Warning: This story contains the name and images of a deceased Indigenous person.
When Ricky Hampson Jr's nephew heard about his death, the young boy asked his mum: "If I go to hospital, will they save me?"
Hampson Jr's bereaved sister, Anita Chatfield, recalled the moment her eight-year-old son considered his own place in the world after his uncle's sudden death.
"No child deserves to have those feelings," Chatfield told an inquest today into Hampson Jr's death in Dubbo.
The 36-year-old Kamilaroi-Dunghutti man, also known as Dougie, died on August 16, 2021, from two perforated duodenal ulcers less than 24 hours after being discharged from Dubbo hospital, in western NSW.
He went to the emergency department on August 14, describing "10 out of 10 pain" and a tearing or popping sensation in his abdomen.
Emergency doctor Sokol Nushaj said he misdiagnosed Hampson Jr with the drug-related condition cannabinoid hyperemesis syndrome.
Nushaj said "coginitive bias" influenced the error, as he had treated other patients with the condition and recognised Hampson Jr's symptoms of agitation and pain.
But the senior doctor acknowledged he never displayed the key symptom of vomiting.
"It is a matter of deep regret," Nushaj told the coroner last week.
In the final days of the inquest, the Hampson family described their deep torment over the loss of Dougie.
"He was meant to walk into the Dreamtime as an aged and frail man, warm in his bed, surrounded by his loved ones, leaving behind a lifetime of memories and happy times," Chatfield said, her voice wavering.
"Instead, he was a young man and died alone in unimaginable pain and suffering because of a system that failed him."
His mother, Lydia Chatfield, described herself as "broken" and slept to avoid her pain.
"We meet in my dreams, but you always look confused to see me crying because I found you," Chatfield said, reading a message to her firstborn.
"I hold onto you and breathe you in and you wonder what all the fuss is about, like you haven't really left me."
Hampson Jr's children gathered to tearfully remember him and performed a traditional dance outside the courthouse.
A slideshow played to the court showed him as a child, riding a bike, running through a sprinkler, grinning under a shimmering Christmas tree and snuggled in spotty pyjamas.
Videos showed him as an adult holding his own children, playing with young relatives, dancing and laughing.
It included the final image of him captured on the hospital's CCTV, showing him clutching a bottle of water.
Ricky Hampson Sr said his son's death was the hardest thing he'd ever experienced, followed by the inquest.
The family want justice and change so all First Nations people can be safe in the healthcare system, he said.
"When systemic racism in our institutions is taking black lives in one way or another, it has a ripple effect that destroys so many of our lives.
"It enforces our people's lack of trust within these institutions and the system itself."
For 24/7 crisis support run by Aboriginal and Torres Strait Islander people, contact 13YARN (13 92 76).
