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FM
Former Member

Man's death at home after ER release stirs review of discharge rules

 

Jan. 10, 2014 at 2:53 PM, Source

 

WINNIPEG, Manitoba, Jan. 10 (UPI) -- The death of a Canadian man on his doorstep after being released from a Winnipeg emergency room has officials calling for changes in hospital discharge rules.

 

David Silver, 78, was found dead near the front door of his home Dec. 31 hours after a taxi had brought him home from Grace Hospital where he had been taken by ambulance after complaining of nausea, stomach ache and a headache, the Winnipeg Free Press reported Friday.

 

Officials said he appeared to have had a heart attack shortly after the cab left.

 

Silver's nephew, Miles Pollock, called his uncle's death part of a "systemic problem."

 

"It's the middle of the night. It's minus 40. He's an old man who's sick. He's not dressed to be outside, and a) you send him home and b) you send him home unaccompanied in a taxi," Pollock said.

 

When found, Silver was dressed in pajama bottoms, bedroom slippers and a coat he apparently had been wearing when he went to the hospital.

 

Doctors at the emergency room said they diagnosed Silver with kidney stones and gallstones, but that he wasn't sick enough to admit. They sent him home with instructions to call his doctor.

 

Pollock said staff at the medical examiner's office found Silver had an enlarged heart, blocked arteries and high blood pressure.

 

Lori Lamont, vice president and chief nursing officer with the Winnipeg Regional Health Authority, said the agency was investigating the treatment Silver received at the hospital and the circumstances of his death once he got home.

 

Lamont said Winnipeg hospitals are required to follow discharge rules that include ensuring a patient is ambulatory. Taxi drivers who take patients home typically help the person in and out of the vehicle. She said she wasn't sure why that wasn't done in Silver's case.

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Winnipeg hospital confirms death of 2nd man after release

Confirmation follows report on David Silver, 78, who died after discharge from Grace Hospital

CBC News, Posted: Jan 10, 2014 3:32 PM CT, Last Updated: Jan 10, 2014 10:04 PM CT, Source

 

Hospital release deaths

The recent deaths of two Winnipeg men who were found outdoors after being sent home from hospital by taxi has Manitoba's health minister promising new rules to make sure discharged patients are transported home safely.

 

The Winnipeg Regional Health Authority (WRHA) confirmed Friday it is investigating a second death involving a man who had been discharged from Grace Hospital in late December.

 

News of the case came after CBC News reported that 78-year-old David Silver died on his front porch after being sent home from Grace Hospital in a taxi on Dec. 31.

 

David Silver

David Silver, 78, died on his own porch after being released from Winnipeg's Grace Hospital at 1:30 a.m. on Dec. 31. He was sent home in his pyjamas and slippers and with a cab slip. (Family photo)

 

The WRHA said both men's cases meet the requirements for officials to launch critical incident investigations.

 

Silver was taken by ambulance to the hospital on Dec. 30 suffering from stomach pain, nausea and a headache.

 

His family told CBC News that doctors told him he had gallstones and kidney stones and the problem wasn’t serious enough for him to be admitted to the hospital.

 

At 1 a.m. on Dec. 31, they told Silver they were sending him home. He was given a cab slip and sent home in his pyjamas and slippers, according to family members, even though the temperature at the time was –37 C without the wind chill.

 

On the way to his door, Silver collapsed and died. He wasn’t found until about 14 hours later, when his caregiver arrived to find him frozen in the snow.

 

His family said Silver didn’t die from freezing to death, but of a heart attack or some kind of a heart-related issue.

Man found on sidewalk

The WRHA says in the second case, a man was discharged from Grace Hospital and driven by taxi to a residence on Arlington Street.

'It's common sense to make sure that the person gets to the door in a safe manner. - Erin Selby, health minister

Less than an hour later, a passerby called 911 after seeing a man lying on the sidewalk outside the home.

 

"Our understanding was that he was alive when he exited the taxi," Arlene Wilgosh, the WRHA's president and chief executive officer, told reporters on Friday.

 

"And it is our understanding as well that he was deceased when emergency personnel arrived," said Lori Lamont, the health authority's chief nursing officer and vice-president of interprofessional practice.

 

Shawn Zemla, who lives in the building next door to the man's home, said he woke up one morning and heard a woman screaming.

 

Grace Hospital

The WRHA says in the second case, a man was discharged from Grace Hospital and sent to a residence on Arlington Street. Less than an hour later, a passerby called 911 after seeing a man lying on the sidewalk outside the home. (CBC)

Zemla said he saw a man lying on the pavement outside his building, as passersby and emergency responders tried to revive him.

 

"I ran outside and I grabbed as many blankets as I could and I covered him up," he told CBC News.

 

"We couldn't get him on his back because he was really heavy-set, so it took us quite a while to get him from being face-first in the snow."

 

The man, who had been in the hospital's emergency room for about 24 hours and was thoroughly examined, died of an underlying medical condition, according to the health authority.

 

The health authority did not release any details about the man, such as his name or age.

 

As for when the second death occurred, a WRHA spokesperson would only say an incident took place "where a gentleman left Grace Hospital at 8:20 a.m. within approximately a one-day range of the incident with Mr. Silver."

 

Lori Lamont and Arlene Wilgosh

Lori Lamont, left, and Arlene Wilgosh of the Winnipeg Regional Health Authority speak to reporters about the two Grace Hospital cases on Friday. (Caroline Barghout/CBC)

 

Overnight low temperatures in Winnipeg at the time were between –33 C and –38 C without the wind chill.

 

The WRHA says taxicabs are commonly used to transport patients home from hospitals in the city, but it did not have specific numbers.

 

Wilgosh said the WRHA will meet with the provincial Taxicab Board next week to develop a plan to ensure discharged patients get inside their homes. As well, officials are reviewing the discharge protocols in both cases.

 

"One key point that I wanted to leave with you is one of the similarities of these cases [is] that they do both involve transportation by a taxi cab," she said.

 

Health minister wants onus on cab drivers

On Friday, Manitoba Health Minister Erin Selby said the onus should be on taxi drivers to ensure patients being driven home by cab get inside their homes safely.

 

Erin Selby

Health Minister Erin Selby said Manitoba Health is drafting a protocol to be sent to all regional health authorities. (Angela Johnston/CBC)

 

"I think it's clear that when a patient is discharged from hospital and returned by taxi that that should include making sure that patient gets through the front door safely," she told reporters.

 

Selby said Manitoba Health is drafting a protocol to be sent to all regional health authorities.

 

"People on the front line make the decision of what is the best way to discharge people … in many cases it is a cab," she said.

 

"In the case somebody be discharged from a taxi, we are going to expect — and it will be mandatory — that the taxi cab driver ensure the person make it to the front door safely," she added.

 

"It's common sense to make sure that the person gets to the door in a safe manner."

 

No one from Winnipeg's main taxi companies, or the Taxicab Board, has responded to requests from CBC News for comment.

 

'It's still happening'

The WRHA's current guidelines do not require cab drivers to escort patients to the door, but officials said cab drivers typically do watch for patients to get inside or help them.

 

The health authority revised its safe discharge policy after Heather Brenan died under similar circumstances in January 2012.

 

Brenan, 68, was sent home in a taxi from the Seven Oaks Hospital emergency room. She collapsed on her doorstep and died from blood clots in her lower legs.

 

An inquest has been called into Brenan's death, but no date has been set yet.

 

Her daughter, Dana Brenan, says while the WRHA's policy may have been revised, it appears that no one has made sure protocols are being followed.

 

"Clearly there's been no change, that it's still happening," she said.

 

"Yes, it's a different hospital than in my mother's case, but this is obviously a city-wide policy."

 

On Friday, officials said they are looking into whether the WRHA's discharge policy should be changed for the period between November and April because of the cold winter weather.

FM
Last edited by Former Member

Unfortunate things do happen, my friend Danyael.

 

These two issues, among numerous others, leave one to indeed wonder about the attention provided to patients, regardless of age.

 

By the way, age is catching-up quickly with you, Danyael.

FM

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