Tears fell but Laura Tssessaze's voice was rock-steady Tuesday as she recounted how she and her husband had to console the nurses left devastated following the death of the couple's daughter.
"We gave them comfort, to tell them what had taken place was not their fault," Laura, with husband Donald at her side, said during a press conference in Winnipeg.
"(The nurses) were grateful we thought about it that way."
On May 27, Lisa Tssessaze, 30, the couple's disabled daughter, stopped breathing and later died on the floor of the nursing station in the community of Lac Brochet despite the desperate pleas by phone from nurses to airlift the woman to see a doctor in Thompson.
Now, Manitoba's northern aboriginal chiefs have called for an inquest into the young mother's death and the state of northern health care.
They claim the woman died as a result of negligence on the part of at least two doctors: one in Winnipeg who removed a tracheal tube that had been in place for eight years, and another in Thompson who denied nurses' pleas for a medevac flight.
"I strongly believe if she had been sent out, if she had been given medical attention, she'd be here today," Laura Tssessaze said.
'I strongly believe if she had been sent out, if she had been given medical attention, she'd be here today'
Five times over two days Lisa went for help to the nursing station at Lac Brochet, 1,015 kilometres northwest of Winnipeg. A tracheal tube she relied on for eight years after she was seriously injured in a 2006 house fire that killed her son had been removed the previous week in Winnipeg and she was having severe breathing problems.
Nurses repeatedly called for a medevac from Thompson to fly to the Northlands Denesuline First Nation at Lac Brochet to transport the woman back for treatment, but the Tssessaze family maintains the nurses were turned down.
Instead, the family was told a doctor, making regular rounds, would fly into Lac Brochet on May 28 and Lisa could be seen then.
Lisa's fifth and final trip to the nursing station was the day before that. She fell as she struggled to get to the medical van, and again as it pulled up to the nursing station. She collapsed once more just inside the door of the nursing station.
"As a mother, I saw my daughter fighting for her breath -- gasping for her air," her mother said.
Two of the three nurses at the station hooked Lisa to a monitor and began mouth-to-mouth resuscitation to revive her.
"They were still asking me if they could keep trying, even when she was gone. I looked at the flat line. They looked at me and said, 'Do you want to continue?' All I did was (shake) my head, 'No way. There's nothing more you can do.' "
An autopsy later determined the woman died of pneumonia.
Her family and Manitoba's northern chiefs say the real cause of death was negligence and they've called for an inquest to look into gaps in health care they claim cost people their lives. Lisa is the third person from Lac Brochet in the last three years to die from insufficient medical care, community leaders said.
"She never gave up on life but it was like Health Canada did. They gave up on her. The system failed her," said Grand Chief David Harper of Manitoba Keewatinowi Okimakanak, which represents 30 northern First Nations.
Manitoba Health confirmed it is investigating the death. It also suggested family with questions about the care or medical advice given to a patient also contact the College of Physicians and Surgeons.
"The Northern Health Region is also aware of this incident and has confirmed that as part of the usual process following a tragic occurrence like this, they are also reviewing the case. The decision to call an inquest is made by the chief medical examiner. They have indicated that if an inquest is called, they are prepared to co-operate fully with that process," a provincial spokesman said.
Manitoba Chief Medical Examiner Dr. Thambirajah Balachandra said he's familiar with the case.
"We do investigate all cases that are reported and an inquest is a major thing so we take care to select our cases. This one will be thoroughly investigated and then we will make a decision," he said.
Lisa Tssessaze had survived a northern house fire in 2006 that killed one son, left another in a wheelchair and disabled her. She'd suffered extensive burns and the amputation of one of her legs.
She'd lost one brother to homicide the year following the fire and a brother-in-law the next year when his snowmobile fell through the ice.
She never complained and refused all medication, despite suffering frequent pain, her family said.
With her son, 10, in a wheelchair and an 11-year-old daughter to care for, she lived with her parents and managed to earn her high school diploma. She was enrolled in a college culinary arts program in The Pas this coming fall.
The Tssessazes say Lisa fell through the cracks in a flawed system that involves two levels of government and hospitals in Winnipeg and Thompson, not including the Lac Brochet nursing station.
"I do not want to see another family go through this. If there is anything I can do to prevent this from happening again, I will do it," Laura said.
Donald Tssessaze said his daughter should have been warned ahead of time doctors intended to remove the tracheal tube. And she never should have been sent home without medical care, he said.
"They should have kept her in the city for two or three days when they took the trachea (tube) out," he said.
And the question of why Lisa was denied a medevac flight to the nearest hospital, once she did run into trouble, must be answered, her parents said.