PHA releases findings following death of dialysis patient

PHA releases findings following death of dialysis patient

Says during December alone, patient missed four scheduled appointments


NASSAU, BAHAMAS – Following its investigation, the Public Hospitals Authority (PHA) on Sunday outlined the series of events which may have led to the death of 25-year-old Neil Johnson, a dialysis patient at the Princess Margaret Hospital (PMH).

A statement released Sunday outlined that an internal investigation conducted by the PHA, revealed that the patient, who also goes by the name Neil Bethel, began receiving Dialysis treatment at PMH in October this year (2018).

At the commencement of his treatment, the PHA said Johnson received information regarding his diagnosis of renal failure, as well as the requirements for renal replacement dialysis therapy and the ‘life and death’ implications of the scheduling requirements of his treatment plan.

According to the PHA,  Johnson was slated to have Dialysis on Monday, Wednesday and Friday of each week.

However, records retrieved from PMH revealed that Johnson was non- compliant.

The PHA said during the month of December alone, Johnson missed scheduled appointments on the 3, 7 and 10; and contrary to media reports, he also missed his appointment on December 14.

The PHA said when Johnson presented on December 17 for treatment, all available treatment stations were in use and he could not be accommodated due to a shortage of staff in the Dialysis Unit.

Johnson, the PHA said, was clinically assessed in line with protocols and given another appointment date.

The PHA added that Johnson was further advised to restrict his fluid intake to less than 500ml over the next 24-hour period, and to avoid high phosphorous and potassium containing foods like fruits, potatoes and citrus products.

“He was advised to return to ER if he experienced any shortness of breath, chest pain or chest discomfort symptoms that he did not manifest at that time,” the PHA said.

“Johnson left the Unit, but later returned to the Emergency Room where he was again triaged and assessed, and scheduled for emergent treatment at the Dialysis Unit on December 18 at 5:00 a.m.  – the opening time of the Unit.

“Unfortunately, Johnson (cardiac) arrested at 4:30 a.m. on the 18th of December after multiple attempts to intervene were unsuccessful,” outlined the PHA statement.

The PHA said patients who voluntarily miss treatments must report to the hospital’s Emergency Room for assessment.

“Before a patient is deferred he/she is evaluated and triaged, and then the next available time for treatment is given, usually within 24 hours,” the PHA statement concluded.


Neil Bethel need not have gone on dialysis in October if either his primary care physician or his nephrologist knew the medical literature. This is a requirement for being licensed as a physician. It’s been possible to prevent 90% of dialysis for nearly 25 years. The first thousand patients’ outcomes were published in 2002 (PubMed ID: 12396747; PDF available as paper #1 at The number of successfully treated patients is now more like four thousand (data not published). More details are at, including why healthcare has refused to eliminate dialysis, the most lucrative condition in all of medicine (paper #9 at same URL)

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