Winnipeg man dies after red flag ignored, cancer not treated soon enough, his daughter says
Thirty years ago Jeni Descartes' father, Kasmier D'Amico, battled Stage 4 Hodgkin's Lymphoma and won.
So when the 57-year-old man learned the cancer had resurfaced this past summer, his family believed he could beat it again. But his daughter believes doctors took away that chance, when they chose not to tell her father about the tumour on his liver when it first appeared.
"When something like this shows up in a patient that's previously had cancer, they deserve to know," said Descartes.
D'Amico had bypass surgery in March 2014. When he went back to do a follow up CT scan in May 2015, Descartes said doctors discovered a 5 to 6 centimetre mass on his liver.
The radiologist that performed the scan made a note of it in a report that was sent to D'Amico's general practitioner. He also noted that the mass was more prominent than an earlier study in 2014 test results Descartes said her father knew nothing about.
"This radiologist that did this report already had suspicions that these were cancerous growths," said Descartes.
Red flag ignored
They were suspicions Descartes said the radiologist made very clear when he wrote "I would recommend an MRI of the liver to better characterize the lesion. Does this patient have a history of primary malignancy?"
"Being that my dad had a history of primary malignancy with the lymphoma, that's a flag, right then and there," said Descartes.
"When this report was sent back to his doctor's office in May, nothing was done," said Descartes. "My dad was not told. There was no follow-up testing. There was no 'send to ultrasound.' There was no anything."
Descartes said her father received a letter in the mail two months later informing him of another MRI appointment. She said it was a test her father believed was another follow-up to his bypass surgery.
He had the test on Aug. 26. It revealed the mass had doubled in size. It was now 10.2 by 12 cm, and it had spread.
"I didn't find out about this until the day we sat in the gastroenterologist's office and he told us that my dad was inoperable in September," said Descartes.
D'Amico was told while surgery wasn't an option, chemotherapy might be, but not until a biopsy was done to determine exactly what type of cancer he had. But the earliest that could be scheduled was late October.
"By then a couple of weeks had passed and we had seen between the May report and the August report how quickly those growths were responding and we needed to get things moving," said Descartes.
Waiting for a biopsy
She started making calls to CancerCare to arrange for treatment for her father while he waited for a biopsy, but Descartes said CancerCare wouldn't receive him as a patient.
All the while she said her father's condition continued to deteriorate.
"His GP, his gastroenterologist and his oncologist were all having discussions with the radiologist about moving the appointment for the biopsy sooner. The radiologist was refusing," said Descartes. "I was told that there was only one CT guided, or ultrasound guided biopsy done in Winnipeg per day. And there was a waiting list and that's why they couldn't move him because there were other patients that were more urgent."
'Somebody's dropped the ball'
D'Amico had a biopsy Oct. 21. It showed he likely had aggressive bile duct cancer.
"It had already spread significantly in his abdomen. However his oncologist came in and said to him and all of us ... You were handed a really bad card. Somebody's dropped the ball," Descartes said. "You're a strong man, you're young ... and I think that you would do well with chemotherapy or some kind of treatment."
Descartes said that gave her father all the more reason to fight.
"He was excited. He was like, OK. I've done this before. I've been down this road. I can handle it again. I can do it,'" she said.
Up until that point Descartes said her father knew he was sick, but had no idea he would be dead in a matter of days.
"It was never going to be cured .... But he was also made to believe that he would have a quality of life. That's what he had high hopes of," Descartes said.
The family would soon be dealt another blow, she said.
Advised to take advantage of time left
When D'Amico was finally accepted as a patient by CancerCare, Descartes said he was told the disease was too far gone, and chemotherapy was no longer an option. He was advised to arrange for palliative care to make whatever time he had left as comfortable as possible.
The next evening he fell into a coma at home. He was admitted into Riverview Healthcare the following day. He died six days later, on Nov. 17.
"Had my dad have had a little bit of treatment it might have given him a little bit longer. [It] most likely would have given him a little bit longer. Definitely not the days that he ended up with. but maybe a few weeks, maybe a month," said Descartes.
D'Amico worked as a truck driver for Gardewine for the past 20 years. Two years ago he sold his big rig and became an employee of the company. His pension would have kicked in on Dec. 3. He died 17 days before that date.
"So now my mum is left without that option because the doctors didn't give him the few weeks or few months that he was entitled to," said Descartes.
Descartes believes Manitoba's medical system wrote her father's death card. She's written to the minister of health demanding changes. She also plans to file a complaint against her father's doctor with the College of Physicians and Surgeons of Manitoba.
"They knew. They had to have known how progressed he was, had they have told us or gone to CancerCare or said to CancerCare, 'We suspect this patient is this progressed. Let's put some things in place,'" Descartes said.
Descartes believes if CancerCare had agreed to treat her father sooner, instead of waiting for the results of the biopsy, it might have given D'Amico more time.
WRHA: 'We recognize there are some barriers'
The Winnipeg Regional Health Authority said "approximately four CT biopsies and seven [ultrasound] biopsies are performed each day between HSC and St. Boniface depending on recovery bed capacity that day."
The spokesperson said biopsies are done based on urgency of need or within one month of request on average. Very urgent cases are seen within a number of days."
The WRHA said "we recognize there are some barriers to increasing the number of biopsies performed each day and have taken short-term measures to improve access such as standardizing procedures, setting targets and adding a radiologist but we continue to look at long-term solutions to increase bed space at each site and increasing staffing to capitalize on a team approach to care."
The spokesperson said the WRHA has been in contact with the family and is looking into this case. It is conducting a review of D'Amico's medical records to see "if there is anything that requires further review or any changes in process."
"At this point, this case has not been verified to be a critical incident but we will look into the details further and share what we learn with the family," the spokesperson said.
CancerCare said its goal is to begin treating patients within 60 days of cancer being suspected.
A spokesperson said health care providers have been asked to follow new processes to shorten patient wait times.
"Primary care providers are expected to send out written referrals for further tests or consultation with a specialist within 24 hours of seeing the patient when cancer is suspected," the spokesperson said.
CancerCare said patients and their families can call for help navigating the steps towards obtaining a cancer diagnosis by phoning 1-888-837-5400.
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