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Nova Scotia orders review after man dies waiting for hospital transfer

Health Minister Randy Delorey addresses the audience at a bill briefing at the legislature in Halifax on Tuesday, April 2, 2019.
Health Minister Randy Delorey addresses the audience at a bill briefing at the legislature in Halifax on Tuesday, April 2, 2019. Andrew Vaughan/The Canadian Press

Nova Scotia’s health minister has ordered a review into the circumstances surrounding the death in hospital of an Annapolis Valley man as he waited for an ambulance transfer.

In a statement, Randy Delorey said he is asking the Nova Scotia Health Authority and ambulance provider Emergency Health Services to conduct a joint review of David Benedict’s death.

Benedict’s wife told CBC that her husband died in Soldier’s Memorial Hospital in Middleton, N.S., earlier this month from a brain bleed while waiting to be transferred to a hospital in Kentville, N.S., for further testing.

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She said the transfer was delayed three hours.

Delorey said he understands Benedict’s family has questions, adding: “I have as well.”

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“Our Emergency Health System is dynamic and moves ambulance resources on a priority basis. There should be an ambulance available when one is needed,” Delorey said.

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Delorey said the province is already reviewing the province’s ambulance service, and he’s looking forward to receiving the final report from Fitch and Associates when it is finished.

The U.S.-based consulting firm was hired to look at ways to provide an “efficient, effective and sustainable” emergency medical system for the next 10 to 15 years.

Jeff Fraser, director of provincial services for EHS, said with a review of the incident underway it’s too early to comment on exactly what happened.

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But he said the challenges facing the ambulance service are well-known, in particular delays once ambulances arrive at clogged emergency departments.

The service, which handles an average of 550 calls a day, is working with the health authority to meet a standard patient handover time of 20 minutes after Delorey issued a directive to that effect last spring, Fraser said.

“We are nowhere near the target to date,” he said. “It continues to be a problem for our system. This offload issue is not just unique to Nova Scotia but has certainly become a significant operational impediment for us.”

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Fraser said another problem is caused by increased closures at many rural emergency departments due to staffing levels, which means ambulances are often taking patients longer distances.

“We’re pushed hard,” he said.

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Last March, the union for Nova Scotia’s paramedics told a legislature committee that the biggest problem facing the ambulance service is delays off-loading patients at emergency departments that are overcrowded due to a lack of acute care beds.

The union also told the committee that bottlenecks created by the off-load problem and the use of ambulances for non-emergency calls cut into response times.

Union CEO Terry Chapman said the standard response time set in 1997 was just under nine minutes, and now call responses are often much longer.

Those standard times can vary from 15 minutes inside Halifax to 30 minutes in rural areas, Chapman told the committee.