Friday, July 22, 2011

Is "the system", or is Dalton McGuinty, to blame for a Niagara C.difficile-infected patient's death?

Allan Benner wrote in "The system let him down" (St.Catharines Standard, Jul.21, 2011):

"FORT ERIE — In early March, Gary Ball was enjoying the last skiing trip of the winter.
Three and a half months later, he was dead.
Dozens of sympathy cards line a table in his Ott Rd. home in Stevensville. It was his dream home, where he hoped to spend more years living with Denise Ball, his wife of three years.
Now, an urn beside the fireplace holds his cremated remains awaiting burial. Along with a newspaper clipping of his obituary, Denise placed a few mementos beside the urn — items representing the things Gary loved in life, such as a small metal sculpture of a downhill skier and a softball he used while playing slo-pitch.
The 63-year-old retired teacher was always active and healthy, with the exception of mild asthma. He spent his winters downhill skiing and his summers playing baseball and taking care of his two hectares of wooded property.
That changed April 7, while he was out for his daily walk. Suffering extreme pain, he was rushed to Greater Niagara General Hospital and diagnosed with pancreatitis.
Denise said Gary believed he'd get the help he needed at the hospital, that he'd get better — not sicker.
"He believed in the system," Denise said.
"The system let him down."
When she visited Gary four or five days after he was admitted, she learned he'd been diagnosed with Clostridium difficile as well as pneumonia — both conditions were acquired while a patient at the hospital, she said.
"At that time, we didn't know what C. diff was. They weren't treating it like it was a big deal. But I went to his room one day and there was a tag on his door."
That was long before the first outbreak was declared May 28 in St. Catharines. Outbreaks in Welland and Niagara Falls were declared simultaneously June 23 — and it was long before hospital staff stepped up cleaning protocols to combat the outbreaks.
Besides being concerned about cleaning efforts at the time, Denise was also concerned about her husband's hygiene while in Niagara Falls.
"The man was there nearly a month. He was asked the very last day, would he like a shower or a bath," she recalled.
Gary was released from the Niagara Falls hospital April 25.
"He didn't look any better, but I was glad that he came home because I thought, well, I can take care of him," she said.
At home, his condition deteriorated until he was admitted to Welland hospital May 8, where he stayed until May 25.
In Welland, she said Gary felt more at ease than he had in Niagara Falls. She said one nurse took the time to sit with Gary, holding his hand and telling him he'd be OK.
But it was there that physicians found a 22-cm-long pseudocyst had formed on his pancreas.
"If it burst, all the arteries and the heart are behind it," Denise said, recalling a doctor telling her: "This is dangerous."
She said the doctor transferred Gary to the intensive care unit for 24/7 care.
Doctors knew that cyst needed to be drained, but due to Gary's weakened condition as a result of the C. difficile they didn't dare conduct the surgery, Denise said.
"The doctor told him, 'We can't even cut you open because you won't make it,'" she recalled.
"It was like hitting a wall."
The plan was to treat the C. difficile, and get him strong enough for an operation. But his condition got worse.
The couple were concerned about spreading the illness to others so they asked their friends not to visit. Instead, Denise used her iPod to videotape her husband and sent those videos to friends over the Internet to update them on his condition.
In the videos, she said Gary's slow and steady transformation is apparent — from a relatively healthy man weighing 170 pounds to a frail and weak 140-pound man.
"It worried him. He'd look in the mirror. He's not a big guy, but he lost 30 pounds," she said.
During his care, she said he developed additional conditions, including a swollen leg due to a blood clot, a hernia caused by coughing and diabetes from low hemoglobin levels.
Although Niagara Health System officials cannot discuss individual cases due to confidentiality policies, chief of staff Dr. Joanna Hope spoke generally about the ravages the disease can inflict.
"It can be extremely devastating, no doubt about it," she said during a media briefing about the outbreaks Wednesday.
"That's why every case is reviewed, so we can help families develop learning and as always in medicine, be better at dealing with the trials and tribulations of populations and human beings at large."
After Gary's release from Welland hospital, he had a few more attacks of pancreatitis June 11 and 16, Denise said. Each time, he was treated at the hospital and sent home.
June 26 was different. He was lying in bed about 11 p.m., and sat up suddenly describing a "whoosh" feeling. He staggered toward the bathroom and collapsed. Denise called 911, and the same paramedics who took him to the hospital April 7 arrived.
He was pronounced dead June 27 at GNGH, but Denise knows he actually died at home before midnight.
She watched the cardiogram as paramedics worked to save his life and saw the flatline on the monitor.
Although the official cause of death was pulmonary embolism, Denise said she's confident Gary would still be with her if the C. difficile hadn't prevented physicians from treating the underlying illness.
C. difficile has usually been associated with the elderly and frail, but her husband was anything but — healthy and active, with a love of gardening and the outdoors.
"Here was a healthy man, and it took him," she said. "C. difficile did not kill Gary, but having C. difficile caused all those other problems so he could never get to being healthy."
"Our hearts go out to that individual," said Sue Matthews, NHS interim executive director.
"This is a very, very difficult time for this patient's family," Hope added.
Although most people who have died with C. difficile during the outbreak have been older, Hope said that isn't always the case.
"C. difficile affects those people who don't have enough immunity to fight the problems they are facing, either acutely or on a chronic basis."
While older people have more difficulty fighting off the infection, NHS chief of staff Dr. Joanna Hope said the likelihood of catching C. difficile depends on the impact any underlying condition has on the patient regardless of their age.
"An epidemiologist is with us looking at our data," she said.
Preliminary information provided by the epidemiologist shows the average age of women who died with C. difficile is 80 years old, plus or minus 10 years, while the average age of men who died with C. difficile is 76, plus or minus 10 years. That information, however, "is first cut and may change," she added.
"If you have a younger person, say a 36-year-old with a cancer of the lymph nodes, they are very immune-compromised with a very aggressive chemotherapy and can easily develop infections."
Since the outbreaks began, 25 people have died.
In its official tally, the NHS states 24 patients have died because it does not include a community-acquired case."
I would say that the Liberal government of Ontario let this patient down: they control Ontario's anti-patient-choice monopolist system.
It's McGuinty and all of his sitting Liberal single-payer-health-care-monopoly-pushing MPP's who let not just this patient - but many, many others - down, with their bait-and-switch Liberal healthcare duplicity.
It's McGuinty and his Liberal health-monopolists who arbitrarily decide what health-care rations Tommy Douglas will toss our way.
Thankfully, no comments from any of  Niagara's Liberal monopolist MPP's were included in this story - since, of course, Liberals have nothing to do with any of the unpleasant fallout from their political negligence... especially with an election coming their way this October!
So remember folks, once again: Vote for Jim Bradley and Kim Craitor, and vote often - Jimmy'n'Kimmy will save health care from  McGuinty themselves harris. yah...

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