FREDERICTON — A patient who showed up pale and short of breath at a Fredericton emergency department in 2022 was left to sit in the waiting room for nearly seven hours before he was found dead, slumped in his wheelchair, a coroner's inquest heard Tuesday.
Darrell Mesheau, 78, arrived by ambulance at 9:33 p.m. on July 11, 2022, at Dr. Everett Chalmers Regional Hospital and was initially seen by nurse Danielle Othen, who directed him to the waiting room.
She told the inquest the hospital was short-staffed that night and she was the only triage nurse during her 12-hour shift. She added that she did not have time to check on patients in the waiting room.
After a two-day inquiry that ended on Tuesday, the five jurors heard from 11 witnesses and found that Mesheau died in a natural manner, of heart failure.
The night that Mesheau was checked in, Othen said the hospital had 52 other emergency-room patients.
Crown prosecutor Patrick Wilbur asked the nurse to explain what she meant when she said she was "busy" that night. In response, Othen said there was a "lineup of patients to be triaged." Jurors heard during the inquest that part of Othen's duties was to monitor patients in the emergency room.
The nurse said she assessed Mesheau as a Level 3, meaning he should have been seen by a doctor within 30 minutes to an hour after he checked in. She said he was pale and short of breath.
Mesheau had undergone heart surgery and was a diabetic. Othen said she "could not recall" whether she asked him about his medical history. Jurors were told there were no notes about his history in the hospital's file from that night.
After further questioning, the nurse said that knowing his medical history would have been helpful.
The jury watched nearly 30 minutes of footage from the emergency room security video, which showed the last moments of Mesheau's life.
Deputy chief coroner Emily Caissy, who presided over the inquest, warned that the video might be distressing and gave people a chance to leave if they didn't want to watch it. Several people walked out of the room. As the video played, some of Mesheau's family members, who sat in the front row, shook their heads; one juror clasped her hand to her mouth for the majority of the video's duration.
At 4:33 a.m., a nurse found Mesheau unresponsive in his waiting room seat and called the overnight physician, Dr. Shawn Tiller. He told the inquest in a pre-recorded statement that he discovered the patient already "cool to the touch."
Tiller said a medical team performed CPR on the man and gave him epinephrine to charge his heart. The doctor said the team used an ultrasound machine to see if they could pick up cardiac activity missed by the heart monitor, but " we weren't able to get any cardiac activity at all."
Mesheau was pronounced dead at 4:44 a.m.
Chief pathologist Dr. Sen Rong Yan told the five-person jury that Mesheau's death was caused by heart failure.
After the man's death, New Brunswick Premier Blaine Higgs replaced his health minister and the head of Horizon Health, the agency responsible for the hospital, calling Mesheau’s death "simply unacceptable."
Ryan Mesheau told reporters the two years since his father's death have been "arduous at times and grim for the family."
"Time kind of deepens loss," he said.
But he welcomed the inquest, saying it could help other patients if it leads to changes in the health network.
"The bottom line is Horizon Health made mistakes. Every medical professional seemed to fail my father the night of his death by not following their own standards, protocols," he said.
"He was dropped off by ambulance at the (emergency room), at 9:30 on July 22. Left alone in a wheelchair for seven hours in the middle of the floor and died perhaps 40 minutes before anyone noticed and before CPR, any resuscitation protocols started."
Had the medical professionals done their duties, his father would still be alive, he said, adding that his family is "definitely" considering a civil court case.
Mesheau said Higgs's decision to fire two people was "small" and "insignificant."
"I guess you can call that rearranging the deck chairs on the Titanic," Mesheau said. "It's also window dressing designed to create a favourable impression for him."
This report by The Canadian Press was first published April 9, 2024.
Hina Alam, The Canadian Press
