Interior Health and BC’s ambulance service say they are reviewing an incident where a Nakusp man died late last month on the doorstep of Arrow Lakes Hospital.
“Whenever an event like this occurs, the staff and administration will review to learn if there was anything that we could do to improve, and that is occurring in this situation,” says Lannon De Best, executive director of clinical operations for the Kootenay-Boundary district of Interior Health.
People familiar with the incident told the Valley Voice the man began experiencing medical trouble on the morning of Sunday, January 29. The family called for an ambulance to come to their home on the outskirts of Nakusp. They were told it would be at least 90 minutes’ wait for emergency services to arrive.
According to several sources, after waiting an hour, the family made a second call to the ambulance service, only to be told the wait would still be 90 minutes. The man’s condition worsened, and they decided to take him to the hospital themselves with the help of a neighbour.
The man had a cardiac arrest en route, and they were administering CPR to him as they arrived at the emergency department of Arrow Lakes Hospital. But when they got there, they found the doors to the building locked. A staff person finally came and opened the door, but before they could get him treatment, the man had died.
‘Dynamic deployment’ model
Both Interior Health and BC Emergency Health Services said patient confidentiality prevented the disclosure of some details, but they offered their deepest condolences to the family for their loss.
Official statements from both services said the system had worked normally.
“The closest available ambulance was immediately dispatched, and paramedics were en route to the patient when the call was cancelled by the caller indicating they were self-transporting to the hospital,” BC Emergency Health Services wrote in an email to the Valley Voice. “At no point in time did BCEHS Dispatch direct or instruct the caller to transport the patient directly to hospital.”
BCEHS told the Valley Voice that the closest ambulance crew was from “Winlaw and Castlegar,” about 97 kilometres away.
“BCEHS is a provincial service with no municipal boundaries, and we use a dynamic deployment model to make the most of available resources to respond to our patients. We know it is stressful waiting for an ambulance,” the email states.
BCEHS said the Nakusp ambulance station was not staffed for the day shift that day because of illness. Late last year, the Province announced that Nakusp’s ambulance station was moving to a 24/7 fully staffed model – but that has yet to be implemented.
“As you know, BCEHS has been experiencing some staffing challenges,” the BCEHS statement continues. “And since last year BCEHS, in partnership with the provincial government, has made significant changes and investments to improve and stabilize our staffing.”
For its part, Interior Health says the Arrow Lakes Hospital was operating normally, and that “staff reacted quickly and responded in a timely manner when this patient arrived at the hospital.
“At the time of the incident, Arrow Lakes Hospital was open and fully staffed to provide emergency services,” said the statement from IH’s De Best.
De Best said ALH has a patient ambassador at the front from 8 am to 4 pm daily to greet patients and ensure COVID-19 protocols are being followed by everyone coming into the hospital. He said if that individual needs to step away or they are off-shift, the door is locked to ensure the safety of patients, staff and physicians.
“When the door is locked, patients/visitors ring a call bell to access the site and protocols are in place to ensure a timely response from our staff,” he added.
‘A failed system’
But friends of the Nakusp man, his family and rural healthcare lobbyists are raising the incident with federal and provincial politicians and IH officials, which one observer calls “incredibly disturbing.”
“This is deeply disturbing and personal to me, as I have lost a very good friend along with the emotional impacts to the family and friends,” said Nakusp Mayor Tom Zeleznik. “Even more than it already was when we started advocating for change to the BCEHS ambulance service on behalf of our communities well over a year ago.”
Zeleznik says he’s been in touch with BC Emergency Health Services officials, and says he is waiting for the results of their investigation. But he’s also calling for, among other things, improved communication between health providers and the community to ensure the public is aware when the system is under strain and response times affected by staffing issues.
New Denver Mayor Leonard Casley called the event “unacceptable.”
“No family should ever be put in that spot,” he said. Casley added he and Zeleznik had made a presentation at the UBCM convention on their concerns with ambulance service levels, and proposed a model to reduce patient transfer times in the West Kootenay at meetings with the head of the paramedics union and the BC Rural Health Network
“The situation that occurred in Nakusp on the weekend is yet another tragic account that has occurred due to a failed system that impacts so many rural residents in our province,” said Paul Adams of the BC Rural Health Network, who added his condolences to the family. “We have so many people in BC who have provided me with stories and accounts of their ordeals, which are consistently due to a system that does not respond to the needs of rural residents.”
Adams says his group is working on “system-wide solutions” to the ongoing problems of ambulance staffing, response times and delivery of healthcare. While they don’t tend to comment on individual events, this one is being raised with officials as an example of the disconnect between the Province and community.
“Community engagement has been absent for far too long… and is resulting in a rural population that is marginalized and lacks trust in the system,” Adams said in an email to the Valley Voice. “Communications need to be reversed and we need to inform our communities from the bottom up and not the top down.”
Adams said while there have been some positive moves made by the Province, especially in the area of ambulance recruitment and salaries, it is situations like this that underscore the need for serious healthcare reform.
“It is time to change and we sense that change is happening. Unfortunately, it won’t save this gentleman nor the damage to those who tried to help him.”
