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Patient in agony, demise said to be “imminent” but no explanation provided by hospital

It would be impossible to describe the agony our mother experienced during her hospitalization, or the distress we felt as we watched her decline with each passing day.  We witnessed it first-hand while we were at her side assisting with her care and recovery for 14 hours a day, often until the early morning hours because of her extreme distress and agitation.  We were left almost entirely on our own in trying to understand what was happening and what could be done to help her.  Many families face difficult situations involving the hospitalization of a loved one.  What made ours all the more unbearable is that empathy and support on the part of much of MAHC’s clinical team were in extremely short supply.  

The view was constantly telegraphed, if not explicitly stated, that our “expectations” for any recovery on our mother’s part were “unrealistic,” that our “demands” for her care were “unreasonable,” and that it would be better for all concerned if we agreed to a DNR order.  While we could never pin anyone down on exactly what they meant, we presume that requests, such as that our mother be seen by a cardiologist when her heart rate was experiencing rapid swings between the 140s and the 30s, was one of these “unreasonable demands.”  It took weeks before MAHC agreed to a cardiology consultation, even though it was aware that our mother had suffered a  cardiac arrest some weeks earlier. Our concern that anti-seizure medication was not being administered according to recommended protocols was likely another of our “unreasonable demands.”  In fact, one of our mother’s doctors commented in the chart that it was “very difficult to please the family no matter what anyone does” in response to our concern that her anti-seizure medication had been abruptly terminated by her care team contrary to FDA and drug maker warnings.  It was supposed to be tapered over a period of at least four to six weeks.  Instead, the drug was completely stopped in less than two weeks.  Anything that involved more work or more cost in our mother’s care was something that appeared to provoke resentment and was very hard to convince MAHC to do, including a video teleconference with a neurology specialist that was never arranged, despite our repeated pleadings and the fact that our mother was recovering from multiple brain injuries.

In any event, her clinical team could never explain the reasons for our mother’s decline, but we were often warned that she could die at any time.  They would have been correct in that prognosis had she remained at MAHC any longer than she did, given the staggering level of neglect and inattention documented in her chart.

In the more than two years since we began to raise questions with MAHC and bring specific concerns to its attention, the hospital has refused to acknowledge a single specific incident or any failure in care.  Even the exploding syringe seems to fall within MAHC’s parameters of “appropriate care.”  It will not admit that failures occurred in required practices for the prevention and treatment of pressure ulcers or in compliance with physician orders.  Nor will it confirm it followed them.  It will not say that all recommended testing and monitoring was conducted.  Nor will it admit that it was not.  It will not acknowledge that procedures to check for the risks of aspiration were omitted on hundreds of occasions.  Nor will it assure us that they were followed.  It will not confirm the state of severe malnutrition our mother was allowed to fall into while she was a patient.  Nor will it claim she was not malnourished.  On it goes.  Is this an example of hospital transparency and disclosure at its finest, or stonewalling and cover-up at its worst?   The reader can be the judge.  

A hospital is supposed to make you better or, at the very least, not make you worse. It is bad enough that a healthcare institution becomes the source of life-threatening risk and pain to a vulnerable patient.  It is an outrage, and a telling commentary on the failures of the Canadian healthcare system, that so many in positions of trust and authority, from the hospital’s CEO and board of directors to its clinical team and nursing supervisors, actually believe they can maintain the fiction that nothing out of the ordinary happened at all.

 

 

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