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Quality of elderly care questioned

Families say patients discharged from city hospital too early

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TWO Winnipeg families hope a judicial inquest called this week into last year’s death of Heather Brenan looks deeper into the quality of care of elderly patients at the city’s hospitals.

The families say their loved ones experienced similar treatment as the 68-year-old Brenan, who was sent home from Seven Oaks General Hospital in a cab in January 2012, collapsed on her doorstep and died the next day.

Mark Popovich said his 87-year-old mother, Elizabeth Popovich, died Aug. 21, 2011, after she had been admitted 10 days earlier — also at Seven Oaks — complaining of shortness of breath.

"I’m not saying they caused her death," Popovich said, "but was her death untimely? Yes, because of the treatment she received there."

Popovich said despite his mother’s complaints that she still had shortness of breath and needed oxygen, she was discharged back to Holy Family Nursing home where she resided. A family member checked on her at the home almost immediately and found her in a hypoxic condition, her skin a blue colour because of a lack of oxygen.

Popovich, who also suffered from cancer, was rushed back to Seven Oaks and was found to have suffered a pulmonary embolism, a blood clot in the lung.

"It just went down from there," Popovich said. "The cancer didn’t kill her. It was everything else."

He said he believes his mother was discharged in order to free up her bed for another patient.

"It was like, ‘OK. You’re leaving. Let’s go.’ Within five to 10 minutes, she was out of the hospital."

The family filed a complaint with the hospital about their mother’s treatment and on June 13, 2012, got a written apology from patient relations consultant Rose Dziadekwich. Popovich’s case was investigated as a critical incident.

"Your concerns regarding your mother’s pain control, nursing observations and communication and discharge back to Holy Family Nursing Home have been followed up with the parties involved," Dziadekwich said in the letter. "We apologize most sincerely for these experiences and can assure you that steps have been taken to address these issues."

Norman Malayney said he had a similar experience with the treatment of his 96-year-old mother, Lucille Nitchuk, also at Seven Oaks. Malayney said he’s considering a wrongful death claim against the hospital. Nitchuk was admitted to the hospital in February 2011 with congestive heart failure.

Malayney said a lab test revealed his mother had a low hemoglobin count and a blood transfusion was ordered. She was also put on medication.

Malayney said his mother was discharged without a transfusion because doctors believed she had responded positively to the medication, Lasix.

He said he believes his mother’s hemoglobin level had not recovered enough to move her out of danger, and that her heart condition worsened after she was discharged.

"Seven weeks later, she returned to the ER," Malayney said. "Staff rushed her in and transfused three units of blood to prevent her from dying."

She died June 26, 2011, at Seven Oaks from heart failure.

"Though my mother was 45 days short of 97 years when she died, mentally she was sharper than sharp and functioned physically at the level of a 50-year-old woman," Malayney said.

A Winnipeg Regional Health Authority spokesman said a comment from the hospital was not immediately available.

WRHA CEO Arlene Wilgosh has said in response to similar incidents that Seven Oaks, the city’s second-busiest ER, provides "safe, quality care."

One of those incidents was the Aug. 31, 2009, death of Anne Rostecki. An internal investigation found the 98-yearold stroke victim died at the hospital after two weeks of delays and inconsistent decisions regarding oral and tube feeding, resulting in a lack of adequate nutrition. The family alleges she was deprived of food for 14 days during her 45-day stay at the hospital.

Chief medical examiner Dr. Thambirajah Balachandra called the inquest into Brenan’s death on Tuesday partly to examine whether a lack of acutecare beds contributed to Brenan’s being sent home prematurely.

Balachandra said the inquest will look at whether acute-care beds were taken up by long-term patients waiting for placement in care homes.

Brenan was kept in the hospital from Jan. 24 to 27, 2012, on a gurney in the emergency room. She was never admitted. After several days of tests, she was discharged when her oxygen level apparently had stabilized. A nurse sent her home in a cab without any house keys and left a message for a friend, saying Brenan was being discharged.

Brenan arrived in a cab and, using a walker, she walked as far as the front doorway before she collapsed.

An ambulance was called and Brenan was taken back to the ER just after midnight Jan. 28, 2012. She died just before noon the same day.

The cause of death was a bilateral pulmonary embolism from one of several blood clots in her calf due to deepvein thrombosis of the lower legs.

Popovich said he hopes publicity about the inquest — a date has not been set — compels the health-care system to address the issue so that there is closer scrutiny when older patients are being discharged.

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