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Yeah, that is odd,but patients often do not understand their caretakers in these situations. The four days is actually a classical "lore" patients understand when they are told that they need dialysis - "if you don't have dialysis now,you will be dead within four days".

But let's start from the beginning:

• With a high velocity high mass rear impact one would expect massive if not fatal neck injuries as the primary trauma. Even if her car was not yet "fully stopped" and still moving everything above a delta-v (difference in velocity) of 30km/h usually has these injuries as their primary trauma.

• Renal failure from rear collisions can have two causes: Either direct damage to the kidneys or due to Rhabdomyolysis - basically a large enough tissue damage to overwhelm the kidneys. Now, this is the first thing that is strange: While both would definitely been possible for a crash as described, the conditions for them to occur are quite special. The kidneys are fairly well guarded within the body and in rear collisions the construction of the car seat also does protect them. The resulting impact has to overcome these "protections" and therefore has to be quite substantial - and then is extremely unlikely to be isolated. With a very very high chance it goes along with major spinal injuries,often also thoracic and other abdominal injuries. That seems not to be the case here. So that leaves Rhabdomyolysis as a possible cause. But this would require a major tissue damage (e.g. like a leg being trapped for ages,etc.) & which sure can happen,but again that is not very likely here and would be much more of a concern for her in that case.

• A bit suspicious is also the photo. It must have been taken shortly after the incident based on the state of the bruises and her clothing. Additionally we find the black substance on her face that could very likely be sooth from a airbag, even though the positioning of it looks very much unlike every sooth I ever saw and the amount of it is rather big, indicating a aftermarket or old airbag. Furthermore the lone ECG dot is a bit suspicious as well - the positioning is plainly wrong for the kind of ECG used in trauma(a six lead ECG which requires four dots in different positions) and for monitoring purposes. And while it could be a (badly placed) left over from a 12 lead ECG, it brings us to the question while there is no 6 lead ECG being seen - a renal failure patient very likely would have been monitored this way, especially shortly after such a crash. (There is something white further down that might or might not be another dot) (Not to speak of things like central lines, peripheral lines, a Sheldon shock catheter or even a endotracheal tube,,etc.) Additionally this is clearly not a ED stretcher but a more permanent full nursing bed.

• All emergency patients in the Perth Metro region are transported by St. John Ambulance. They are very strict about their trauma bypass rules - all major trauma patients are to be transported to the Royal Perth hospital (who have clarified that they haven't seen her) or as a backup to Fiona Stanley or Sir Charles Gairdner Hospital. Only if patients are assessed as minor to moderate on scene or they are so critical that they won't make it there they go to the other hospitals. They are really strict about it, believe me. So...that is kind of strange. Now, of course, patients get undertriaged and might not be end up in the Royal. Let's look at what the alternatives are. Fiona Stanley and Charlie's both are equipped with everything they would need to treat so the transfer she mentioned would not have been needed. Neither is the geographically most likely option (Joondalup) as they have their own renal service. The next option would be Midlands, they have no nephrology indeed, but they work with the large Fresenius Center Midlands- and it's higgly unlikely that they would even have accepted her as a patient as they are known to be "trauma averse" and the Royal isn't too far away. Armadale has a nephro service, so do Rockingham (ICU only,though)and Peel/Mandurah. There is literally no hospital within the greater Metro area, even the closer country hospitals have renal services (Northam and Bunbury). Of course there always could be the possibility that she was transferred due to a sole nephrological condition (trauma would have ended in the Royal again),but that is somewhat unlikely. (For the outsider: There is only two fully private hospital which accept emergency patients - Hollywood who has renal, and Murdoch who doesn't but is directly next to Fiona Stanley and therefore unlikely)

• She claims to have been transferred to a "urology" department - urology has nothing to do with the kidneys in that regard unless the ureters are damaged, everything else is part of Nephrology, vulgo renal service. But patients indeed misunderstand that from time to time, so not a point against her.

Now, that's for what we know or can somewhat base on facts.

Let's guess a little what might have happened:

• Scenario 0: She is correct all along and took a photo at the right time, was incredibly lucky but gave different details about the accident for some reasons.

• Scenario 1: She indeed had a little accident. Happens. She was transported to one of the smaller hospitals due to the fact that she wasn't that injured. They found out that she has a kidney condition for other reason by chance and either she or her spoksperson exaggerated the whole situation for some reason or another.

• She is the victim of an attack (kicking into ones kidneys can lead to renal failure easily) and has been "silenced" in some way or another and this is her way of telling her attacker that she will fall in line and shut up.

• The whole story is badly faked and has been done in some other hospital or nursing home setting for some reasons we cannot know. Attention? Mental health issues? A cover story? Who knows.