The Alberta-based Shock Trauma Air Rescue Society (STARS) helicopter air ambulance service was temporarily suspended by the province Monday following the death Friday of a woman suffering from cardiac arrest.
Provincial officials said it appears the woman, who had been cleared for the flight, had not been properly ventilated with oxygen. The woman was being transported from an undisclosed location in the Southern Health Region to Winnipeg and died on the ground in Winnipeg.
Her death is being treated as a critical incident, the third critical incident connected to STARS since last February. The death will also be added to an ongoing external review of 15 cases involving STARS, Health Minister Erin Selby said at a late afternoon news briefing at the legislative building.
"We need every assurance that STARS is providing safe and appropriate emergency care," Selby said, adding it's expected a critical-incident review of the woman's death may take a few weeks to be completed. "We want to get this right and we will take our time and ensure to act on the advice of medical professionals."
It's the first time STARS air ambulance, which also operates in Alberta and Saskatchewan, has been suspended since it started operating in 1985 in Calgary. STARS started flying in Manitoba during the 2009 spring flood and to date, under a formal agreement with the province signed in 2011, has flown more than 690 missions and transported more than 430 patients. The annual operating cost for the STARS service is about $12 million.
The province's decision to temporarily withdraw from STARS was made with input from STARS CEO Andrea Robertson.
"Up until the decision to temporarily suspend STARS, I was advised that STARS was providing appropriate medical care," Selby said. "We know that this helicopter ambulance plays a vital role in our health-care system, which is why this is not a decision that was made lightly."
STARS Manitoba spokesman Colin Fast said the company is co-operating with government. He would not comment on whether STARS believes the suspension is justified.
"The government's our partner here. We're going to be totally co-operative with them," Fast said.
He added STARS will share its own internal review with the province, but will not make it public.
"We're still here if the suspension is lifted or there's an emergency," he said.
Gerry Delorme, executive director of health emergency management, said the woman's death is the third critical incident in less than a year related to STARS.
The first occurred last February and involved an adult -- no details have been released -- and saw six dispatch restrictions placed by provincial medical officials on STARS, including the type of patient the service could fly and the distance it could transport patients.
The second critical incident was in May involving two-year-old Morgan Moar-Campbell. He was being flown from Brandon aboard the STARS helicopter for tests following a seizure. The boy was in an induced coma and could not breathe on his own. When he landed in Winnipeg, it was discovered his breathing tube had been pulled out, depriving him of oxygen and leaving him severely brain-damaged. His case is now the subject of a lawsuit.
Delorme said at the time medical officials discussed the risks of continuing service with STARS and agreed to put either a physician on board all STARS inter-facility flights or a senior air medical crew including a paramedic or nurse with more than five years experience.
"It's clear, based upon this third critical incident, that basic medical practices and basic medical advice appears not to have been followed," Delorme said. "We'll be looking second-by-second at the decisions that were made, the care that was provided to this individual, the effects of the care that were provided to this individual."
Delorme said specifically, the critical incident review will look at whether the woman was given enough oxygen and if that contributed to her death.
"The crux of the critical-incident review will be the failure to deliver sufficient oxygen to a patient that was intubated in air transport," he said.
On board the flight were a physician, a paramedic, a nurse and two pilots, Delorme added.
The Office of the Chief Medical Examiner is also reviewing the woman's death to pinpoint cause.
Selby added the critical review will also look at whether the woman would still be alive if she were not put on the helicopter and whether a ground ambulance would have been more appropriate.
Selby said the province has reconfigured its fixed-wing air ambulance system in the absence of STARS so patients needing medical care are flown from rural Manitoba to Winnipeg as quickly as possible. The fleet includes two critical-care air ambulance jets and 24 basic air-ambulance aircraft.