A medical centre in outback South Australia has launched an internal review after a man suffering from a suspected heart attack was refused entry and had to be treated at the local pub instead.

The 85-year-old Adelaide man and the off-duty paramedics treating him were denied access to Innamincka's Cooper Basin Royal Flying Doctor Service (RFDS) medical clinic.


The man had become ill while volunteering in a working bee in Innamincka on August 27.

Three off-duty paramedics administered aid before requesting access to the medical clinic, but were denied due to it being unstaffed by RFDS SA/NT personnel.

The paramedics were then left to treat the man the Innamincka Hotel.


With the closest RFDS staff located over the New South Wales border in Broken Hill, RFDS SA contacted the Far West NSW clinic and personnel arrived in Innamincka at about 6:30pm.

But the nurses from Broken Hill were also denied access to the Innamincka clinic.

A request to use the local ambulance to transport the man to the airstrip so he could be flown to Royal Adelaide Hospital (RAH) was also denied.


With his condition deemed too risky to be transported to the airstrip sitting upright, he was transported there on a mattress in the back of a ute.

The man was stabilised at RAH, but off-duty paramedic David Jaensch said it was "pure dumb luck" he and the other medical personnel were there.


The first responder said he did not want to "cast aspersions" on the RFDS's organisational management, who he said were exceptional on the scene, but the incident raised a lot of questions.

"The concerning part, for me, was there was knowledge of these people being there [by RFDS]," Mr Jaensch said.

"Some of the [volunteers] had come up with the understanding that there was a full-time medical clinic available."

'Breakdown' in process​

The RFDS's presence in Innamincka was sporadic until 2019, when it began rostering three nurses to operate on two-week fly-in-fly-out rosters in the town.

That presence became even greater when the RFDS clinic was opened in 2020, thanks to an anonymous donation.


At that time the clinic was managed by RFDS NSW until RFDS Port Augusta took over management of the clinic in 2023.

Since then the service has deteriorated, according to residents.

Innamincka Progress Association chair Janet Brook said the incident was a "real near-miss" that highlighted the changes the clinic has undergone in the past two years, and the challenges it's presented for locals.

"As time has gone on … we've probably seen some real problems, especially around emergencies," she said.

"There have been quite a few instances when the nurses have already flown out and then we'll find out that no-one is at the clinic after the fact."

Ms Brook said the issue had become so concerning that the Progress Association had discussed reinstating its disaster management plan, which had been used prior to the RFDS clinic being built.

"You might as well forget that the clinic even exists half the time," she said.

The RFDS has launched an internal review into the incident and said the an "unforeseen" absence of staff from Innamincka and a "breakdown" in process had rendered the clinic inaccessible.

RFDS SA/NT executive general manager of strategy, brand and reputation Charlie Paterson said the organisation was struggling with the same staffing issues as others around the country, but was working on an "action plan".

"There are three or four steps there that we can take which are quick fixes and enhancements … and then we can consult with the community around how we can provide for those times of absence," he said.

RFDS SA/NT said it would consult Innamincka residents as to how to provide for the community when nurses were absent, and how it could allow access to its ambulance without entering the clinic.

By Declan Durrant