Family of man who died after waiting hours in ER for urgent care want nurses held accountable

Family members of Akeem Scott, a young Black man who died after waiting several hours in a Montreal hospital emergency waiting room have asked for a formal revision of the Quebec's nurses order decision not to discipline the nurses who triaged him.

Scott, 26, died in June 2019 of acute peritonitis, a life-threatening but treatable condition, after giving up and leaving the Jewish General Hospital's emergency department in pain and frustration.

He had arrived by ambulance with severe stomach pain and vomiting, but despite spending some of that time lying on the floor in agonizing pain, he was not seen by a doctor in the several hours he waited

"There was no humanity. They allowed him to stay there in pain for many hours, no pain medication, no nothing," said his brother, Lloyd Allison, at a Friday news conference. 

"They asked him to get off the floor at one point when he was writhing on the ground in pain. That itself, I feel, is one of the reasons that he may have got up and left. He wasn't treated humanely."

'Reality of the ER' 

On June 20, 2019, Scott's condition had been classified as Level 3 on the Canadian Triage and Acuity Scale (CTAS) by the triage nurse, which means he should have been seen by a physician within 30 minutes of being triaged at the hospital. 

After hours of waiting without care, Scott left to get some rest at a friend's house, planning to return to the hospital the next day, according to the family. He died early the next morning before he could make it back. 

"I feel the accountability is trying to be put on him for having left, but we want to make it understood that the reason he left was the way he was treated," said Allison. 

The family filed a complaint against the nurses order in 2021, blaming Scott's death in part on the attending nurses' failure to provide proper care while he was at the ER. They also questioned whether racial bias played a role in his death. 

Last month, Quebec's nurses order handed down its decision to dismiss the complaint. 

It stated that while it is "unfortunate" that Scott did not receive a medical evaluation within the time provided for by the CTAS, "we cannot, however, blame the nurses alone for the fact that the reality of the ER makes it difficult to provide medical care within the time limits set by the triage scale." 

Fo Niemi, executive director of the Center for Research-Action on Race Relations, who helped the family file the complaint, says he thinks this can set a "disturbing" precedent that nurses shouldn't be held liable due to the chaos of the ER. 

"This is possibly sending a very, very negative message with regard to professional liability, accountability of the hospital and more importantly, patient safety," he said. 

Discrepancy between nurses order, coroner's report

Arguing that the facts don't add up, the family is also calling for a revision of the reports.

According to the nurses order, Scott arrived at the ER at 1:04 p.m., was triaged at 1:14 p.m., and left at 3:15 p.m., before getting a medical evaluation. 

But a coroner's report released in 2019 says he was triaged at 1:18 p.m., and left at 5:11 p.m — almost four hours after being triaged and without being given anything for the pain. 

"All these contradictions make no sense and delegitimize every investigation that has [happened] so far," said Niemi.

He said the nurses order also hasn't been transparent with the results of its inquiry. 

"We still don't know who the nurses are, how many nurses were involved in this whole process and also, how did they know these nurses don't have biases?" said Niemi. 

Scott's mother, Marcia Samuels, struggled to hold back tears as she demanded answers at Friday's news conference. 

"I just want to know why they are contradicting each other," she said. "What's going on? What is the real truth here?" 

Samuels says it feels like she's living in a nightmare each and every day. 

"It's been very hard for me. Very painful," she said. "He was a very, very good kid. He would do anything for anyone.

"The day he died, a part of me died also."

The order of nurses refused CBC's request for comment.

Hoping for answers, Samuels filed a motion to challenge the order's decision with a review committee last week. 

Advise staff before leaving, read new ER signs

Scott died of acute peritonitis — an inflammation of the peritoneal lining, a membrane that lines the inner abdominal wall, according to the coroner's report from 2019. 

"It is a medical emergency that must be treated as quickly as possible, as it can be life-threatening," the report reads. 

The coroner recommended that the Jewish General Hospital, which is part of the CIUSSS West-Central Montreal, review its treatment of Scott that day.

In a statement to CBC Friday, the CIUSSS said it followed the coroner's recommendation and found the hospital fully followed its standards of care and protocols. 

It added that since the incident, it has added posters in the ER asking all patients to advise staff if they decide to leave before being seen by a doctor.