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Fraser Health defends late night discharge of Tsawwassen senior
An incident involving a 90-year-old legally blind Tsawwassen woman discharged in the middle of the night from Delta Hospital has resulted in a firestorm of criticism and hard questions aimed at Fraser Health.
Vivian Fitzpatrick was released from hospital at about 2 a.m. on Oct. 1, and sent home in a taxi cab wearing nothing more than pajamas and borrowed hospital socks.
After initially releasing a public apology about the incident, the health authority refused to answer questions until its president and CEO was cornered by reporters during a scrum in Surrey on Tuesday.
“It is appropriate to be at home,” said Dr. Nigel Murray. “Emergency departments are really busy, noisy places, and if the clinical staff believe that it’s appropriate for a patient to be at home that’s the best place.”
In a statement released to the media on Wednesday, Murray reiterated those talking points.
"It is especially critical for the health of these patients that we discharge them home to their families, or caregivers, as soon as they are medically cleared to do so," he said. "When the decision is made to discharge a patient, this process is taken very seriously, and appropriate plans are made to support each person’s individual needs."
Murray said that while he supported the "clinical decisions" that were made by hospital staff, he recognizes "that the care experience was not a positive one for this individual, and we have apologized for this."
On Monday, Delta Hospital’s head of general internal medicine Dr. Robert Shaw wrote an open letter criticizing the media’s coverage of the incident.
He said Fitzpatrick was discharged only after her live-in caregiver was notified by the Delta emergency, and had confirmed she was waiting for her at the apartment when she arrived by taxi. Shaw also pointed out that Delta Hospital receives the highest patient satisfaction of any hospital in the Lower Mainland despite limited resources. He said the hospital has no critical care beds, no surgical ward, no acute surgery, and restricted cardiac services.
“Over the past 10 years, our critical care unit and acute surgical beds have been eliminated,” he said. “This past summer, emergency surgeries such as appendectomies have also been cut; and medical floor nurse to patient ratio has increased from one in six to one in 14.”
Shaw also said medical staff have been under pressure from Fraser Health to quickly discharge or transfer patients from the ER, adding the Ministry of Health provides more money to those hospitals with quick discharges.
Fitzpatrick, a resident of Tsawwassen since 1964, was rushed to Delta Hospital around 10 p.m. last Monday (Sept. 30) for high blood pressure wearing nothing but her pajamas.
Her live-in caregiver immediately phoned her daughter, Paddy Munro, to let her know what was happening. Given the late hour, Munro didn’t drive to the hospital right away since health authorities are required to call her prior to discharge. That never happened.
When Munro called the hospital at 7 a.m. to ask if she could pick up her mother she was shocked by the answer of the person on the other end.
“The person said she had departed emergency,” said Munro, who was flabbergasted. “That’s not a term you want to hear associated with a hospital. And I said, pardon?”
She was transferred to another person who informed her that the discharge had happened at around 2 a.m.
“I said, not possible, I wasn’t called.”
Munro hung up the phone and called her mother. She couldn’t believe it when she answered. Hospital staff had called Fitzpatrick’s caregiver to arrange to meet her at the other end of a cab ride. Her caregiver told Munro that Fitzpatrick arrived covered in blood from an intravenous drip that wasn’t properly staunched when it was removed.
Fitzpatrick initially said she would rather die than visit the hospital again, but has since changed her mind.
“I feel bad because I’m just stressed and upset,” she explained. “I said I didn’t want to go back to the hospital. But it was the conditions I didn’t care for at the time.”
Neither mother or daughter are blaming Delta Hospital, the nurses, or the doctors.
“Me and mom believe this is Fraser Health and the citizens of Delta should be asking what they’re doing to our hospital to have caused this to happen,” said Munro.