Gerhardt, Robert John

44y · Male·Metastatic small cell neuroendocrine carcinoma of lung

Robert Gerhardt, 44, died of metastatic small cell lung cancer on 6 May 2011 at Princess Alexandra Hospital, shortly after receiving compassionate parole. He had presented to PAH emergency department on 28 September 2010 with respiratory symptoms. A chest x-ray that day revealed a mediastinal density reported by radiology as possibly requiring CT investigation, but this was not followed up for nearly two months until diagnosis was made on 22 November 2010. While the coroner found the delayed diagnosis would not have changed the outcome (cancer was already advanced), the failure to act on the radiology registrar's report represents a missed diagnostic opportunity. Additionally, in February 2011, Mr Gerhardt requested morphine for chest pain but was given only paracetamol by nursing staff; the coroner found this acceptable as nursing staff could not administer morphine without physician approval, though the request could have been escalated.