Quadriplegic Quebec man chooses assisted dying after 4-day ER stay leaves horrific bedsore

On a Thursday in January, Normand Meunier arrived at the hospital in SaintJérôme, Que., with a respi‐ ratory virus. Weeks later, he would emerge with a se‐ vere bedsore that would eventually lead him to seek medical assistance in dying (MAID).

Meunier, 66, had been a truck driver before a spinal cord injury in 2022 left his ar‐ ms and legs paralyzed.

Before being admitted to an intensive care bed for his third respiratory virus in three months this winter, Meunier was stuck on a stretcher in the emergency room for four days.

His partner, Sylvie Brosseau, says without hav‐ ing access to a special mat‐ tress, Meunier developed a major pressure sore on his buttocks that eventually worsened to the point where bone and muscle were ex‐ posed and visible - making his recovery and prognosis bleak.

"Ninety-five hours on a stretcher, unacceptable," Brosseau told Radio-Canada in an interview.

"Every time we go to the hospital, it's my duty to tell them that Normand is quad‐ riplegic and needs an alter‐ nating pressure mattress … I don't understand how this can happen, because a mat‐ tress is the most basic thing."

Brosseau says although she advocated for her part‐ ner, she was told the special bed had to be ordered.

'I don't want to be a bur‐ den': Meunier

Without access to a mat‐ tress that shifts pressure points to prevent the forma‐ tion of bedsores, a patient's position must be changed frequently, says Jean-Pierre Beauchemin, a retired geria‐ trician and professor at Uni‐ versité Laval's faculty of med‐ icine.

"When you're lying down, always in the same position, there's hyper-pressure be‐ tween the bone and the skin," said Beauchemin.

"A pressure sore can open in less than 24 hours, and then take a very long time to close."

The buttocks, heels, el‐ bows and knees are particu‐ larly vulnerable.

A rotation schedule every two hours is generally neces‐ sary for a person confined to bed, according to a Quebec Health Ministry reference sheet.

Meunier had previously suffered other bedsores, no‐ tably on his heel, but nothing as disabling as the pressure sore he developed after his hospitalisation in SaintJérôme.

Speaking with RadioCanada the day before his death, Meunier said he pre‐ ferred putting an end to his physical and psychological suffering by opting for a medically assisted death.

He was told the sore - a gaping hole a few centime‐ tres in diameter - would, at best, take several months to heal, according to the experts they consulted.

According to his partner, he underwent two debride‐ ments in one month - a treat‐ ment in which dead or in‐ fected tissue is scraped from wounds to help them get bet‐ ter.

"I don't want to be a bur‐ den. At any rate, the medical opinions say I won't be a bur‐ den for long; as the old folks say, it's better to kick the can," said Meunier.

He died at home on March 29.

'A case of disbelief,' says advocate

"That whole story is a cry‐ ing shame," said Steven Laperrière, the director gen‐ eral of the Regroupement des activistes pour l'inclusion au Québec (RAPLIQ), which supports people with disabili‐ ties.

"It's really a case of disbe‐ lief … What are we doing in order to help disabled per‐ sons or sick people to live in dignity prior to dying in dig‐ nity?"

He says the health-care institution was "negligent to say the least" and that get‐ ting a proper mattress is not like "trying to get a space shuttle into orbit."

"It's pretty basic … No‐ body will convince me that within a few hours the proper mattress could not have been found," said Laperrière.

"To me, that's totally a lack of professionalism," said Laperrière, who says Meuni‐ er "would probably still be alive today" if staff had "been really professional about it."

145 alternating pressure mattresses available, says health authority

In an email to CBC, man‐ agement at the local health authority, CISSS des Lauren‐ tides, said it is taking Meu‐ nier's case "very seriously."

"An internal investigation is underway to shed light on the events," read the state‐ ment.

The health authority con‐ firmed it has 450 therapeutic mattresses, including 145 with alternating pressure, in its facilities (including hospi‐ tals and long-term care facili‐ ties) and that equipment is available if staff request it, according to Radio-Canada.

But adapted mattresses and beds are not found in ERs, says Steve Desjardins, director of nursing at the CIS‐ SS des Laurentides.

"An emergency room is not an appropriate place for this type of mattress, be‐ cause beds aren't used in an emergency room, they're stretchers [and] there isn't really a mattress adapted [to be put on] a stretcher," said Desjardins.

"An emergency room is a riskier place for a fragile per‐ son. That's why, if necessary, we're going to work actively to give them access to a bed in an inpatient unit."

'Deeply troubling,' says professor in health law

Trudo Lemmens says this case is "an illustration of problems in our health-care system."

The Scholl Chair in Health Law and Policy at the Univer‐ sity of Toronto says people who are already vulnerable are left feeling like more of a burden in the system.

"Then the system re‐ sponds by saying: 'well, you have access to medical assis‐ tance and dying,'" said Lem‐ mens.

"Medical assistance in dy‐ ing is more easily available and on a more regular basis than some of the most basic care."

He says he is increasingly hearing stories of people who are struggling in the sys‐ tem and turn to MAID.

"It's deeply troubling," he says.

Along with Brosseau, Moelle épinière et motricité Québec (MÉMO-Qc), an advo‐ cacy group for people with disabilities, is now demand‐ ing the Quebec government launch an independent in‐ quest into Meunier's death. They believe the health au‐ thority's internal investiga‐ tion is insufficient.

Walter Zelaya, the head of MÉMO-Qc, said the investiga‐ tion could be done by any agency outside the CISSS, like a coroner or another com‐ mission.

"For years, on many occa‐ sions, MÉMO-Qc has ex‐ pressed to the various au‐ thorities in the health net‐ work the major shortcomings in several regions of Que‐ bec," it said in a news re‐ lease.

"It is regrettable that a death has to occur and be publicized by the media for the health authorities to lis‐ ten."

They are also requesting a meeting with Christian Dubé, Quebec's health minister, to address the circumstances and lack of care that led to Meunier's eventual death, which "unfortunately, far too many people with disabilities face."

Dubé told reporters

Friday that he will wait for the report from the CISSS in‐ vestigation before deciding if an independent inquest is necessary.

"We can say it's the excep‐ tion, but it's unacceptable what happened," he said.