Rise of deaths in emergency departments could be linked to delayed treatments: N.B. doctors

The number of patients who have died in emergency departments at Horizon Health hospitals has risen in recent years, although it’s not clear why.

On July 12, a man waiting in the emergency department waiting room at the Dr. Everett Chalmers Regional Hospital in Fredericton, N.B., passed away. His death sparked outrage, demands for improvement, and a shakeup of Horizon’s leadership.

The health authority launched an internal review. That review was completed in early August, though it’s not clear if the details will be made public.

CTV News requested the number of people who have died while waiting in ERs across Horizon hospitals, but the network does not distinguish between those who died in the waiting room versus those who died after being admitted into the emergency department.

It did release numbers, which show an increase in the number of patients who have died in emergency departments.

In 2021, 287 patients died in Horizon hospital emergency departments -- higher than in the previous three years.

Between January and July of 2022, 174 patients died, on pace to surpass last year’s total.

“Regarding deaths in our hospitals, Horizon’s Decision Support Team provides this data based on the specific department, and not necessarily an exact location within a department, such as a hallway or waiting room, for example,” said Greg Doiron, Horizon’s vice-president of clinical operations.

“In the emergency department, this can largely be attributed to the fact that a physician is required to evaluate a patient prior to pronouncing them deceased. These physician evaluations are never conducted in an ED waiting room.”

New Brunswick Medical Society president Dr. Mark MacMillan says -- while it’s difficult to identify a single cause for the increase -- doctors are concerned that some patients delayed getting treatment because of the pandemic.

“This in turn creates a cascade effect on the health of the population, with approximately a third of those who delayed medical care due to the pandemic reportedly experiencing negative consequences, such as worsening conditions, as a result. Combined with health human resource shortages in the system this could partially explain a rise in emergency room deaths,” he said.

Jean-Claude D’Amours, Liberal health critic, noted during a committee hearing last week that the average wait time is also increasing.

From an average of 93 minutes to 135 minutes, year over year.

“I would say that this would be an average depending on the day of the week, and time of the day,” said Horizon Health CEO Margaret Melanson. “It fluctuates, but overall, the wait of over two hours would be considered what’s actually the average.”

Some have noted, with staffing shortages reaching a level not seen in years, that ER wait times will be higher this year.

The Department of Health says that patients who seek care at emergency departments are often “arriving at times of severe medical distress, in high-acuity situations. We know staff do their best to help everyone in these situations.”