Answers sought after man dies in Winnipeg hospital waiting room

[Jayems]

Originally Posted by Dion

Problem here is that he wasn't abusing the system. He went to his GP at that clinic complaining he couldn't urinate due to problems with the catheter the hospital put in. He had no legs and was in a wheel chair so they put him in a taxi with a note from his GP. Surely someone could have read his note his GP sent with him.

I have, admittedly, commented with out reading the entire story and based judgement on that fact that he was a 'regular.'

I worked for 5 years in a Calgary ER and know full well how the system works and how it is abused.

That doesn't mean he shouldn't have been checked on, though. But I can see how he may have been missed.

[OilersBaby]

Originally Posted by BlackArcher101

While I feel sorry all around for the situation, how exactly will suing help prevent this from happening again and also who was the negligent party here?

I don't like the long wait times either, but in the end I can't complain because when I went through triage I was deemed to be less important than others, and that I'm fine with. I ended up waiting in the ER for 7 hours with both of my arms frozen in position and a tingly feeling in my entire body. Pretty scary at the time, but they recognized the symptoms as non life threatening.

The negligent party was the hospital itself because they should have a policy implemented that each person or group who walks through the ER door should be greeted and asked what the problem is. It doesn't even have to be paid staff as someone else pointed out..it could be a volunteer. The hospital needs to be held accountable for the death of this man. Suing isn't always for the money but so that a change can be implemented....and that it won't happen again for the same reason.

[Lithium]

Originally Posted by OilersBaby

The negligent party was the hospital itself because they should have a policy implemented that each person or group who walks through the ER door should be greeted and asked what the problem is. It doesn't even have to be paid staff as someone else pointed out..it could be a volunteer. The hospital needs to be held accountable for the death of this man. Suing isn't always for the money but so that a change can be implemented....and that it won't happen again for the same reason.

Who would volunteer to be a door greeter at the emergency room?

He sat there for thirty-four hours. I'm not sure if he was sleeping or what exactly the details of his stay in the waiting room were, but don't you think after 45 minutes he was getting a little worried and should have done something about it?

[Thunderball]

I can see 1 or 2 hours... I can even see 4 hours... but 34 hours without anyone noticing... that's negligence, plain and simple... and they should be held just as accountable as private sector employees would be.

[Dion]

Speech problem likely a factor, says pastor

Winnipeg pastor Ken McGhie, who knew Brian Sinclair, said the man's speech impediment may have made him reluctant to ask for help.

"These have got to be the most vulnerable people in our city, anywhere, people that can't communicate and he should have been known to have not been able to effectively communicate," McGhie said.

"He was very hard to understand and especially if he got a little bit excited there was no way in the world you could understand his excited mumblings."

Followup a standard practice, says ex-ER director

What should have happened, what should always happen is communication. Doesn't matter who it is or what the problem is — if a physician thinks a person needs an ER, it means communication," Lerner said. "That includes if a person drives to an ER. The minute they get through the door, they should go to a triage desk."

Phoning the ER when a patient is sent to hospital is the "usual courtesy," he said.

http://www.cbc.ca/health/story/2008/...ir-family.html

[Bagor]

Originally Posted by BlackArcher101

Yes, someone could have... but didn't because it probably wasn't presented to them. How did this guy get to the clinic in the first place and how did he explain to the GP his problem? If he did it then, how come he couldn't when he arrived at the hospital? Not sure if that has been answered before or not... it just doesn't make sense to me. To blame the ER staff for not doing this or that... things that aren't standard practice in the first place... well... that's grasping for someone to blame which is becoming more common in today's society. Can't we just chalk this up to an accidental death instead of saying someone or a group of people are at fault?

Agree, however it's going to be looked at as an entirely preventable death.

It's an obvious comunication breakdown between GP, patient and hospital. I can only assume that the GP made a judgement call that the individual was of an able state to present himself. Hopefully lessons are learned.

Originally Posted by OilersBaby

The negligent party was the hospital itself because they should have a policy implemented that each person or group who walks through the ER door should be greeted and asked what the problem is. It doesn't even have to be paid staff as someone else pointed out..it could be a volunteer. The hospital needs to be held accountable for the death of this man.

Completely disagree. Why should the hospital be held accountable for something they were completely unaware of? The fact that they didn't have a policy (which is totally unrealistic anyway) doesn't make them liable. If they had a policy and failed to implement it, then different story.

Phoning the ER when a patient is sent to hospital is the "usual courtesy," he said.

There's the problem. It needs to be made mandatory.

[Dion]

Originally Posted by Bagor

Completely disagree. Why should the hospital be held accountable for something they were completely unaware of? The fact that they didn't have a policy (which is totally unrealistic anyway) doesn't make them liable. If they had a policy and failed to implement it, then different story.

I agree with OB on her point.

It shouldn't take the death of a man for a policy change to be implimented. It was a preventable death that could have been avoided. Why not look at all the possibilities that could happen in an ER as opposed to reacting after a person dies.

[OilersBaby]

Originally Posted by Lithium

Who would volunteer to be a door greeter at the emergency room?

He sat there for thirty-four hours. I'm not sure if he was sleeping or what exactly the details of his stay in the waiting room were, but don't you think after 45 minutes he was getting a little worried and should have done something about it?

A lot of people, probably seniors who are retired and want to give back to the community. That's who does it at my hospital....

Maybe he wasn't feeling good and whatever illness/pain/medication he was taking didn't allow him to think clearly to ask for help.

[OilersBaby]

Originally Posted by Bagor

Completely disagree. Why should the hospital be held accountable for something they were completely unaware of? The fact that they didn't have a policy (which is totally unrealistic anyway) doesn't make them liable. If they had a policy and failed to implement it, then different story.



There's the problem. It needs to be made mandatory.

The hospital should BE aware..that's the problem. They should have a policy that anyone who walks in through their door should be asked what they need and be instructed accordingly......

[Bagor]

Originally Posted by OilersBaby

The hospital should BE aware..that's the problem. They should have a policy that anyone who walks in through their door should be asked what they need and be instructed accordingly......

So ..... basically every visitor, drug or any other type of rep, service personnel, delivery person, drunk, relative, cop should be interviewed on arrival?

You realise the logistics of this? How do you record who's been instructed and who hasn't? Do you reinstruct a visitor if they pop out for a smoke or give them an armband so you know they've been instructed? How does that work in your hospital? Do seniors work night/evening/weekend shifts?

I'm betting there's a "visitors please report to reception" sign or something similar in the ER.

If blame has to be placed here, I'd lay it on the GP that sent him without communicating it but to be fair to the GP maybe the individual (in their perception) was in a lucid state on leaving before the infection kicked in or the kidneys backed up causing confusion (pure speculation on my part).

If the patient had been under the care of the hospital then fair case. Individuals/Families/attending GPs have to bear some responsibility for their care also.

Dion, I agree it was a preventable death. A simple phone call/fax from the GP would have done it.

[Dan02]

Originally Posted by Bagor

So ..... basically every visitor, drug or any other type of rep, service personnel, delivery person, drunk, relative, cop should be interviewed on arrival?

Through the doors marked Emergency?? I don't think thats unreasonable. There should be someone at the door in emergency to direct people where to go depending on whether they are in need of medical attention or just a family member/cop/sales rep. As it is the emergency room probably provides the least amount of direction of any of the main enterances.

And as for blame, i don't think there is any person to blame here, the system gets the blame not any individual. As for how long he waited without seeing anyone, last time i was in the ER when i sliced myself open i was told they were over 9 hours behind. When they're that busy chances are when the shifts change the room is full and the nurses don't have a clue as to who is who, seeing someone wait in their their entire shift under those circumstances wouldn't seem unusual at all.

[Dion]

Manitoba Health has asked emergency department staff to ensure every person in the waiting room is spoken with to determine whether he or she has been registered. Something that would have prevented this guys death. Sadly they start doing it after someone has died

[Bagor]

Originally Posted by Dan02

Through the doors marked Emergency?? I don't think thats unreasonable. There should be someone at the door in emergency to direct people where to go depending on whether they are in need of medical attention or just a family member/cop/sales rep. As it is the emergency room probably provides the least amount of direction of any of the main enterances.

Have you ever been to the Foothills Emergency department? It's basically a 2nd entrance to the hospital and often used as a thoroughfare (which goes through the waiting room to the main lifts.

Honestly you are talking about a ridiculous backlog of people to implement this.

Originally Posted by Dan02

And as for blame, i don't think there is any person to blame here, the system gets the blame not any individual.

Agreed.

[Dan02]

Originally Posted by Bagor

Have you ever been to the Foothills Emergency department? It's basically a 2nd entrance to the hospital and often used as a thoroughfare (which goes through the waiting room to the main lifts.

actually i haven't been to foothills in many years and can't remember so i reserve comment on foothills, but at lougheed would seem to be easy to implement.

[NuclearFart]

As posters have pointed out, it's not logistically reasonable to accept immediate and full responsibility for every single organism that passes through the hospital doors, especially a department as chaotic as the ER. Unless they arrive in an ambulance, the patients have to at least do something to help themselves, as we don't have the resources to hold everybodies hand as soon as they step through the door.

And of course theres the issue of tolerating people who abuse the waiting room, which complicates things even further. I think this played a much larger role in why this happend, then people are willing to admit.

Lastly, I don't think a GP phone call would have made much difference. Major ER departments are way too busy to keep an eye out for one person in the waiting room, let alone to accurately disseminate the message from a ER doc who took the call, down to the nurses and finally to the receptionist. Sending a stable patient via taxi from a clinic (especially on a native reserve) to the ER is actually quite common, and it's worked flawlessly thousands of times, until now.