Hospital smoking bans endanger patients: study

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Patients have been accidentally locked out of hospitals during smoke breaks, a new study says. (ROY ANTAL / POSTMEDIA NEWS ARCHIVES)

IT was a bitter winter night, -30 C, in December 2000, when a 54-year-old hospital patient slipped outside Seven Oaks Hospital in her hospital gown, pulling her intravenous pole behind her.

She wanted a smoke.

An hour later, she was found comatose in a snowbank. The woman had suffered hypothermia and frostbite to her hands and feet. Four fingers on her right hand had to be amputated. She was left with limited mobility in her left hand.

The door had locked automatically behind the patient and she couldn't find a way back in. "I remember it well because it was so bizarre. This woman was caught on surveillance crawling around outside the hospital for an hour, looking for a door she could get back inside," the woman's lawyer, Robert Tapper, said Monday.

She didn't find an open door. The security guard somehow missed the horrific footage as it recorded the ordeal.

If there is anyone who fits the profile of what Canadian researchers found in a study on the unintended safety consequences of smoking bans in hospitals, it was this woman, her lawyer said.

"Hospitals should not judge patients. They should treat patients," Tapper said, adding that even a decade later the case troubles him.

"Here was a lady who goes out to smoke -- I don't think people should smoke either -- but she goes out, the door locks behind her. She's locked out in her nightgown with an IV in the frozen bloody snow and she collapses in a coma in the snow. Hello?"

The woman successfully sued Seven Oaks Hospital and the nurses. The hospital secured a confidentiality agreement.

The study, published in this week's issue of the Canadian Medical Association Journal, found IV lines and electronic pumps malfunction in extreme cold, patients are accidentally locked out and nurses can't locate patients when they leave the unit for a smoke.

The study, which focused on two hospitals, Winnipeg's Health Sciences Centre and Edmonton University Hospital, found patients and staff continue to smoke on hospital property despite policies banning smoking inside all buildings, entrances and on all hospital grounds.

On Monday, the woman, who didn't want her name published, declined comment on the study or her own suffering.

"I just want to put it behind me," she said from her home in East Kildonan.

Patients outside Health Sciences Centre and Seven Oaks Hospital, where the woman nearly died in 2000, said Monday they get little respect or understanding from hospital staff for their addictions.

Security guards chase them away from HSC entrances.

At Seven Oaks, the patrols aren't frequent and a picnic table sits near the sidewalk outside the Leila Avenue entrance, in unspoken acknowledgement smokers will smoke.

"You could be dying of cancer and the doctors will make you get pneumonia by making you smoke outside," said Randy Johnston outside Seven Oaks where he was smoking Monday. "The least they could do is make it humane and create a smoking area that's sheltered."

David, a 25-year-old stabbing victim, stood outside Health Sciences Centre in a hospital gown, a jacket and with an IV pole. He said smoking is an addiction and he suffers from it. "It's hard not to smoke when you've been smoking so long," David said.

The Winnipeg Regional Health Authority doesn't plan any changes in the wake of the study.

Dr. Michael Routledge, in charge of population and public health at the WRHA, said city hospitals are proud of their smoking bans. Security guards enforce them by asking patients who smoke to move away from hospital entrances.

"We try to create a smoke-free atmosphere," Routledge said. "And this is about making sure everybody knows we have a policy."

Winnipeg hospitals offer smoking-cessation options, including the patch and nicotine gum to smokers while they're patients to discourage smoking.

"That's one of the advantages," Routledge said. "As we enforce the policy, people won't go out to smoke."

-- with files from Postmedia News

alexandra.paul@freepress.mb.ca

Republished from the Winnipeg Free Press print edition November 1, 2011 A4