Quebec hospital fortifies safety procedures after two babies die weeks apart

after a nurse at Ste-Justine Hospital injected her by mistake with a dose of potassium that was 10 times greater than what was prescribed, coroner Jacques Ramsay noted. This caused the girl to go into a cardiac arrest from which she neverrecovered.

In the second case, a 23-month-old cancer patient being treated for neuroblastoma at the hospital died on Dec. 12, 2016, after a nurse accidentally gave the boy an injection of potassium rather than saline.

Hours after the coroner made the two reports public, Ste-Justine released a statement expressing its condolences to the families, and emphasized that it has since adopted strict protocols to prevent similar medication errors from recurring.

Dr. Marc Girard, SteJustine’s director of professional services, declined to say whether the nurses who committed the errors had been disciplined.

Ghali Chorfi was being treated for a form of cancer that had attacked one of his kidneys and had been responding to treatment. On Dec. 12, 2016, the boy was given medication as part of that treatment and was supposed to receive a routine injection of saline to rinse out his vein.

The child reacted almost immediately to the injection, his pulse stopping and his limbs contracting as he went into cardiac arrest. The nurse and other staff began resuscitation procedures, and a blood test conducted 15 minutes after the injection found dangerously high levels of potassium in his system.

While medical personnel eventually succeeded in reducing the presence of potassium, the cardiac arrest and the effects of the resuscitation procedures took their toll and the child died that day.

Coroner and physician