Family says N.S. doctor shortage delayed removal of grandmother's body

Dione Allen is still trying to wrap her head around the image of her grandmother's body lying in her nursing home room for hours after she died because there was no doctor available to sign her death certificate.

Allen said a nurse told the family the body could remain there for up to two days. That's because without a signed death certificate, a funeral director cannot remove a body.

Allen's 99-year-old grandmother, Sadie Allen, died at 12:51 a.m. on May 20 at the High-Crest Springhill nursing home in Springhill, N.S.

Sadie was well known in Springhill. She was one of the last surviving widows of the 1958 Springhill mine disaster.

Sadie's husband, Fidell Allen, was one of the miners who died after a seismic shockwave tore through the tunnels of the No. 2 colliery. The "bump" trapped 174 miners underground; 75 died.

"Every year, she would go down to the entrance of the mine and she would paint the big telephone pole white as high as she could reach, just to, I suppose, to memorialize what had happened there and also for my grandfather," Dione said in an interview.

'It just leaves me shocked'

"I was very surprised … that a body could remain in a room, in a nursing home, for up to two days and that it's just acceptable … because there aren't enough doctors," said Dione, an RCMP officer who works in the forensics section in Iqaluit.

"It just leaves me shocked. I'm still trying to process the whole situation."

Upon Sadie's death, Dione spoke to the nursing home staff about her grandmother's wishes for funeral arrangements. Initially, she said, a nurse told her no one from the funeral home was available to pick up Sadie's body and that it "would remain in her room until the following morning."

"And at that point in time I told her that … I just didn't feel that that was very respectful and that it was unacceptable — that you cannot leave a body in a room until the following day to be removed."

When Dione asked the nurse for phone numbers for the medical examiner and the funeral home to get to the bottom of why they weren't picking up the body, the nurse told her "that it was actually because there was no doctor available to come and sign the certificate of death … and that there was not a doctor available for two days," Dione said.

Need for more doctors

According to the Nova Scotia Health Authority website, the northern zone, which includes Cumberland County, needs 17 family physicians and 13 specialists.

"We were extremely mortified that the nursing home had thought it would be OK to leave Grammie in her bed, in the heat that was up there, with just the window cracked," Reinders-Cooley said.

"I find it bad enough that the living can't get a doctor when they have issues. But when a person is dead and they're under the care of a nursing home, there should be no such thing as a doctor shortage. There should have been a doctor on call that could have come in and spoken to the family or could have actually signed the paperwork."

Trouble getting papers signed 'rare'

High-Crest's administrator, Conrad LeBlanc, would not discuss this case. However, in a statement, he said under Nova Scotia's Vital Statistics Act and Timely Medical Certificates Act, only physicians, medical examiners and, in some cases, nurse practitioners are authorized to sign a medical certificate of death.  

Where a doctor is unavailable to sign the certificate upon a resident's death, the nursing home refers the matter to the Nova Scotia medical examiner and requests that office to complete the death certificate, which allows a funeral director to remove the body.

"In rural areas, we often find it challenging to obtain a signed medical certificate of death where the death occurs overnight," LeBlanc wrote.

"In some cases, where we are unable to obtain a signed medical certificate of death, the medical examiner will arrange to have the body removed to a mortuary until such time the medical certificate of death can be completed. For us, this is a rare occurrence."

All protocols followed

MJ MacDonald is the executive director for the continuing care branch of the Department of Health and Wellness. She said the department has protocols in place to ensure a timely response to a death in a facility or in homes when a family physician or attending physician cannot be present.

"This particular instance, as I said, I can't speak to, but I do have confidence that the processes and protocols that are in place were respected and followed."

MacDonald said it would be a "relatively rare instance" that a death certificate was not signed within a few hours.

"There is a memorandum of understanding with the medical examiner's office and they're on-call 24/7, so the response is excellent," she said.