Re­port calls for bet­ter ER response times

Dy­ing man lan­guished for hours in chilly emer­gency hall­way

The Guardian (Charlottetown) - - ATLANTIC - BY MICHAEL TUTTON

A Nova Sco­tia hos­pi­tal re­view is call­ing for shorter response times for pa­tients sent to emer­gency, in response to the dis­turb­ing story of how a 68-year-old man who was dy­ing from pan­cre­atic cancer lan­guished for six hours in a chilly ER hall­way.

The widow of Jack Webb re­cently pro­vided The Cana­dian Press with a copy of six in­ter­nal rec­om­men­da­tions com­pleted by the Nova Sco­tia Health Au­thor­ity af­ter the saga of his treat­ment emerged in late April.

The re­view in­cludes the goal of hav­ing in­ter­nal medicine spe­cial­ists meet their pa­tients within two hours when sent to ER, a stan­dard the hos­pi­tal fell far short of in Webb’s case.

“I’m putting my trust in them that they’re go­ing to do the right thing and im­ple­ment these items that they rec­om­mended. I can’t guar­an­tee they are, but I’d like to have a fol­low up meet­ing in three months to en­sure they put things in place,” said Kim D’Arcy, Webb’s widow, in an in­ter­view.

D’Arcy has said that prob­lems in her hus­band’s care be­gan weeks be­fore his Feb. 1 death, when the cou­ple wasn’t in­formed he had just weeks to live and end-of-life treat­ments weren’t ar­ranged.

By mid-Jan­uary he was strug­gling to breathe, prompt­ing Webb to visit the Cobe­quid ER on the out­skirts of Hal­i­fax and lead­ing to his trans­fer to the Hal­i­fax In­fir­mary ER.

D’Arcy said at that point a key prob­lem oc­curred, as a spe­cial­ist in in­ter­nal medicine who was sup­posed to meet him wasn’t at the In­fir­mary ER when he ar­rived, send­ing the se­verely ill man into the hall­way lineup.

Af­ter his wait, Webb spent time with a bro­ken IV in his arm, was later bumped from his pri­vate room by an­other dy­ing pa­tient into a med­i­cal teach­ing unit, and, on his last day, he heard staff yell, “If he stops breath­ing, don’t re­sus­ci­tate,” she added.

All of this un­folded as the hos­pi­tal was in the midst of daily special alerts known as “code cen­sus” where the ER de­clares it’s over­crowded and sends pa­tients into reg­u­lar wards that may al­ready be strug­gling to cope.

Af­ter The Cana­dian Press pub­lished the ac­count just days be­fore the May elec­tion cam­paign, the former health min­is­ter promised the mat­ter would be looked into, while op­po­si­tion par­ties said the case was part of a wider health-care cri­sis in the prov­ince.

The re­sult­ing “qual­ity re­view” says fu­ture pa­tients who are directly trans­ferred to in­ter­nal medicine from other ERs in the city should be seen “within two hours of ar­rival, ir­re­spec­tive of pa­tient lo­ca­tion (e.g. hall­way).”

It also rec­om­mends the hos­pi­tal sys­tem cre­ate a more stan­dard process for treat­ing pan­cre­atic cancer, and “ex­plore op­tions” for quicker fol­lowup by emer­gency de­part­ments when pa­tients have a spread­ing of “metastatic” dis­ease like pan­cre­atic cancer.

D’Arcy said she finds some of the rec­om­men­da­tions to be too gen­eral, and won­ders how she or the public will know if they come to pass.

“How they im­ple­ment that and the nuts and bolts of that, I’m never go­ing to get that from them,” she said.

CP PHOTO

Kim D’Arcy dis­plays an image of her late hus­band, Jack Webb, at her home in Bed­ford, N.S.

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