Abandoning of patient ‘unacceptable’
Province seeks answers after botched Rosslyn evacuation
“Totally unacceptable” is what Ontario Health Minister Christine Elliott had to say about a senior with COVID-19 being inadvertently left behind during the evacuation of the Rosslyn Retirement Residence.
Two more residents have died in the disastrous outbreak at the retirement home on King
Street East, bringing the total to four. An 86-year-old man and an 80-year-old man died in hospital Tuesday. Hamilton’s COVID-19 death toll is now 30. During question period Wednesday, Elliott said it “certainly should not have happened” that the ill resident went without care for roughly 18 hours before family alerted St. Joseph’s Healthcare.
“That is not acceptable under any terms, not acceptable at all,” said Elliott in response to a question by Sandy Shaw, the NDP MPP for Hamilton WestAncaster-Dundas. “We are working with our partners to review the protocols and understand why this could have happened, and to make sure that this never happens again.”
The Rosslyn was the first home in Ontario to be evacuated and temporarily shut down during the pandemic, said Winnie Doyle, executive vice-president of clinical operations at St. Joseph’s Healthcare.
In total, 62 residents went to St. Joseph’s and Hamilton General — some needing intensive care — while two seniors made other arrangements. So far, there have been no answers on where they went.
“They had every resident evacuated to hospital because of a horrific COVID-19 outbreak, and unbelievably, one resident was left behind in the empty home, forgotten,” Shaw said. “This is truly a nightmare.”
It’s not clear who was even in charge of the evacuation on May 15. The Ontario Ministry for Seniors and Accessibility says it was public health. But Hamilton’s medical officer of
health, Dr. Elizabeth Richardson, says it was St. Joseph’s and the Hamilton Paramedic Service.
No Rosslyn staff were left at the home by the time it was evacuated and there was no master list of residents.
“It’s up to the operator ultimately,” said Richardson. “We can do everything we can in terms of supporting ... but ultimately the operators are accountable.”
The health minister says the Retirement Homes Regulatory Authority is working with public health and what used to be the Local Health Integration Network (LHIN) “to understand what has been happening.” A debriefing is expected Thursday.
Ontario’s Patient Ombudsman is also monitoring the situation closely. While the office doesn’t have oversight over retirement homes, its mandate does include hospitals and community care.
Issues with the Rosslyn were detected even before the pandemic, with public health finding bed bugs, mice and cleaning issues in the home during food inspections from 2018 to 2020.
Richardson said the Rosslyn was one of a “small number” of homes that required orders around infection prevention and control during COVID-19. While the home complied with the order, it still ended up with an outbreak that wasn’t detected until patients started being sent to Hamilton’s hospitals and staff there realized it could be the virus.
It’s unknown how COVID-19 got into the home, but Richardson says visitors have been going to the Rosslyn during the pandemic. What’s not clear is how many or whether it was essential visitors only, as per the province’s directive, because there is no visitors’ log. Richardson says anyone who visited the Rosslyn on April 26 or later should self-isolate for 14 days from their last visit to the home.
The outbreak was declared May 10 with one infected resident. By May 12, it had already been flagged as being at risk so St. Joseph’s, LHIN Home and Community Care, public health and Hamilton paramedics were sent in to help with staffing, testing and infection prevention and control.
On May 14, public health triggered an inspection from the regulatory authority because the home was so short-staffed due to increasing numbers of workers testing positive or fearing they would become infected. Public health also issued additional orders.
The Ministry for Seniors and Accessibility says the authority found a “failure to protect residents from neglect” as well as issues with infection prevention and control.
Despite all of these interventions, the virus spread in days to 63 of the 64 residents and 20 staff, including five who came from temporary agencies.
“It’s not like long-term care homes where there is staff there all the time to do a higher level of support,” Richardson said about retirement homes. “What we’ve seen as a pattern is if they are having some problems with staff, which a lot of them are, and if they haven’t been able to get PPE (personal protective equipment), once they get a case ... it’s easy for these to end up in a problem.”
She points to the city’s other big outbreak, at Cardinal Retirement Home on Herkimer Street. Cardinal had 47 residents infected and nine die as well as 18 staff test positive.
She called for retirement homes to be part of the province’s independent commission into long-term care. Premier Doug Ford said retirement homes will be part of a separate inquiry.
Hamilton now has 595 confirmed cases of COVID-19 and seven more probable.