An Aboriginal man who died after being wrongly diagnosed with a drug-related condition was "really scared" of hospitals, just like many people in the Indigenous community, an inquest has been told.
Ricky Hampson Jr died on August 16, 2021, from two perforated duodenal ulcers less than 24 hours after being discharged from Dubbo hospital in western NSW.
The 36-year-old Kamilaroi-Dunghutti man went to the emergency department on August 14, writhing in pain after feeling a popping sensation in his abdomen.
Emergency doctor Sokol Nushaj has told the inquest he misdiagnosed Mr Hampson Jr with cannabinoid hyperemesis syndrome.
Dr Nushaj said his error was due to "cognitive bias", having recognised symptoms of the syndrome when Mr Hampson Jr was admitted in an agitated state.
The condition can be seen in cannabis users and features vomiting and nausea, which Mr Hampson Jr did not experience, accompanied by abdominal pain.
Deputy State Coroner Erin Kennedy will consider whether racism and prejudice were factors in Mr Hampson Jr's treatment.
Jamee McBride was the overnight emergency registrar on August 14, managing as many as 65 patients during the height of the COVID-19 pandemic.
Dr McBride said Dr Nushaj, his senior colleague, mentioned his diagnosis in a handover.
The junior doctor said he did not know Mr Hampson Jr was Indigenous and would have approached treatment differently if he did.
"We're all taught and aware that Indigenous people are a more vulnerable population," Dr McBride told the inquest in Dubbo on Thursday.
"But also, personally, for me being Indigenous, I understand the complexities of being an Indigenous person seeking healthcare."
Callan O'Neill, the barrister for some of the Hampson family, said Mr Hampson Jr wrote to a sick relative in 2017 apologising for not visiting because he was "really scared" of hospitals.
Dr McBride said that was consistent with the experience of Aboriginal people and it was important for health staff to know if someone was Indigenous.
Dubbo hospital has since introduced the use of an icon that appears on an Indigenous patient's computerised records.
The icon led to small changes, but challenges remained, Dr McBride said.
"There seems to be a lack of understanding and awareness for what it means for an Indigenous person to present to a hospital," he said.
"That level of fear that exists in our community, the mistrust, the lack of trust or no trust in the hospital system (is) quite a complex topic that stems back to the history of this country."
Earlier in the week, Dr Nushaj apologised to the Hampson family, some of whom walked out of the courtroom.
Nurse Maree Trow, who tended to Mr Hampson Jr on the morning of August 15, acknowledged she did not report his high heart rate to a doctor.
His pulse was 129 beats per minute at 7am on August 15, 126 about an hour later and 124 just after 10am, all levels that require reporting.
Ms Trow said she was told Mr Hampson's pulse was also high throughout the night, but a doctor thought it could have been due to dehydration.
"On refection now, I would have done something different than I did," Ms Trow said.
The inquest continues.
