A woman's last week in pain included 26-hour wait at Fredericton ER, son says

Mary Lou Beckett was still working with Fredericton seniors at age 79.

She was relatively healthy until last month, when she started getting sick. Unable to eat and in extreme stomach pain, Beckett waited 26 hours at the Dr. Everett Chalmers Hospital emergency department on the last weekend of July.

She was finally seen in the ER and tested, then referred to a cancer specialist in Moncton because of a mass found in her uterus and another pushing up against her bowel.

She was sent home to wait for the appointment, which was eight days away.

After seven days of lying in bed, in pain, she told her husband, Wayne: "I'm not going to make it to Moncton. You've got to call an ambulance."

Paramedics came, took her vitals and told her they were stable. They told her husband to run to the pharmacy and get a Fleet enema, and then they left.

When her husband came back from the pharmacy, Beckett was not responsive. He called paramedics again, but they were unable to revive her.

Beckett's son, Ross Beckett, said he wanted to share his mother's story because no one should suffer so much while waiting for health care.

Even if his mother's death was unavoidable, she was in pain and waited in limbo for too long.

"That's what the health care system is supposed to do," he said. "Get you in, get rid of the pain or at least give you time.

"If they'd operated and she died on the table that would have been more acceptable. … But that didn't happen. She was sent home to lay there in pain."

Beckett's long wait in the hospital is not new. And even if the first team of paramedics had taken her to hospital, she might have continued to wait on a stretcher.

In Moncton, people have been waiting on ambulance stretchers for 24 hours, with the paramedics unable to leave to respond to more calls. In Fredericton a man died while waiting for care in the emergency room.

Staffing shortages have resulted in emergency room closures in Sackville, and other departments closing across the province.

Beckett said the coroner's report showed his mother died from a ruptured bowel. He said she did suffer from diverticulitis, which is when small bulges on the inner wall of the intestines become inflamed or infected, and was on medication for the illness.

Beckett said the family isn't planning on filing any complaints, and aren't levelling specific accusations against a health-care practitioner or department — because it's not one part that caused the delay.

"The system is broken," he said. "Nobody deserves to wait in a waiting room that long."

He said neither he nor his mother had a family doctor. They had to go back on the wait list for a doctor after Dr. Adrian Edgar closed his practice, Clinic 554.

For the government and the health care system, Beckett's message is: "Don't apologize. Just get to work on fixing it."

"There's a lot of people that depend on the health care system and expect better."

Wait times highest in at least four years

Kris McDavid, spokesperson for Horizon Health Network, said the average wait time for "urgent" cases at the Chalmers hospital in 2021-22 has been 2.1 hours. That's compared to 1.2 hours on average last year, and 1.8 hours the year before that. They were around 1.5 hours in 2018 and 2017.

"Urgent" cases include abdominal pain and shortness of breath, according to the Horizon website. McDavid said Level 3 is the only one of five levels of cases for which Horizon publicly reports average wait times.

Margaret Melanson, interim president and CEO of Horizon Health Network, said wait times "can vary widely" depending on the severity, the number of staff on duty and bed availability.

She said staff use the Canadian triage and acuity scale to determine the seriousness of a person's illness or injury. 

That process does take into account pain, but it's not the only driving factor for urgency. 

Melanson said the network has started a pilot project where patients in the waiting room are monitored by a licensed practical nurse, personal care attendant or a nursing student.

The Department of Health said it won't answer any CBC News inquiries on this story because it can't comment on specific patient cases.

Paramedics diverting patients from ERs

Derek Cassista, president of the Paramedic Association of New Brunswick, said a program that started in January gives paramedics the power to assess patients and decide not to take them to hospital.

He said the program has seen "thousands" of patients referred to clinics or pharmacies instead of emergency rooms just in the last month. He said this has helped off-loading delays and emergency room wait times tremendously.

"It's being able to decide and have input on where a patient should go in the health care system instead of just blindly taking them to an emergency room where we know ... the a wait times are horrendous," he said.

"It's entirely unacceptable. So we're doing what we can."

Paramedics use a special scoring system to assess patients and decide if their symptoms warrant going to the hospital. If a patient scores too low, paramedics can refuse to take them to hospital even if they insist.

Ross Beckett said his mother wanted to go to the emergency room the day she died. Ambulance New Brunswick, Horizon and the Department of Health can't confirm or deny this because of patient confidentiality.

Like any program, Cassista said, this one's not perfect and there's risk associated with everything. He said every decision to refuse to take people to hospital is audited by Medavie/Ambulance New Brunswick to make sure it was the correct one.

"There's always room for improvement. There's rigorous quality assurance that goes on with these types of incidents," he said. 

"That being said, taking everyone to the emergency room is not something that we can sustain. We don't have the resources to do it. So there has to be ways for us to find other avenues of health care for people."

Cassista can't comment on specific cases, but said paramedics do err on the side of caution, and the scoring system has "redundancies" to protect patients.

"The key is for practitioners to stay within the confines of the program and not just do things on their in their own judgment."

Christianna Williston, spokesperson for Ambulance New Brunswick, said she can't discuss this specific case but answered questions about the program in general.

She said all paramedics are trained to use the scoring system, and they can connect with a "paramedic clinical educator" or a physician if they need help assessing whether a patient should go to hospital.

If paramedics find the person does need to go to hospital, the patient can still refuse to go, she said.

"This option has always been available to our patients. Paramedics will respect a patient's decision to refuse treatment or transport and will ask that the patient sign a form."

Ross Beckett said Mary Lou was a kind and loving mother. She worked for one employer for 56 years, she was loyal and loved to cook.

He said her father lived until he was 97, and he was hoping he'd have her in his life for a little longer.

"I loved her very much," he said. "I'm going to miss her, she's going to be missed by a lot of people."