Trust in health-care system takes another hit after man's death following long wait in Winnipeg ER

A Winnipeg woman who trained as a doctor in the Philippines says she doesn't trust the Manitoba health care system after hearing about the man who died while waiting in the emergency department at Health Sciences Centre this week — and after waiting 24 hours for care herself at the same emergency room last year.

Rosemarie Figueroa, 59, is speaking out after learning about the man's death on Tuesday.

In late November, Figueroa's family doctor recommended she go to the ER over concerns her months-long cough and difficulty breathing were symptoms of a pulmonary embolism — a blood clot in the lungs that can be fatal — she said.

Figueroa says a doctor at Seven Oaks General Hospital came to the same conclusion, gave her medication and ordered the scans she needed, but not before she first waited 24 hours at the HSC emergency department without being seen by a doctor.

"I'm angry. I'm frustrated. I'm disappointed … and scared at the same time, because we don't want to go to the emergency anymore," Figueroa told CBC News in a phone interview.

In an interview with CBC Manitoba's Information Radio, Premier Wab Kinew says Manitobans should continue to trust the health care system, because it has "excellent people working on the front lines."

His government said Wednesday it had ordered a critical incident investigation into the man's death after spending almost eight hours in the waiting room at HSC's emergency department.

Shared Health, which oversees the delivery of health care in Manitoba, has said emergency department staff attend to the highest acuity patients first, while other patients are checked on and reassessed according to their initial triage.

Patients should notify someone if their symptoms change or get worse, a spokesperson for the provincial health organization said in an emailed statement.

'It's been happening to everybody'

Figueroa came to Canada in 2004, after practising medicine in the Philippines for about five years.

Although she didn't end up practising in Manitoba, Figueroa says her most recent experiences as a patient bear a stark contrast to the emergency departments she's worked at in private and public hospitals in her home country.

When Figueroa arrived at HSC in November, she communicated her concerns about a potential pulmonary embolism and her symptoms to the triage nurse, Figueroa said.

But from 3 p.m. on Nov. 26 until 3 p.m. the next day — with little food or water — Figueroa didn't see a doctor, she said, despite repeatedly advocating for herself with the nurse and calling HSC's patient relations office.

"I'm kind of feeling emotional because this … has not just happened to me. It's been happening to everybody else, right? Our lives …  [are] very, very much dependent on those people who are in front of the triage," Figueroa said.

"It's just so sad."

After a day in the HSC emergency department, Figueroa left for Seven Oaks General Hospital, where following two hours of waiting, she collapsed and was seen by a doctor, Figueroa said.

When asked to describe her trust in the health-care system, Figueroa answered: "zero."

Review to consider man's background if relevant: premier

CBC spoke with other Winnipeggers who shared similar thoughts on their trust in the health-care system.

Dr. Barry Lavallee, CEO of the Indigenous health organization Keewatinohk Inniniw Minoawawin Inc., also told CBC that Indigenous people in the province did not trust the system even before it "fell apart."

"The deterioration of trust with the health-care system is only amplified currently," Lavallee said Wednesday, pointing to a recent case where an Indigenous woman at his clinic avoided a Winnipeg hospital for care when she needed it.

Lavallee alleges Indigenous people continue to face racism in the health-care system, whether their symptoms are interpreted as alcohol or drug intoxication, or they're told they aren't taking care of their children properly when they're brought in for a cough or fever.

Few details have emerged about the man who died at HSC on Tuesday, except that he was middle-aged.

Kinew says the critical incident review will do a thorough investigation into his case.

"I don't know the person's identity and their cultural background to say whether that is something that needs to be looked at, but if it does need to be looked at, if it is relevant, then we will," Kinew said in his conversation with CBC's Information Radio.

"The point of a critical incident report is to learn from the mistake."

HSC officials have said the ER was over capacity in the night leading up to the man's death but that staffing was close to a baseline level. 

Shared Health told CBC in an emailed statement Wednesday it will not speculate on what issues may have contributed to his death until the critical incident review is done.

At an unrelated press conference on Thursday, Kinew said Manitoba has reached the limit on incremental changes it can make to health care and needs to make larger-scale structural health care reforms.

'We already know the problem'

The board of the Canadian Association of Emergency Physicians was in a meeting when it heard about the man's death, board member Dr. Fraser Mackay told CBC.

"We're just a blink away from that happening in any department in the country, to be honest," Mackay said Wednesday. 

"We already know the problem. The problem is not new."

Mackay agrees high-level change in health care across the country is needed, and that's what his association has researched and now advocates for.

Its primary focuses have been resolving challenges with access block — when patients are admitted to emergency departments but can't be transferred to appropriate beds elsewhere — and health human resources, Mackay said.

"The step now is to engage [with] people that can actually make these changes happen and figure out how to do that."

Mackay fears without these changes, even more patients will present at ERs with even more severe health conditions or illnesses, which could have been caught sooner with preventative medicine and shorter waits at hospitals.

"A lot of us are frustrated and suffering from burnout," he said.

He urges Manitobans not to blame patients who go to the ER for help and not to blame individual health-care workers.

"This is really a systems-level problem."