expert, Dr. Teresa Turnbull, believed that the supervision was not so serious.
It was a departure from best practice not to get a second opinion, but she said Dr. X worked hard to find a diagnosis.
Judge Keller agreed.
“I came to the conclusion that at least the best practice could be for a doctor [X] read the nursing care notes every time she examined Boyd, and refer him to a specialist after the examination on January 6, 2012, these were subjects of opinion on which opinions may differ. And that these issues are not a violation of a reasonable standard of care, “he said.
“The cause of his illness was known to be difficult to identify.”
The judge dismissed Elizabeth Catanz’s claims.
So would Boyd Katans be saved with his previous hospital treatment?
Lewis believed that if antifungal drugs had been prescribed in December 2011, he would “probably” have survived.
She said that if it was discovered earlier, the lesion in Boyd Kattans ’brain could be surgically removed.
But in the end, it was all speculation.
“We’re guessing,” Lewis admitted.
While Elizabeth Katans expressed in court her frustration with her son’s treatment, she repeatedly refused to speak to the ODT about the case until it was finally resolved.
The appeal will be heard in the High Court in June.