Quebec emergency room doctor Sebastien Marin warned about “dangerous” waiting times under Canada’s public health care system on Tuesday after an elderly patient died in front of him after suffering an aneurysm and waiting for 16 hours to see a doctor.
“Honestly, when we have a patient who walks in alive and just dies in front of us, it’s always frustrating when we can’t do anything. But it’s even more frustrating when we know that the patient did the right thing. He tried to get care somewhere and he just didn’t get it,” Marin said in an interview with CTV News of Montreal.
Marin said the patient in question was a man in his 70s who visited another hospital first after suffering his aneurysm, waiting 16 hours in the emergency room, and then switched to Marin’s hospital after he was unable to see a doctor. He died from a ruptured aorta within minutes of arriving at Marin’s emergency room on Saturday morning.
“We can’t 100 percent guarantee that the patient would have survived but he would have had a good chance of surviving if we would have started treating his aneurysm at the right time,” Marin said.
In a series of anguished Tweets written in French written on Saturday, Marin noted the patient was in “pain” and lamented there was “almost nothing to do except offer our condolences” because it took so long for him to see the unfortunate man.
One of Marin’s tweets linked to a Radio Canada article published later on Saturday that described his patient’s ordeal, explaining that the poor man actually went home after waiting 16 hours in the other E.R. before his condition deteriorated even further, prompting him to seek help at Marin’s Barrie Memorial.
Marin told Radio Canada the case was an alarming example of systemic failure, pointing out the patient was a known risk for aorta rupture due to his aneurysm, as clearly noted in his medical records.
“This is a patient who should not have waited in the emergency room. This is a case that was quite clear, a case that was dangerous,” he said.
“It is obvious that with emergency room overcrowding, with the number of patients who leave without having seen a doctor, we put the population at risk with circumstances like this,” agreed Dr. Gilbert Boucher, president of the Association of Specialists in Emergency Medicine of Quebec (ASMUQ).
Boucher complimented Quebec’s triage nurses for “doing a great job,” but said “they too are under pressure” from crushing levels of hospital overcrowding.
“Contestation is terrible. We are out of service. We can no longer serve the population. The population is at risk,” he said.
CTV explained just how bad hospital overcrowding has become:
In Quebec’s Montérégie region, where Marin works, six of the eight emergency rooms were over capacity Monday morning. His hospital was at 60 per cent capacity, whereas the Centre hospitalier Anna-Laberge was at 150 per cent capacity and the Hôpital du Suroît was at 169 per cent capacity.
Last week, the Royal Victoria Hospital in Montreal was at more than double capacity (230 per cent). As of Monday, most of the ERs on the island were either at or over capacity.
Dr. Marin pointed out that hospital overcrowding is made worse because many patients “don’t have a family doctor or speedy access to care at a clinic,” so they turn to the emergency room. Quebec politicians have admitted there are not enough family doctors or clinics to go around, but they pledged to create “mini-hospitals” in Quebec City and Montreal that could alleviate E.R. congestion by tending to “lower-priority cases.”
Marin told Radio Canada he expected effective reforms to “take years and years,” because “quick fixes that have been tried in the past just don’t work.”
The Registered Nurses’ Union of Newfoundland and Labrador was more pessimistic in February after a CBC News investigation revealed hospital overcrowding was much worse than the public had been led to believe by health officials.
“We have a system now that is broken and our members are broken. They are at a point in time where something has to give, something has to change. We’re at a crucial point in health care and we need change now,” union president Yvette Coffey warned.
Coffey said that beginning long before the Wuhan coronavirus pandemic, Canadian hospitals were quietly running “double overcapacity protocols” that basically shuffled patients out of treatment units and stored them in hallways – but simply moving the patients around to reduce the number who reported they could not get into a room was doing nothing to improve their health because there are not enough doctors and nurses to treat them.
Coffey grimly noted the pandemic actually alleviated hospital overcrowding slightly and temporarily because people were afraid to go to the emergency room – but of course, that also meant people who needed treatment were unable to see doctors in person.
Polls have long shown a sizable portion of Canadians do not trust their overcrowded healthcare system and this lack of trust was clearly exacerbated by the pandemic. Examining such a poll in January, the National Post suggested the Chinese coronavirus was the shove that sent a tottering system into collapse.
Canada’s shortage of both regular and intensive care beds – one of lowest ratios of beds to population in the industrialized world – was made painfully obvious by the coronavirus. The National Post noted the United States is not too far ahead of Canada on those ratios but had a lower rate of intensive care bed occupancy at the dawn of the pandemic.
CBC warned last week that Canada’s overstressed emergency rooms are about to be hit by both flu season and a resurgence of Chinese coronavirus cases. Hospital officials pleaded with the public to bring “less severe” health problems to clinics and primary care providers before turning to emergency rooms or calling ambulances.
“Hospital officials said that as of Monday, the medical surgical hospital occupancy was at 107.3 per cent, with occupancy in the intensive care unit (ICU) at 90.9 percent. It’s been at, near or over capacity for much of the year,” CBC noted.