Hospital death a ‘homicide’

Hey there, time traveller!
This article was published 14/02/2003 (8450 days ago), so information in it may no longer be current.

The drug overdose death of an elderly patient by a nurse at St. Boniface General Hospital last year was a homicide, Manitoba’s chief medical examiner said yesterday.

Dr. Thambirajah Balachandra said Ettie June Morris, 83, died “suddenly and unexpectedly” on Jan. 4, 2002, after being given a lethal dose of potassium acetate by intravenous. Morris, who had been admitted to hospital the previous day, was waiting for surgery for a broken hip when she died.

Balachandra said he doesn’t believe the fatal dose was delivered accidentally.

“From the evidence that we have, I cannot say it was an accident,” Balachandra said. “The manner of death is homicide.”

Three nurses were involved in Morris’s care; two are still employed at the hospital, Balachandra said. All three have been interviewed by the hospital, police and medical examiner.

The hospital says it knows from the patient’s chart who administered the dose.

Balachandra has ordered an inquest into Morris’s death.

The suggestion that a hospital staff member may have purposely killed the retired Air Canada secretary — known to her friends as June — caught St. Boniface officials by surprise.

“We are taken aback by that,” Hubert Gauthier, CEO of the St. Boniface General Hospital, told a news conference yesterday. He said he only learned of Balachandra’s homicide finding from his news release.

Gauthier said he was frustrated that more than a year after Morris’s death, the hospital still has not been told whether one of its staff members had purposely killed a patient.

He urged police to speed up their investigation so that both hospital staff and patients can feel safe. Failing that, he said he wants the province’s justice minister to step in to get the investigation finished.

“We’ve been hoping ever since this thing started we would have clear answers. Now, we’re a year later and for us it’s important to get to the bottom of this,” Gauthier said.

There are 25 nurses on the fourth-floor surgical intensive care unit where Morris was being treated, Gauthier said, adding the accusations of homicide are hanging over the entire hospital.

“There are too many unanswered questions and I’m asking the minister of justice to use his powers if the Winnipeg police can’t come to grips with it. I cannot sit with that kind of uncertainty in my organization.”

Winnipeg Police Service Insp. Blair McCorrister said he didn’t know when the ongoing criminal investigation into Morris’s death would be complete.

Gauthier said a hospital investigation found the charts had been properly filled out and all the procedures followed.

All but one staff member involved in Morris’s care still work at the hospital. That member, a male nurse, has “gone back to where he came from,” Gauthier said, refusing to elaborate on his whereabouts.

He also wouldn’t say whether that nurse was the one who administered the potassium acetate.

“I’m not going to answer that,” he said. “I don’t have any conclusions… and the police have not indicated anything to us.”

McCorrister would reveal no details of the police investigation.

Morris was supposed to get potassium acetate because a blood test revealed she had low levels of potassium in her blood, which could affect the function of her heart and other muscles. The dose ordered to bring her potassium levels up to normal was not the dose she was given. What she was given killed her.

Health officials say this is the first case they know of in which a patient in a Manitoba hospital has been killed by an overdose of a drug administered by health professionals — intentionally or not. The hospital reviewed deaths prior to Morris’s and since, and no other patients died because of a potassium overdose, Gauthier said.

Balachandra would not discuss whether he felt this was a mercy killing. Potassium chloride, a more commonly used alternative to potassium acetate, is a preferred drug for assisted suicides because when administered in high doses death is quick and painless.

Morris, who worked for Air Canada for 42 years, lived alone and was discovered lying on the floor in her St. Boniface home by police before she was admitted to hospital. She may have been lying there for at least two days waiting for help, according to the woman’s friends.

Balachandra said in addition to the broken hip, she was suffering from dehydration and pneumonia.

Kaaren Neufeld, chief nursing officer for St. Boniface General Hospital, said the hospital has already put tighter security in place for potassium chloride, including having potassium diluted by the pharmacy and sent up to wards in lower concentrations, and stocking concentrated forms of the drug separately with warning labels. In wards where concentrated potassium needs to be kept on hand, it is stored in a secure, automated machine that records who took some, how much, and the date and time.

At the time of Morris’s death, the pharmacy sent concentrated potassium to the ward, and access to the concentrated form was less secure.

Catheryn Martens, director of patient safety for the Winnipeg Regional Health Authority, said all other hospitals in Winnipeg have improved potassium use procedures, and will slowly be brought into accordance with what St. Boniface is doing.

The Criminal Code defines homicide as the death of a human being caused by another person. Culpable homicide, an offence, consists of murder, manslaughter or infanticide.

— with files from Bruce Owen and Alexandra Paul

mia.rabson@freepress.mb.ca