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'She kept asking for help': Iqaluit woman monitored daily by nurses dies from liver failure

An Iqaluit woman is speaking out about Nunavut's health care system, after her mother died from liver failure despite regular visits from nurses who failed to note her symptoms.

Coroner calls for competency review of nurses, more Inuktitut translation

Annie Kootoo with her granddaughter Alethea at the hospital in Iqaluit in December 2014, before she was medevaced to Ottawa. (Submitted by Bernice Clarke)

An Iqaluit woman is speaking out about Nunavut's health care system, after her mother died from liver failure despite regular visits from nurses who failed to note her symptoms.

According to a coroner's report released last week, Bernice Clarke's mother Annie Kootoo died in 2015 from liver failure caused by the drug she was taking to treat tuberculosis.

When Kootoo, 61, was diagnosed with tuberculosis in November 2014, she was sent home to be treated by the public health team, as there was a shortage of isolation beds at the hospital.

The medication she was being given to treat tuberculosis can be toxic to the liver, and she was warned to avoid taking Tylenol, to lower the risk of liver problems.

Bernice Clarke's mother Annie Kootoo died in 2015 from liver failure caused by the drug she was taking to treat tuberculosis. Nurses visited Kootoo to monitor her treatment but failed to note her liver failure symptoms. (Nick Murray/CBC)

In the following weeks, she was visited at home by nurses to monitor her tuberculosis treatment.

During a number of visits in December, Kootoo complained of loss of appetite, as well as fatigue and a sore neck. The nurses didn't perform a physical assessment, chart her complaints or inform her doctor.

"She kept asking for help, and the nurses didn't listen," said Clarke.

"A simple blood test. One hour. That's what would have saved my mother."

According to the coroner's report, when Kootoo contacted the hospital to report her symptoms, she was told her TB physician was on vacation and she would have to wait for her follow-up appointment at the end of December.

On Dec. 29, she was admitted to the emergency room at Qikiqtani Hospital, where doctors were told she had been experiencing symptoms such as loss of appetite, fatigue and yellowing of the eyes for two weeks. Blood tests were done. She was diagnosed with acute liver failure and medevaced to Ottawa.

Her condition deteriorated and she fell into a coma Jan. 3. She died that night.

Family petitions for investigation

Kootoo's family asked the coroner to investigate her death and the medical treatment she received. 

"They didn't listen to my mother," said Clarke. "And for the nurses, like, you're there to help people. You're there to save lives. What happened to these people that didn't catch her?"

One of the coroner's recommendations is for health care providers to use Inuktitut translators to inform patients and family members about possible complications of TB medication and signs and symptoms to watch for, along with written instructions in English and Inuktitut. (submitted by Bernice Clarke)

The coroner's report makes 11 recommendations. They include that the nursing licensing board review the competency of the nurses involved in this case and that health care professionals should follow the Nunavut government's standards for assessing patients.

The report also recommends health care providers use Inuktitut translators to inform patients and family members about possible complications of TB medication and signs and symptoms to watch for, along with written instructions in English and Inuktitut.

 Clarke says more needs to be done.

"What I would like is more Inuktitut-speaking in the medical field," she said, adding that Nunavut's health care system is "dangerous" without it.

Clarke also called for everyone, Inuit and non-Inuit, to be treated equally.

The Department of Health says it's reviewing the recommendations. 

with files from Nick Murray