When Jean Malavoy was rushed to Hull hospital on the night of 1er as of October 2, 2020 after falling down some stairs, the property’s only ‘scan’ was broken. The 71-year-old patient had to be transported 12 kilometers away, to the Gatineau hospital, to undergo this examination, before being returned to Hull for emergency surgery. However, he died a few hours later, victim of a ruptured spleen.
Posted at 11:18 a.m.
The only computed tomography (CT scan) of the Hull hospital was the subject of “fairly frequent breaks” according to the DD Josée Bussières, emergency physician at the Hull hospital, who testified Monday at the coroner’s public inquest into the death of Mr. Malavoy. So much so that a contingency plan had been established to overcome these breakdowns. The situation was not recent.
As early as 2017, four intensivists from the Hull hospital wrote a letter to the establishment’s management to mention that given these breakages, a second “scan” had to be purchased. “I believe that a center like ours should have at least two CT scans in order to serve our population as it should and offer them what is a standard of practice”, wrote the intensivists. A second “scan” has been added since the death of Mr. Malavoy at Hull hospital.
A defender of Franco-Ontarian culture
The circumstances of Mr. Malavoy’s death are the subject of a coroner’s inquest these days in Gatineau. Born in France and raised in Montreal, Mr. Malavoy was described by his daughter, Isabelle Malavoy-Mundle, as a “passionate about culture” and an “ardent defender of Franco-Ontarian culture”. He was notably director general of the Vanier Museopark and was the father of five young adults.
The evening of 1er October, around 11:30 p.m., Mr. Malavoy fell down the stairs of his daughter’s house. 911 was called immediately. According to his daughter, who was by his side at the time of the events, Mr. Malavoy was unconscious for a few moments before coming to his senses. If, at the start, Mr. Malavoy, who suffered from diabetes and hypertension in particular, seemed in a rather stable state, his condition deteriorated quickly, testified Mme Malavoy Mundle. His father became disoriented. “He no longer remembered that he had fallen,” said the girl.
Mr. Malavoy had severe back pain. It will later be learned that a broken rib had pierced his spleen and that the patient was bleeding from the inside.
Paramedics arrived within 15 minutes. Mr. Malavoy was transferred to Hull Hospital. The only doctor at the Hull hospital that evening to see the emergency room, the DD Bussières determined that the patient should undergo a “scan”. But the device was down that night.
Mr. Malavoy was therefore sent by ambulance to the Gatineau hospital to take his “scan”. There, the scan was also having issues and had to be restarted, resulting in 30 minute delays. The patient was then returned to Hull Hospital for emergency surgery. When he arrived at 2:55 a.m., he was conscious, but still had back pain. He will undergo surgery, but will die the next day, October 2, at 5 p.m.
Coroner Julie-Kim Godin, who is leading the investigation in this case, mentioned in the opening that the objective of the procedures will be in particular to “understand the circumstances of the failure of the “scan”” of the Hull hospital. And follow the thread of the decisions taken, in particular with regard to inter-hospital transfers. For Isabelle Malavoy-Mundle, it is clear that her father “would have liked the facts to be revealed and for all citizens of the Outaouais to receive quality health care”.