When Aimee Dunn learned that a patient died alone in a Fredericton emergency room waiting room less than four months after losing her baby in the same emergency room, she felt pain again and anger
“My baby looked perfect,” said Dunn, who had to deliver a stillborn baby girl by C-section on March 23 at Dr. Regional Hospital. Everett Chalmers.
“They promised to do better. Now someone else is dead.”
The heart of Dunn’s pain is why it took someone 12 hours to check on her baby.
LOOK | Fredericton couple still grieving after losing son in emergency room
A woman who lost her baby in the Fredericton ER says the hospital promised to do better
Aimee Dunn says the hospital promised to make changes, but then she heard a man died in the emergency waiting room.
Dunn, who was 35 weeks pregnant, says her medical history should have made her pregnancy a primary concern.
By age 30, Dunn had already had a miscarriage and an ectopic pregnancy.
Diabetic since childhood, she entered the hospital with her insulin pump.
A plaster cast of Reia Dunn’s feet and hands, given to Dunn and Waite by staff at Regional Hospital Dr. Everett Chalmers. (Submitted by Aimee Dunn)
And her records showed she had had lupus, an autoimmune disease that can increase the risk of pregnancy complications.
She said she had been in the care of Dr. Erica Holloway, a maternal-fetal specialist.
Dunn believed the maternity ward would take good care of her.
He knew its nooks and crannies, he worked there at night cleaning.
Their duties include taking out trash, sanitizing equipment, and cleaning up after women give birth in the labor and delivery unit.
“It can take up to an hour,” Dunn said. “But none of that bothers me. I’m happy to do it.”
Something has gone wrong
On March 22, when Dunn was still excited about her day approaching, she would soon be a mother herself in labor and delivery, holding the baby girl she had already decided to name Reia, Dunn began to feel pain .
He started throwing up and freaking out uncontrollably.
Her partner, Mitchell Waite, said she called labor and delivery and was told to bring Dunn.
But when they arrived at the unit, they were turned away and told to go to the emergency department.
Dunn was admitted immediately at 5:43 p.m., according to the autopsy report.
She already has symptoms of preeclampsia, a known risk factor for maternal death and fetal death.
But Dr. Stephen Cashman in the ER seemed concerned about his cannabis use, Dunn said.
Early in her pregnancy she had been diagnosed with hyperemesis or severe nausea and vomiting. A cannabis user since the age of 15, she decided to continue using it during her pregnancy against the advice of her doctors. He said it helped reduce nausea, but more importantly, it made him hungry.
Dunn says he is getting better with the support of his friends and family. From left are Aimee’s grandmother Albina Stuckless, Aimee’s best friend Anita Mihailescu and Aimee’s mother Joanne Dunn. (Rachel Cave/CBC)
In the ER, both Dunn and Waite felt dismissed by the nursing staff and Cashman.
“He really didn’t want to do anything else with us,” Waite said. “He doesn’t even talk to me, and I don’t even smoke weed.
“Both him and the nurse were treating us like poor potheads.”
Dunn’s medical records indicate that Cashman was planning to discharge her, but she was reluctant to go and insisted on staying the night.
He does not remember Waite leaving the hospital around 10 o’clock that night.
“I thought everything was handled at this point,” Waite said. “He’s in good hands. He’s in a good place. He’s going to get the care he needs.
“That was not the case at all.”
No fetal heartbeat
According to an emergency room report written by Dr. Anthony Sarkisian, Cashman managed Dunn’s care until she was turned over to Dr. Yogi Seghal, who then turned her over to Sarkisian at 1 a.m.
At the time, Dunn was described as stable with normal blood pressure. According to Sarkisian’s report, Seghal had advised that Dunn was evaluated for labor and delivery and taken to the ER because they felt her symptoms were unrelated to her pregnancy.
Dunn insists she was not seen in labor and delivery.
Shortly before 6 a.m., Sarkisian wrote, it was first brought to his attention that Dunn had elevated blood pressure.
He reviewed her vitals and labs and noticed that she had consistently had high blood pressure since presenting to the ER.
Aimee Dunn and Mitchell Waite after their baby shower on March 5. (Submitted by Aimee Dunn)
“It was clear to me at that point that the patient was suffering from preeclampsia,” he wrote.
He also noted that attempts were made to contact Dr. Sheri-Lee Samson, the obstetrician on call, but she and another doctor had been in the operating rooms performing emergency C-sections.
He noted that Dunn was in diabetic ketoacidosis.
Shortly thereafter, she had a seizure and was rushed to acute care for resuscitation.
When “obstetrics” saw Dunn at 6:30 a.m. on March 23, no fetal heartbeat could be identified, the autopsy report said.
‘doesn’t sound right’
Waite, a mechanic, said he was getting ready for work when he got the call to return to the hospital.
“They said I had to go to L and D [labour and delivery] right away, and I was like, OK, that doesn’t sound right,” Waite said.
“So I’m at L and D and they tell me what’s going on, and they told me about the seizures. They weren’t honest about Reia’s death.
“They’re like, ‘I might be dead.’ So I just stood there, not really understanding the concept.”
Dr Erica Schollenberg, from the pathology department at Halifax’s IWK Hospital, wrote in her autopsy report that the fetus was anatomically normal and likely died during the night.
“The specific mechanism of fetal death in maternal eclampsia is not well understood, but it is likely to be asphyxia due to acute insufficiency of the vascular supply from the uterus to the placenta,” he wrote.
When Dunn had her seizure, Schollenberg said, she had laboratory features of both eclampsia and diabetic ketoacidosis.
Sorry from the hospital
Dunn said it took a while to find the strength to request his medical records.
When he received them, he felt sick again.
She wrote a detailed complaint outlining what happened with Horizon patient representative Gillian Gillies, who set up a meeting for May 31.
Also present were Nicole Tupper, the hospital’s chief executive officer, Dr. Erica Frecker, chief of obstetrics, and Dr. Krishna Pulchan, chief of emergency medicine.
“They basically apologized for what happened,” Waite said.
Dunn said she was touched by Pulchan’s kindness.
“He was a very quiet man, and when he finally got his turn, he spoke very softly,” she recalled.
Dunn and Waite decorated a boy’s room in pink and white before Dunn’s April 27 due date. (Submitted by Aimee Dunn)
He said Pulchan offered his deepest condolences and said tears welled up in his eyes when he read the complaint.
“I couldn’t believe how with everything that happened that night, if one person had given any kind of compassion that this outcome could have changed,” Dunn said.
“Yeah, that was the problem,” Waite said. “Nobody cared enough that night.”
Neither Dunn nor Waite took notes of what was said at the meeting. They said they were told there weren’t enough emergency specialists to staff emergency rooms, so family doctors were filling the void.
They also said the hospital was working on plans to add critical triage care to the labor and delivery unit. The emergency department would make changes to better monitor patients in the emergency waiting room.
Horizon Statement
CBC News requested interviews with any of the doctors who were present at the May 31 meeting and a copy of any action plans that resulted from the review.
No interviews or details were provided.
Instead, Horizon sent a written statement from Margaret Melanson, interim president and CEO.
“Horizon has a comprehensive quality review process that ensures follow-up of concerns expressed by a patient about the care they receive at our facilities. The results, as well as recommendations or mitigation actions, that may emerging from the review are shared openly and transparently with the patient and their loved ones,” Melanson wrote.
Complaint submitted to the university
Dunn said he filed a complaint with the New Brunswick College of Physicians and Surgeons. The university confirmed it is reviewing its complaint filed against Dr. Stephen Cashman of Vancouver.
Outgoing President Dr. Ed Schollenberg said Cashman will have a chance to respond before the university decides on next steps.
The college could decide to hold a disciplinary hearing.
Schollenberg said everything takes time and wondered if this case would end up under the scrutiny of a forensic investigation.
“I think that would be eligible,” he said.
Dunn and Waite are still grieving the loss of their first child.
The hospital let Dunn hold Reia for a while. They also gave him a cast of the Queen’s tiny feet and hands and a handprint.
Dunn said what she really wants, since she will never get her baby back, is for the hospital to follow through on its promise.
Another death in the Emergency
On July 12, a man described as a senior in a wheelchair died alone while waiting to be seen in the Chalmers ER.
Dunn was shocked. He had been told that staff would receive “compassion training” and that improvements were already in the works.
“They said they had a new plan to make sure patients in the waiting room were seen by someone and got some kind of treatment while they were waiting. Even if it’s just Gravol for the nausea.”
He doesn’t want to know that people aren’t getting the right care in the emergency room.
“At this point we are determined to keep fighting for change,” Dunn said.