Emergency room must be expanded, says coroner's jury

The Saint John Regional Hospital needs to expand its emergency room, a coroner's jury recommended Thursday following the inquest into the death of a 78-year-old womanin February 2005.

It was one of 29 recommendations made by the jury looking into the death of Lillian Mullin, who had been sent home from the emergency room two days before she died.

The emergency room was operating in "code orange" when Mullin was admitted the first night, meaningit was severely overcrowded.

'It has to happen. They're in chaos. They're in trouble ... and if they're in trouble, we're in trouble.' —Shirley MacAulay

Shirley MacAulay, Lillian Mullin's daughter, said she hopes the hospital follows the recommendation to expand the emergency room.

"It has to happen," she said. "They're in chaos. They're in trouble ... and if they're in trouble, we're in trouble. If I was a doctor, or I was a nurse working there, I'd be going 'Kudos to that family. Thank God somebody came forward and brought attention to this.' I can't see them thinking otherwise."

More training needed

The jury also recommended emergency staffreceive more training on diagnosis ofabdominal pain in the elderly.

When Mullin showed up at an emergency room after five days of abdominal pain and diarrhea, hospital staff decided she had the flu and sent her home.

She was brought back to the emergency room two days later and died.

Dr. Kalman Protzner, who conducted an autopsy on Mullin's body, told the coroner's jury during the inquest that doctors had advised him Mullin might have died from ischemic bowel disease or C. difficile,but he couldn't prove it one way or another because he didn't take a stool sample.

One of the other recommendations to come out of the week-long inquest was that extramural nurses providing homevisits in New Brunswickreceive more education on identifying diarrhea caused by C. difficile bacteria.

John Evans, the presiding coroner at the inquest, said it's important for people to hear the concerns and problems revealed in this inquest.

"It's important to the community to know … not to lose confidence in their local hospital and their emergency department," he said. "But [they must] also understand some of the limitations [hospitals are] working with."

Valerie Kincaid, a spokeswoman for the hospital, said many of the jury's recommendations are already being put in place, and that various departments will be looking at how to implement the rest of them.

The coroner's jury also said the province needs to come up with a long-term plan for nursing homes, because so many elderly patients are in hospital instead.