Lakeshore General Hospital

LGH opens “game-changing” Family Medicine Unit

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By Chelsey St-Pierre
The Suburban

.A ribbon-cutting ceremony took place at the Lakeshore General Hospital’s (LGH) new family medicine unit last week. The unit will serve to respond to the shortage of family doctors in the West Island, while the average population lacking a family doctor across the province has reached near 30 per cent. It will also serve as a teaching unit with up to 26 residencies taking place over time and 12 expected by next July. 

The ceremony was attended by West Island Mayors Tim Thomas for Pointe-Claire, Michel Gibson for Kirkland, Jim Beis for Pierrefonds-Roxboro and Heidi Ekdvedt for Baie-D’Urfé. “This clinic is not only an important step for the hospital, but a testimony to its greatness,” LGH Director and Associate Chief of family medicine Dr. Shadi Abid told The Suburban. “The immense shortage of family doctors calls for an effort to address that need and that is what we have done here. With each new doctor, we will be able to care for more patients.”

According to the President and Director-General for the West Island Health Authority (CIUSSS-ODIM), Dan Gabay, there are now 6,600 patients already registered to the new clinic, with that number expected to grow significantly as the unit acquires staff in collaboration with McGill’s residency programming. “By acquiring the modular (to renovate the ER), the opportunity for a second floor to position the family medicine unit became possible. By having primary care for patients, it lessens the pressure on the hospital. It is embedded in the hospital intentionally because we want to develop academia within Lakeshore and family physicians are the first big push via McGill with the intention to bring physicians from all specialties (over time).”

“This is an important game-changer for the West Island community. Family medicine is often the first line of care and we have overcome many challenges in bringing this unit to life,” Managing Director at the LGH Foundation Nathalie Kamel said to The Suburban.

“This is an inspiring project. We need to see more responses (like this) to the needs in health care, in the West Island and throughout the province,” Pointe-Claire Mayor Tim Thomas told The Suburban.

“First line medical care and social responsibility are a priority for us,” Marion Dove, Chair of Family Medicine at McGill University, stated. “With the creation of the GMF-U (family medicine unit), we will prepare the next generation of doctors.” n

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Modular ER sparks hope at LGH

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By Chelsey St-Pierre
The Suburban

The transition from the Emergency Room (ER) to the modular ER went smoothly last week at the Lakeshore General Hospital (LGH). Lakeshore ER Department Chief Robert Nathanson told The Suburban that continuing to provide patient care during the execution of the transition was made a priority. “The transition went well because it was well planned. This required a lot of time and energy from a huge number of people to ensure the logistics would make for a smoother transition. Everything was in order by 5 a.m. on transition day. Triage was only closed for a short period and ambulance were diverted to other hospitals except for high priority emergencies. One by one all patients on stretchers were moved. Walk-ins were guided over with a chaperone. By 7:30 a.m. the moving of patients was 90% complete. By 10 a.m. the remaining patients were moved upstairs or discharged when their care was completed.”

The completion of the modular building and the transition is a first sign of hope for many as promises to improve the LGH ER were made in the past but nothing happened. At the announcement of this new construction plan, many critics shrugged it off as “just another plan”. Nathanson admitted that some plans were quashed and shed light on this issue by opening up and sharing details to The Suburban. “Previously when plans were made, we would run into the issue where we would have to cancel patient care in order to execute those plans. This is something we are adamant about and we didn’t want to negotiate with providing patient care. Yes the renovations were much needed and the condition and layout of the ER posed various challenges. A permanent structure that was built years ago is logistically difficult to update but we were not prepared to shut it down at the cost of patient care. This is why a ‘buffer’ space was needed and this buffer will serve us throughout our entire seven-year plan to renovate various sections of the hospital without compromising patient care. The modular ER will allow for the new permanent ER to be built. Once the new ER is built and the transition has been made, the modular building will serve as buffer space while other renovations are carried out step by step without cancelling any patient services. This did take longer and I was just as disappointed to cancel previous plans, but it was worth the wait because it will be done right.” Nathanson says that as a secondary (to patient care) bonus, the renovations using the “buffer” space are also more cost efficient.

Approximately 98% of the equipment in the modular ER is brand new. The ISO rooms and rooms for resuscitation are now situated in clear view of nursing stations. As part of the design, more sunlight throughout the modular ER lifts the mood and more space has been allocated in order to increase capacity from 31 to 38 stretchers.

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Family of woman found dead in LGH ER sues for $1 million

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By Chelsey St-Pierre
The Suburban

The West Island health authority (CIUSSS-ODIM) along with an Emergency Room (ER) doctor and nurse are being sued for $1 million by the family of Candida Macarine, who died on a hospital room floor in the ER at the Lakeshore General Hospital (LGH) in 2021. The 86-year-old woman was found dead on the floor while she was in a negative pressure room in the ER. Despite months of warnings from staff to managers that the room in question is problematic as it is difficult to maintain visibility and monitor patients there, she was placed in that room

On the day of her death, the family was told that she died of cardiac arrest. They later found out from the news, on the eve of her funeral, about the events surrounding her death. “The worst and most devastating thing was that we were only guessing and analyzing from the news that this was our mother,” the deceased patient’s son, Placido Macarine, told reporters.

In March of that year, the family demanded an investigation but were disappointed when Quebec coroner Amélie Lavigne concluded that negligence and abandonment had not played a part in Macarine’s death. In October, 2022, the Centre for Research-Action on Race Relations (CRAAR) drafted a letter to Quebec’s Chief Coroner’s demanding that the investigation be reopened, stating that the family and CRARR have serious and legitimate reasons to believe that the report made by coroner Lavigne “contains major omissions of crucial and pertinent evidence.” The family, supported by the CRARR, suspects that racism may have played a role in the negligence, ultimately leading to the potentially avoidable death of their mother. Despite the demands, the Coroner’s investigation was never re-opened or reviewed. The family did not give up and requested Macarine’s complete medical file. The medical file and the allegedly incomplete Coroner’s report were used to build their case and target the lawsuit to one ER doctor, a nurse and the local Health Authority in charge of overseeing the LGH.

The lawsuit alleges that Macarine’s death was avoidable and caused by inadequate medical care that was covered up. “The medical services and care provided to the plaintiffs’ mother throughout her stay at the hospital’s ER were wholly inadequate, causing crucial, cumulative incidents that led to the avoidable death. Staff at the hospital purposely and voluntarily concealed critical information from the family. As such, the defendant’s staff wrongfully and negligently failed to inform the plaintiffs about pertinent facts leading to their mother’s death.”

On March 23, 2021 the CIUSSS-ODIM admitted in a statement to the press that “although the investigation is still ongoing, the CIUSSS is already able to say that its communications with the family were incomplete, especially at the time of the announcement of the death.”

In response to a request made by The Suburban to the West Island Health Authority on its current position vis-à-vis the lawsuit, CIUSSS spokesperson Alexandre Cadieux stated that the staff at the West Island CIUSSS understand that these times are difficult for loved ones of the patient. “We are available and listen to families when situations like this arise. The family was met by members of the management of our establishment. Given that the case you mention has now been brought to court, we will refrain from commenting on this specific case so as not to compromise the ongoing process.”

Candida Macarine was a mother of 10 children. The lawsuit is claiming $100,000 for each of her surviving eight children and the families of her two deceased children.She died just hours after being admitted to the ER with respiratory distress.

On May 9, the family and the CRARR, who have supported them throughout this process, will hold a press conference to discuss the lawsuit launched earlier this week.

In the meantime, Cadieux highlighted a number of changes that have already taken place in order to improve patient care, including: monthly meetings of experts including the medical team to proactively analyze adverse events occurring to improve practices, the integration of four nursing advisors specializing in emergencies to supervise and support new nurses, offer training, and strengthen nursing practice, the designation of staff members to regularly monitor patients at risk of falling, the application of 15-minute rounds, which allows areas away from the emergency to be monitored to ensure the safety and comfort of patients. n

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LGH nurse suspended following death of patient

Local Journalism Initiative / / / , ,

By Chelsey St-Pierre
The Suburban

Kishore Baijoonauth, a Lakeshore General Hospital (LGH) nurse, received a five-month suspension following the death of an 81-year old patient that was in his care in 2022.

According to a Quebec Order of Nurses Disciplinary Council ruling issued on March 1, it was determined that Baijjoonauth was negligent in his professional duties towards the patient.

Baijoonauth pled guilty to the disciplinary complaint made against him on January 24 after information contradicting his notes were shared in discovery. Baijoonauth had noted that the elderly patient was calm and did not suffer from chest pains or palpitations, meanwhile, the patient contacted his partner and relatives over a dozen times in a state of panic. In another mention in Baijoonauth’s notes, it reads that the patient did report having chest pains for which he gave him a Tylenol.

The patient was known for having heart problems. He died on January 16, 2022 at 3:30 a.m. after being admitted to the emergency room a day prior.

According to the disciplinary report and his own admittance, the nurse did not carry out the assessment and follow-up required according to the patient’s state of health and did not inform the doctor of the change in the patient’s condition.

Baijoonauth pled guilty to the disciplinary complaint made against him and has been suspended and ordered to pay all of the expenses surrounding the complaint investigation. It was noted in the report that he was very remorseful and apologized to the patient’s family. Prior to the events that led to the disciplinary action taken against him, Baijoonauth practised as a nurse for two years before the incident and had no history of negligence.

Health reporter, Aaron Derfel, for the Montreal Gazette, broke the story of six patients, including the aforementioned, that triggered an investigation ordered by Quebec Health Minister Christian Dubé in 2023.

The report from the investigation listed 135 recommendations to improve the hospital, including better training and working conditions for hospital staff. It also includes building a new emergency and critical care unit. As of last fall, the construction of a modular building began and the new building is expected to be completed by 2025. n

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Quebec Ombudsman warns of excessive use of restraints at LGH

Local Journalism Initiative / / / , , , ,

By Chelsey St-Pierre

The West Island health authority (CIUSSS) and the Quebec health ministry received recommendations following an investigation conducted by the Quebec Ombudsman of the Lakeshore General Hospital (LGH), after multiple reports of negligence were filed.

“In January 2023, the Québec Ombudsman received several reports of negligence in the quality of care and services provided by Lakeshore General Hospital emergency staff,” Ombudsman Marc-André Dowd wrote. The Quebec Health Ministry requested an independent investigation into the hospital last February.

According to the report, the West Island health authority (CIUSSS-ODIM) and the Ministry of Health and Social Services (MSSS) are aware of the issues of difficult working conditions and work overload at Lakeshore General Hospital.

The investigation includes concerns about staff practices such as the excessive use of restraints. “The investigation showed that there were several flaws in this area,” Dowd determined. Restraints are control measures designed to limit a person’s movements to ensure both their safety and that of others. They can be physical, such as barriers, bindings and force, or chemical, such as sedatives.

Dowd noted that emergency staff lacked knowledge about the protocol governing control measures; restraints were sometimes used too quickly without alternative measures attempted first and there were shortcomings when it came to supervising and record-keeping use of the control measures.

Several recommendations were made to the Quebec Health Ministry as well as the West Island health authority and both are required to report back to the Ombudsman by April 30.

This hospital serves a population of more than 225,000 and its emergency room receives more than 40,000 visits a year, making it one of the busiest in Montreal. “Despite their heavy workload, all staff members are concerned about providing quality services and care to users,” Dowd stated. n

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