Heart patients to receive written timeline for surgery, minister announces

A new Manitoba policy aims to ensure that cardiac patients get a written timeline for when their surgery should occur, and that the cases of people who die while waiting for their procedure are tracked, reviewed and reported.

A memo to Health Minister Uzoma Asagwara Thursday from Shared Health’s specialty surgery lead, Dr. Ed Buchel, outlines a process to improve communications with patients.

It’s in response to the death of Debbie Fewster in October, after she had waited months for heart surgery that she was told she needed within weeks.

In March, her family and advocates called for legislation, dubbed “Debbie’s Law,” that would require health authorities to tell patients when they cannot provide life-saving treatment within the recommended period, and to advise them when to seek it outside Manitoba.

Asagwara said Friday their ministerial directive has the authority to “ensure that immediate steps can be taken to put patients first, and to make sure that there’s a process in place that prioritizes the patient experience, prevents this kind of a tragedy from happening, and that that work was done as quickly as possible.”

The policy says that prior to surgical consultation, the patient will receive written information about how cardiac patients are assessed for acuity and the targeted wait times for their acuity level. During their consultation, the surgeon will provide to the patient in writing the timeline for when their surgery should occur, along with the targeted wait time for their acuity.

“Ensuring this vital information is available is essential,” Doctors Manitoba said Friday. “Both patients and their surgeons are dependent on the health care system to provide appropriate hospital resources and wait-list management, to ensure timely cardiac surgery is provided within the medically recommended timelines,” a spokesman for the advocacy group said.

“Ensuring this vital information is available is essential.”–Doctors Manitoba

The Shared Health memo to the minister says the surgical and anaesthesia program “is working to address and eliminate patients from waiting for surgery outside of their specific, targeted wait times.”

It does not say what happens when a patient doesn’t get their surgery within that time.

“The vast majority of Manitobans who need cardiac care receive that care” within the targeted wait times, the minister said.

When circumstances indicate that a person may fall outside the targeted wait, “the expectation is that surgeons take swift action to make sure that patients are able to receive the care they need within those targeted benchmarks,” Asagwara said.

“It could be adding additional (surgical) slates, adding more capacity to make sure that people are able to get those surgeries within those benchmarks.”

Debbie Fewster’s son said he’s “very pleased that the government seems to be taking this seriously,” but doesn’t see how a policy that doesn’t have any “teeth” would have prevented his mother from dying while she waited for overdue surgery.

“What happens when the expected wait time is longer than the surgery can be performed?” Daniel Fewster asked Friday. “Are there penalties (for) the health regions that fail to meet those times? Is there accountability? If a surgeon knows that a patient can’t receive treatment, are they required to say so?”

Such legislation may have meant his mom was offered the choice of going out of province for surgery rather than waiting, Fewster said. The 69-year-old from Niverville was told by a cardiologist that she needed triple bypass heart surgery within three weeks. When Debbie Fewster died more than two months later, her surgery still hadn’t been scheduled.

Fewster said he’s unaware of anything in writing that was given to his mom about her targeted wait time for surgery. He doesn’t know if having that in writing from the cardiac surgeon would have helped her receive surgery in time.

She might have “pushed a little harder,” but she believed she was in good hands, her son said.

“I have a text from her saying how blessed she feels because they’re seeing her so quickly, and then they didn’t,” Fewster said.

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The policy will track patients who die awaiting cardiac surgery, and review whether the wait caused or contributed to their death. The Winnipeg Regional Health Authority has said 19 people died while on the wait list for cardiac surgery from 2018 to 2024.

It couldn’t say how many of the deaths were related to the wait.

“There are all kinds of reasons why people may pass away waiting for any type of surgery — a car accident — that could be completely unrelated,” the health minister said Friday.

Reports will be done quarterly and made public “in the most responsible way,” Asagwara said.

Since there are very few patients who die waiting for heart surgery, there’s an increased risk of publicly identifying them, the minister said.

“Our intention with this is to understand why people have passed away while they are on a wait list. If it is directly related to care they’re meant to receive, then the work of understanding how we prevent that from happening is key. We can get recommendations from those assessments and those reviews that we can make policy changes,” Asagwara said.

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Critics who backed Debbie’s Law say the new policy is a start, but doesn’t go far enough.

“It’s not clear what happens if the wait time exceeds the recommended wait time,” Tory health critic Kathleen Cook said. “What Debbie’s family had asked for in those situations was that patients would be made aware of out-of-province options. That’s nowhere to be found here,” she said.

“It’s positive to see the government is going to track and analyze cases where patients die while waiting for potentially life-saving treatment,” said Colin Craig with the SecondStreet.org think tank.

He called for more accountability, noting there are no penalties imposed if a patient dies because the government took too long to provide treatment.

carol.sanders@freepress.mb.ca

Carol Sanders
Legislature reporter

Carol Sanders is a reporter at the Free Press legislature bureau. The former general assignment reporter and copy editor joined the paper in 1997. Read more about Carol.

Every piece of reporting Carol produces is reviewed by an editing team before it is posted online or published in print — part of the Free Press‘s tradition, since 1872, of producing reliable independent journalism. Read more about Free Press’s history and mandate, and learn how our newsroom operates.