Aeromedical transport | Two coroners urge Quebec to improve service

Quebec must speed up the replacement of its obsolete planes and ensure that there is enough aeromedical transport available, two coroners recommend in their reports published Wednesday.

The two patients under investigation died before they could be treated at their destination.

The first case was revealed by The Press at the beginning of the year. Ben-Stevens Thusky, aged 28, was never able to be transported on board the plane that came to pick him up at the Val-d’Or airport last January.

Read “Death on the Tarmac”

The absence of a night pilot at the Government Air Service (SAG), the fitting out of a private subcontractor’s aircraft and the freezing of certain medical equipment delayed and then prevented the patient from boarding, confirmed the coroner, M^e Francine Danais.

After waiting for a long time on the tarmac in -22°C, the ambulance had to take the man back to the hospital.

He suffered a first cardiorespiratory arrest on the tarmac, then a second upon his arrival at the Val-d’Or hospital, where he was pronounced dead, less than an hour after leaving the airport.

It is necessary to “accelerate the replacement of obsolete aircraft in the emergency air transport fleet and, if necessary, improve it as soon as possible” and “promote the attraction and retention of pilots”, recommended Mr.^e Danais at the Ministry of Transport and Sustainable Mobility of Quebec (MTQ).

Quebec must also require its private suppliers to maintain heating during waiting times and allow medical teams to familiarize themselves with their aircraft models.

In the second case, it took nearly six hours for the Salluit CLSC to receive the emergency medical evacuation team needed to transport a 61-year-old patient in August 2022. Kitty Kumakaluk went into cardiorespiratory arrest on the plane and died shortly after arriving at the Inuulitsivik Health Centre in Puvirnituq.

“It is necessary to ensure the availability of qualified personnel and sufficient aeromedical transport means in order to respond in a timely manner, according to clinical needs, to requests throughout the territory of First Nations and Inuit communities,” recommended in particular the coroner, M^e Julie-Kim Godin, at the Ministry of Health and Social Services.

Transport Minister Geneviève Guilbault and Health Minister Christian Dubé had no comment to make Wednesday, their respective offices said.

“The case reported The Press “is unacceptable,” the office of Minister Geneviève Guilbault had indicated in January. He had then promised “measures to promote the attraction and retention of personnel and renew our air fleet.”

“Replace the fleet as quickly as possible”

“It’s unfortunate that we had to have these two cases for the government to change its mind,” lamented Wednesday the president of the Syndicat de la fonction publique et parapublique du Québec (SFPQ), of which the SAG pilots and technicians are members.

“It’s crystal clear that we had to replace the fleet as quickly as possible. This is what we have been denouncing for many years,” recalled Christian Daigle in a telephone interview.

The SAG has four planes: two Challengers and two Dash 8s. But they are “aging and require more and more maintenance, which means they have to be taken out of service, in addition to being in insufficient quantity,” confirmed coroner Francine Danais.

However, air transfers from remote regions have increased over the past five years (+38%). The SAG must therefore use private planes “which are not equipped in the same way” and with which “medical teams are not [familiarisées] “.

Last January, this delayed the plane by 50 minutes: the medical team on board in Quebec had to familiarize themselves with the layout of the supplier’s Pilatus PC-12 before flying to Val-d’Or.

The president of the union representing SAG pilots and technicians now says he is a little more “optimistic.”

The 17.4% salary increase over five years granted to the common front of the public service and the adjustments planned for the SAG in the agreement in principle should “make up part of the salary difference with the private sector” and promote retention and recruitment.

The purchase of a 2017 Challenger aircraft in mid-June and “rumors that there are discussions with Bombardier to purchase much newer aircraft” also raise hopes in the ranks of the SAG.

“It’s a step in the right direction. For the rest, I’m still waiting for official announcements from the government, and to know when the money will be spent.”

“Bombardier cannot comment on the identity of its customers or share information related to its discussions,” a company spokeswoman responded Wednesday.

Quebec has paid nearly $28.5 million in a private contract to acquire a used Bombardier Challenger CL-650. The aircraft must first be adapted for medical transport before entering service. The government’s call for tenders to find a supplier is open until September 13, and the contract is for one year.

Precarious patients

The condition of the two patients awaiting emergency air transport was very poor.

The Val-d’Or man, who had just been hospitalized in intensive care with pneumonia and severe septic shock, had been vomiting blood for three days. His “only viable option” was a medical device available only in urban centres. “Although Mr. Thusky’s health was very precarious […] and that it is impossible to determine whether the treatment […] “If his life had been saved, his chances of survival would surely have been greater,” nevertheless concluded coroner Francine Danais.

The patient from Salluit arrived at the CLSC with latent tuberculosis, a chronic cough, bronchiectasis (dilation of the bronchi) and blood on her lungs that she was expelling through her mouth.

“Certainly, Salluit is a remote region,” agrees coroner Julie-Kim Godin.

“In the case of M^me Kumakaluk, it was rather issues of organization of services, prioritization of requests as well as availability of human and material resources that contributed to the significant transfer delay,” she emphasizes however.

Check coroners reports