Winnipeg Free Press - PRINT EDITION

Nurse could have treated Sinclair, MD tells inquest

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A Health Sciences Centre nurse, not a doctor, could have administered all the care Brian Sinclair needed, a medical clinic doctor told an inquest looking into the man's death.

A note in Sinclair's pocket would have given HSC medical staff all the information they needed to treat him.

Dr. Marnie Waters, a physician at the Health Action Centre, testified Monday Sinclair's stable condition was why she sent him to the HSC in a taxi instead of an ambulance, and with a letter from her instead of with an attendant.

Waters said while Sinclair did need medical help for what she believed was a blocked urinary catheter, he didn't need emergency care when he left her for the five-minute ride to the hospital on Sept. 19, 2008.

Waters said she and an HAC nurse agreed the emergency department was "the safest and most appropriate place for Brian" because it was mid-afternoon on Friday and the clinic would be closing later that day, they didn't have the equipment to lift the double amputee from his wheelchair to a bed, and the HAC lab wasn't open Fridays to test his urine for signs of infection.

Waters said "a fast-track or minor-treatment area by nursing" was all she thought he needed when he arrived at HSC.

Waters admitted she had to compose herself before trying to make a couple of phone calls when, three days after she saw Sinclair, she was told he died in the emergency department's waiting room still waiting to be seen.

"It was a really emotional piece of news," she said.

Waters said Sinclair's death has changed how she looks at patients and situations: "I'm working from the position the unexpected happened, so I'm always expecting the unexpected now."

Sinclair, 45, died on Sept. 21, 2008, of a treatable bladder infection after waiting untreated for 34 hours at HSC.

The inquest has heard Sinclair could have been dead as long as seven hours before fellow patients alerted hospital security that the man appeared to be dead.

Waters said Sinclair was calm, showed no distress and wasn't sweating when she saw him around 2 p.m. when he came to the clinic complaining of pain in his penis and no drainage through his urinary catheter since the day before.

She said when she felt his abdomen, his bladder had distended about four centimetres above his pubic bone. She said she didn't consider this an emergency because she has seen other patients whose bladders distended 10 centimetres.

In the two-paragraph letter she gave Sinclair to show at the HSC emergency department, Waters wrote she was concerned "he is likely obstructed, possibly due to a dislodged foley (catheter).

"I am unable to provide adequate foley care here and ask that he be seen by nursing at your facility to ensure adequate foley placement and urine output."

The inquest has been told the letter was found tucked in Sinclair's pocket after a medical team tried briefly to revive him when he was found not breathing in the hospital's waiting room.

Later, Waters told the judge that even with new procedures put in place by the Winnipeg Regional Health Authority after Sinclair's death, doctors at clinics who now have to phone emergency rooms when transferring patients there still have problems.

She said she has experienced problems with emergency-room staff linking her phone call with her patient.

As well, she said there have been times she has called the emergency room at one hospital, but the ambulance is redirected to another facility because of overcrowding.

Waters said it would be good if a document could be created for patient charts that would let physicians know their patient is under the authority of the public trustee and the reason why that happened.

The inquest continues.

kevin.rollason@freepress.mb.ca

Republished from the Winnipeg Free Press print edition October 22, 2013 B1

History

Updated on Tuesday, October 22, 2013 at 9:45 AM CDT: Blog box added

10:15 AM: adds photo

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