Hanna woman's death in hospital prompts investigations by AHS and RCMP

Cory Ashley believes his wife, Lillian Vanasse, would still be alive if she had received the care the couple had been begging for.

On Christmas night, Vanasse was taken by ambulance to the hospital in Hanna, Alta. The 40-year-old had "flu-like symptoms" and trouble breathing, according to her EMS report.

Ashley, 50, says he paced the hospital floors for two hours, watching his wife struggle to breathe, lying in a stretcher. Despite repeatedly asking for oxygen, he says it wasn't provided. Hospital records requested by Ashley and shared with CBC News show no record of oxygen being provided to Vanasse. 

Since her death, Ashley says his emotions have ranged from extreme sadness to anger toward the medical staff who handled her case.

"My wife did not deserve this," he said. "Why do these people have a job right now? Why are they working?"

Ashley has since launched complaints with Alberta Health Services, the College of Physicians and Surgeons of Alberta, the College and Association of Registered Nurses of Alberta and the RCMP.

AHS and RCMP confirm they are investigating. The regulatory bodies wouldn't comment beyond that, saying the complaint process is confidential, unless the complaints are referred to in a public hearing tribunal.

Ashley says his wife, who was originally from the Sandy Bay First Nation in Manitoba, made a connection with everyone she met.

And he says he owes it to her to find out why she died.

"I'm not stopping digging," he said. "I'm not stopping fighting."

Christmas Day 

Ashley says he would usually wake his wife up every morning with a cup of coffee but, on Christmas Day, he decided to let her sleep in.

When he finally went into their room around noon, she told him she wasn't feeling well. Still, he says, she got up, opened one of her Christmas gifts and then went back to bed.

Later that night, he says he noticed her face was beet-red and she was hot and sweaty and struggling to breathe, so he called 911 around 8:30 p.m.

EMS stated in their report that Vanasse had distressed breathing and decreased sounds on her right lung and noted she was admitted to the emergency department at the Hanna Health Care Centre at 9:15 p.m.

Ashley says when he arrived at the hospital, about 15 minutes later, he was escorted to Vanasse's room.

He says she was put in a COVID-isolation room in case she had the virus. 

Ashley says after he gowned and masked up and entered the room, he noticed his wife was lying on her side, weak and still labouring to breathe.

"I said, 'Honey, are you OK?' And then she's like, 'No, this hurts to breathe. I don't know what's wrong. I'm really scared.' And she was terrified, I could see it," said Ashley.

Ashley says he yelled at staff more than once throughout the night to give his wife oxygen, but he says they didn't provide it.

Ashley says after about an hour and a half of being in the emergency department, he started recording Vanasse's heavy breathing on his cell phone, along with one interaction with a hospital employee, which he shared with CBC News.

In the recording, the staff member tells Ashley the doctor was having trouble accessing test results because of computer problems and that was the reason for the "hold up."

In the video, the staff member also mentions Vanasse's methadone prescription. 

Ashley says Vanasse takes methadone to manage abdominal pain but says the pain had been getting worse lately so Vanasse would increase her daily dosage sometimes, including on Dec. 24, the day before she was seen in the emergency department.

By upping her daily dose, he says she ran out of her prescription a few days earlier than she normally would have.

In the recording, the employee can be heard saying to Ashley: "She's admitted to taking too much methadone and hasn't had any since yesterday morning."

The video continues with Ashley responding, in part, saying: "This is not meds, or any of that crap. She can't frickin' breathe. That's something. Get your damn doctor and tell her to get down here now." 

The hospital records note "Methadone withdrawal" as part of her diagnosis. They also state staff gave her some methadone that night. 

According to her records, Vanasse also had an echocardiogram, a chest X-ray and additional lab work including a COVID-19 test. They state the chest X-ray came back clear and COVID-19 was later ruled out.

The records also state staff tried to encourage her to slow down her breathing.

Vanasse's death

RCMP escorted Ashley out of the hospital shortly after 11:30 p.m.

The reason, according to the medical records, is that he had become aggressive toward staff and was recording his interactions with them.

While in his car, Ashley started to record another conversation, this time with an RCMP officer who was providing an update.

In the video the officer says, "You might as well go home for the night; she'll likely be released in the morning." The officer also says the doctor checked Vanasse's vital signs and "everything was looking pretty normal" but they were going to keep her overnight for observation.

Ashley says he went home, made a few phone calls, and fell asleep. He says he then woke up around 2:30 a.m. and noticed he'd just missed two phone calls from the hospital, minutes earlier.

When he called back, he says he was told to get back to the hospital because his wife had stopped breathing.

According to the hospital records, Vanasse's heart stopped around 1 a.m. and CPR was performed on her for the next two hours.

Ashley says staff were doing chest compressions when he walked back into his wife's room.

That's when he says he knew she was gone.

"I knew it instantly," he said. "I could tell just by looking."

When he touched her leg, it felt cold. He believed she'd been gone for a while. 

Ashley says he's been overwhelmed with condolences since her death.

Medical insight

CBC News contacted a medical doctor to inquire about the use of oxygen when a patient is unable to properly breathe.

Dr. Monty Ghosh, who has experience in addiction medicine and internal medicine, says oxygen is a temporary measure that can be used to help support a patient. But he says it is not a cure and further intervention is required to determine the underlying problem.

"It's not a reversal of what's going on, but it can help buy some more time as you try to figure out what is going on,  keep the patient a bit more comfortable, as we're trying to work things up,"  said Ghosh, an assistant clinical professor at the University of Calgary.

While Dr. Ghosh was not familiar with the case nor provided any specific details, he said that, in general, there are reasons why oxygen isn't always provided, whether that's because the body's oxygen levels are reading normal (which they were in Vanasse's case, according to her medical notes), or if a patient is anxious and hyperventilating, because wearing a mask may worsen the situation.

But he says a patient's use of methadone is not a reason to withhold oxygen.

Complaints 

Since his wife's death, Ashley has lodged several complaints with different provincial authorities. He says he's also reached out to the media in the hopes of bringing some attention to his wife's death.

"I keep going over and over it and it doesn't change how I feel," said Ashley, through sobs, as he retold the story from his dining room table, with pictures of his wife surrounding him.

Ashley believes his wife's Indigenous background and drug history played a role in the way she was treated by hospital staff. He's alleging they labelled her as a drug addict who was just seeking more drugs, rather than a chronic pain patient who needed help breathing.

But Ashley couldn't offer any proof to back up these allegations.

He says in his complaints he is seeking full suspension of all staff members involved in the "mismanagement" of his wife's care. And he wants a third-party investigation.

Alberta Health Services says it couldn't comment specifically on Vanasse's death or the complaint but issued the following statement.

"This is a tragic incident, and our deepest sympathies are with the family and loved ones of the patient at this time," the statement reads.

"Alberta Health Services (AHS) is committed to providing environments that support high-quality care for everyone receiving health-care services. Any allegations of misconduct by staff or physicians are thoroughly investigated and reviewed internally. We are working through our patient relations process in response to the concerns expressed by the family, which includes a review of the incident(s) and the related concerns expressed."

"Such reviews can be helpful in identifying improvements that can be made to help ensure similar concerns do not occur in the future," it adds.

"Through our AHS values, we emphasize the importance of treating all people with compassion, dignity, respect and fairness as we strive to provide safe, inclusive and quality care for all Albertans. Diversity and inclusion are essential to everything we do at AHS. We strive to create an environment where everyone, including patients, families, healthcare providers, physicians and volunteers, feels safe, healthy and valued."

AHS also said staff are provided "mandatory Indigenous Awareness training" as part of "a number of training and learning opportunities available online and in-person, covering a broad range of diversity and inclusion topics."

RCMP tell CBC news they are investigating to see whether anything criminal in nature occurred.

Ashley says a medical examiner investigator told him their initial report showed the presence of a wet lung.

Dr. Ghosh says a wet lung is when fluid builds up in the lungs for any number of reasons, such as an infection or cardiac failure. He says the fluid needs to be analyzed to determine where it came from, but he says it can cause problems breathing.

Ashley says he must wait six months to a year for the medical examiner's report to find out what caused his wife's death.