The Quebec coroner’s office announced Sunday it will investigate the deaths of dozens of seniors at a private long-term care facility west of Montreal linked to what Premier Francois Legault has described as a possible case of “gross negligence.”
The office said in a statement that it will probe the circumstances surrounding the deaths and issue recommendations if needed.
“Remember that coroners intervene in cases of deaths that are violent, obscure or could have occurred following negligence,” the coroner’s office said in a statement.
A police investigation was launched over the weekend after regional health authorities were able to access patient files at the Residence Herron and found that 31 of the residence’s 150 or so seniors had died since March 13. Quebec’s health department is also investigating.
Legault said at least five of the deaths were due to COVID-19, but that number could rise.
“Quite honestly, I think … there was gross negligence at Residence Herron,” Legault said on Saturday.
On Sunday, an enraged Keira Whitehead stood outside the residence with her family. Her 89-year-old father John Whitehead died there last Friday.
“It’s just progressively gotten worse. It’s the staff, the management, the owner. They’ll have to pay,” she told Global News.
Crime scene investigators from Montreal Police’s major crimes unit were on site Sunday.
“We’re collecting documents, we’re seizing stuff like work schedules, lists of employees, different types of evidence we will analyze,” said Montreal Police spokesperson André Durocher. Officers will also be meeting with personnel, residents and family members to see if there is enough evidence to bring charges.
102-year-old Sam Abracen was among the 31 who have died at Herron. According to his family, Abracen was still vibrant and sharp. They want to know how the final days of his life played out.
“In the last four or five days, not only could I not get in touch with my grandfather, I couldn’t get anybody on the phone there, no nurses or anything. Then, the next call you get is he’s gone,” said Clifford Albert, Abracen’s grandson. Abracen died on April 6th, after the facility had gone into government trusteeship.
Medical malpractice lawyer Patrick Martin-Menard said a simple coroner’s inquest is not enough, and that families deserve a public inquiry into what happened at Herron.
“What we need is a public coroner’s inquest where the public and the family members can be informed, can attend, and fully see the conclusions of the process,” he said.
Martin-Menard said a class action lawsuit is already in the works against the owners of the facility, and the West Island Regional Health Authority (CIUSSS).
“It seems there has been serious neglect on the part of the residence, but also on the part of the CIUSSS, who was supposed to support the residence. Families need to have access to this information,” Martin-Menard said.
The authorities first inspected Residence Herron on March 29, three days after word of the first death. They found the residence “deserted” as staff had walked off the job.
Lynne McVey, head of the health board, has said her team began assisting the short-staffed workers to feed, wash and change patients, but only learned the full scope of the problem after getting a legal order allowing them to view families’ contact information and patient medical files.
On Sunday, McVey visited the residence along with an investigator from the Quebec Health Ministry. She called the situation inside “stable,” and said four doctors are on hand along with nurses and orderlies examining residents.
Social worker Mandy Novak, who spent her Easter Sunday volunteering at the residence, painted a bleak picture of what it was like inside.
“There’s a smell in there, a smell of the deceased,” she told Global News. “There are wounds that need to be taken care of and were not taken care of for a long time.” She said there were clear signs of negligence.
Katasa Groupe, which owns the residence and several others, has not answered requests for comment, and the home is now under government trusteeship.
The Residence Herron story is only the latest report into troubling conditions at seniors’ and long-term care homes, which have been linked to a large percentage of the country’s COVID-19 deaths.
That includes another residence in Laval, north of Montreal, where 21 people have died and 115 have tested positive for COVID-19.
The coroner’s office said in its statement that it is not currently investigating other homes, but is watching the situation and could intervene if needed.
In a statement on Sunday, the provincial health department confirmed it would proceed to inspect all the province’s 40 private long-term care centres in the coming days.
“Every effort is being made to protect seniors and avoid tragic situations such as the one observed in the Herron private residential and long-term care centre that is not covered by an agreement,” the statement said.
Dr. Theresa Tam, Canada’s chief public health officer, on Sunday lamented the deaths that COVID-19 has caused in long-term care facilities across the country, which she described in a statement as a “tragic legacy of this pandemic.”
“These heart-breaking events underscored the need for stringent infection prevention and control measures and led to the development of infection prevention and control guidance for long-term care homes,” she added.
That guidance includes strict rules around who can enter such facilities and detailed instructions on how to minimize the chances of an outbreak through proper hygiene and screening.
The Quebec ombudsman launched an investigation into the Residence Herron in 2017 after it received complaints including inadequate nursing care, a poor approach towards patients with cognitive difficulties, complaints over food and a lack communication with families.
The investigation found that the facility was providing adequate care, but the ombudsman cautioned in its report that management needed to ensure there was enough suitably-trained staff, given its intention to increase its number of patients.
Whitehead said last year she had seen clear signs of her father being neglected.
“I took him to the dentist last year, and his diaper had not been changed,” she explained. “His feces were seeping out through his pants in the dental chair.”
In 2019, an inspection by Health and Social Services did not note any particular problems with clinical practices, but issued recommendations including the development of a policy to combat mistreatment, as well as improved communications with residents and their families, particularly in the areas of residents’ rights, end-of-life decisions and palliative care.