Family of man who died waiting for care at Fredericton ER sues Horizon, 2 nurses
Darrell Mesheau, 78, died at the Dr. Everett Chalmers Regional Hospital on July 12, 2022
The family of a man who died waiting for care at the Fredericton hospital's emergency department two years ago is suing health-care providers for negligence over his death, alleging "reckless and outrageous acts and omissions" in his care and treatment.
Susan Mesheau of Fredericton, executor of the estate of her brother Darrell Mesheau, has filed a notice of action against Horizon Health Network and two nurses.
Darrell Mesheau, 78, spent about seven hours in the waiting room of the Dr. Everett Chalmers Regional Hospital ER before he was discovered slumped and motionless in a wheelchair by a licensed practical nurse around 4:30 a.m. on July 12, 2022.
His death sparked outrage across the province and prompted a major shakeup of New Brunswick's health-care leadership, including the firing of Horizon's president and CEO, replacement of the health minister and removal of the Horizon and Vitalité boards.
It also led to a coroner's inquest earlier this year, which ended with three jury recommendations aimed at improving ER services and preventing deaths under similar circumstances.
The family's lawsuit names as defendants Regional Health Authority B, doing business under the name of Horizon, which is "legally responsible for the acts and omissions of its nursing staff," as well as Danielle Othen and April Knowles.
Othen, a registered nurse, "was responsible for triaging patients" in the Chalmers ER waiting room July 11-12, 2022, based on the Canadian Emergency Department Triage and Acuity Scale, according to the statement of claim, filed with the Court of King's Bench in Fredericton.
Knowles, a licensed practical nurse, "had a duty of care to monitor and care for patients in accordance with their triage level" July 11-12, the court documents state. "As part of her duties, [she] had to check and monitor patient vitals," such as heartbeat, breathing rate, temperature and blood pressure.
Seek punitive, special damages
The Mesheau family, including his four siblings, two children, and granddaughter, contends the defendants failed to provide him with "proper medical care and attention.
"This included, but was not limited to, the defendants not providing [Canadian Emergency Department Triage and Acuity Scale] Level 3 medical care, which prescribes a patient vitals check and reassessment every 30 minutes."
They further allege the defendants' "acts and omissions caused or contributed to" Mesheau's death, and that their actions "fell well below the standard of care."
None of the allegations have been proven in court.
The family is seeking unspecified punitive and/or exemplary damages, special damages for financial losses, and damages for "loss of guidance, companionship, and/or support." In addition, they are seeking costs, interest and any other relief the court deems just.
Susan Mesheau declined an interview.
"The family doesn't have anything to add at this time," she said in an email Friday morning.
No statements of defence have been filed yet, according to court staff.
Horizon and the New Brunswick Nurses Union both declined to comment.
Only assessed twice during 7-hour wait
Darrell Mesheau, a former diplomat, arrived at the hospital by ambulance on July 11, around 9:33 p.m., after he called 911, and was placed in a wheelchair in the ER waiting room.
According to the documents, he was "only examined and/or assessed twice by nursing staff with his vitals being taken the same number of times" during the roughly seven hours he waited — although the coroner's inquest heard testimony about a third check.
On July 11, around 10:44 p.m., Othen triaged him as being a Level 3, which is considered urgent, according to the Canadian Emergency Department Triage and Acuity Scale, which ranges from Level 1, the most serious, to Level 5.
She did not note any of Mesheau's medical history, which included a heart attack and quadruple bypass, diabetes, and high blood pressure.
The second time was around 2:03 a.m. the next day, when Knowles took his vitals, according to the documents — although Knowles told the inquest she also took his vitals around 11:15 p.m. and they were within normal limits.
"No medical or nursing staff working at the DECH on July 12, 2022, interacted with Darrell Mesheau from the time his vitals were last taken at or around 2:03 a.m. and the time that he was found unresponsive, cool to touch, and/or deceased by nursing staff in the waiting room at or around 4:28 a.m." the documents state.
A code blue was called, but attempts to resuscitate Mesheau were unsuccessful and he was pronounced dead around 4:44 a.m. A pathologist later determined he died from heart failure.
Horizon failed to provide 'competent personnel, adequate facilities'
Mesheau's death was "caused or contributed to by the negligence" of Horizon, according to the family.
They allege that the regional health authority failed to, among other things, provide Mesheau with "competent personnel, adequate facilities and equipment" and "proper emergency room care."
Othen is accused of causing or contributing to Mesheau's death by allegedly failing to inquire about and document his medical history, failing to properly investigate his symptoms, and failing to have him examined by a doctor.
She also failed to properly carry out the responsibilities of a registered nurse in accordance with Chalmers protocols and guidelines and the standard of care required of a registered nurse at the time, the family contends.
Knowles is accused of causing or contributing to Mesheau's death by allegedly failing to properly record his presenting signs and symptoms, failing to properly investigate his symptoms, failing to properly monitor and care for him, and failing to have him examined by a doctor.
The family alleges she also deviated from the accepted standard of care regarding Level 3 monitoring, and failed to properly carry out the responsibilities of a licensed practical nurse in accordance with Chalmers protocols and guidelines and the standard of care required of a licensed practical nurse at the time.
Knowles told inquest she volunteered to help in ER
During the two-day coroner's inquest, Othen testified she worked a 12-hour shift alone, triaging ER patients the day Mesheau died because they were short-staffed. "We didn't have all of the staff that we should have had to work properly," she testified.
She was unable to monitor the vital signs of patients she had already triaged, she said, because she was too busy triaging new patients coming in.
There were 52 patients in the ER between 7 p.m. on July 11 and 5 a.m. on July 12, and 14 of them were Level 2s, or emergent, the inquest heard.
Knowles testified that she was assigned to work on the psychiatric side of the waiting room the day Mesheau died, but volunteered to help out in the ER because they were short-staffed.
Although she said there was no real change in his vitals between 11:15 p.m. and 2:03 a.m., she was concerned because he was so pale, so she bumped his chart ahead of three other patients.
Around 4:30 a.m., another licensed practical nurse told Knowles that Mesheau "didn't look so good," so she went to take his vitals again and found him unresponsive, the inquest heard.
He was already cool to the touch, according to ER Dr. Shawn Tiller, meaning he hadn't had any circulation in "quite a while."
Knowles testified staff know they're "supposed to do an hourly check," but stressed she had other patients and other duties.
"It means we are human, we are one human … doing six or seven jobs," she said.