Person died after being taken to closed ER, Manitoba's latest critical incident report says

A person in Manitoba died after they were turned away from an emergency department that was closed, the province says in a new report.

That individual had been escorted to the health-care facility. After learning it was closed, the patient was transported to the closest health-care facility, but did not survive.

The person's death is among several highlighted in Manitoba Health's latest critical incident report, which encompasses the final three months of 2020.

The quarterly reports note cases where people have suffered "serious and unintended harm" while receiving health care in the province. While they include short descriptions of each event, they do not provide identifying factors or specific locations.

A long-time advocate of rural health-care is disturbed to hear about the case of the person who died after being taken to an ER that was closed.

"I think we're going to hear more of that, in all honesty," said Dr. Jacobi Elliott, medical director at the medical clinic in Grandview, almost 300 kilometres northwest of Winnipeg.

"The way I see the wind blowing, it feels to me this health transformation [is coming]," Elliott said.

People may not know about temporary closures

She expects more and more rural communities could lose their emergency departments as health care is centralized in larger centres. Small communities in Westman deal with temporary periods — sometimes a night, a weekend, or longer — without an emergency department because of staffing shortages.

The latest critical incident report, published this week, does not reveal why the ER was temporarily closed on the day in question, or where it was located.

Extended ER closures are advertised within a community, but that doesn't mean the notice filters out to everybody in a community.

"Think about it — you close, it's four in the afternoon; where do you put the notice up? On Facebook? On the internet? In a newspaper?" Elliott said.

"How are people supposed to know what's open?"

35 incidents classified as deaths

The incidents in the province's critical incident reports are not reported to lay blame, but rather reveal what could be done differently and what improvements can be made.

In the latest report, 35 incidents are classified as deaths — a higher than usual number in the reports, which can largely be attributed to COVID-19.

It is also likely those incidents involve more than 35 deaths — the report includes a note that "critical incidents related to COVID-19 outbreaks in hospitals or personal care homes are reported as groups." Several of the reported incidents refer to deaths of "residents" or "patients," suggesting more than one person was involved in each of those incidents.

The period covered in the latest report — Oct. 1 to Dec. 31, 2020 —  saw some of the worst COVID-19 outbreaks of the pandemic.

Of the 35 incidents classified as deaths, 26 involved people developing what is described as a "health-care acquired infection associated with a serious outcome."

The quarterly update does not disclose whether all of those infections are a consequence of COVID-19, but almost all of these deaths are reported in groupings.

The previous quarterly report included only one death stemming from a health-care acquired infection.

A CBC News analysis in late 2021 suggested that to that point, more than seven dozen deaths had been linked to COVID-19 exposures amid outbreaks in Manitoba hospital settings since the beginning of the pandemic.

The latest critical incident report also includes a case where a patient died in the midst of a transfer from one rural emergency department to another facility. The decision was made to transfer the patient to a regional hospital, with a physician escort taking part.

As well, there were eight cases involving a delay of some kind, whether for care, treatment, reporting or recognition of symptoms. Some of those instances resulted in a death.