The partial closure of the CLSC de Senneterre last fall is not “a determining factor” in the death of Gordon Richard Genest which occurred on November 30 at the Amos hospital, decides coroner Geneviève Thériault in a report made public Tuesday. .
The 65-year-old’s death sparked widespread media coverage last fall. The mayoress of Senneterre, Nathalie-Ann Pelchat, had blamed the closure from 4 p.m. to 8 a.m. of emergency health services in the small municipality of Abitibi to explain the long delay before Mr. Genest was taken into care.
The affair had gone up to the National Assembly where the opposition parties had vilified the CAQ government for its mismanagement of the health system.
Faced with a major shortage of personnel in the region, the CISSS de l’Abitibi-Témiscamingue was forced last fall to reduce or temporarily suspend several services on its territory, including emergency services at night in Senneterre, which ceased to be offered on October 18. These resumed on March 7.
According to coroner Thériault, however, there is nothing to establish that Mr. Genest could have been saved if he had been able to obtain health services at night in Senneterre or if an ambulance had arrived more quickly. “It is rather the fact that Mr. Genest waited so long before seeking help that was fatal to him given the medical condition involved, of which he was unfortunately not aware,” she establishes.
Mr. Genest’s death was attributable to hypovolemic shock secondary to the rupture of an abdominal aortic aneurysm.
Feed of events
On the morning of November 29, Gordon Richard Genest, a resident of Senneterre, began to feel pain in his lower back and stomach. Several of those close to him recommended that he go to the CLSC, which he refused to do, believing that the pain would pass.
During the night, at 2:38 a.m., the man made a call to 911, mentioning that his pain had become too intense. At that time, the only ambulance serving Senneterre was unavailable since it was already responding to an emergency call.
At 3:15 a.m., the 911 dispatcher called Mr. Genest back and changed the call priority. He asked the ambulance of the municipality of Barraute, located about 32 km from Senneterre, to go to the man whose stomach had started to swell.
The paramedics arrived at 3:49 a.m. and took Mr. Genest to the Val-d’Or hospital, located 68 km from Senneterre. On the road, the sexagenarian loses consciousness.
At 4:50 a.m., he arrived at the Val-d’Or hospital. An ultrasound reveals he has an abdominal aortic aneurysm. Mr. Genest made a first cardiorespiratory arrest. His abdominal aortic aneurysm ruptured. He receives blood transfusions.
At 6:10 a.m., the ambulance rushed the patient to the Amos hospital, located about 70 km from Val-d’Or, where a vascular surgeon was located. At 7:01 a.m., Mr. Genest suffered a second cardiopulmonary arrest as the ambulance entered the garage of the Amos hospital. He was pronounced dead in the operating room at 7:15 a.m.
Risk factors
In her report, Coroner Thériault points out that Mr. Genest had several risk factors for abdominal aortic aneurysm: high blood pressure, smoking and narrowing of the carotid arteries, among others.
Even if he could have been seen urgently at the CLSC de Senneterre, “we cannot be certain that a clinical examination by Mr. Genest […] would have allowed the doctor to suspect an abdominal aortic aneurysm,” she wrote. The CLSC de Senneterre does not have any abdominal ultrasound, computed tomography or magnetic resonance imaging device, specifies Me Thériault.
As for the delay before the arrival of the ambulance, she adds that it is “the result of an unfortunate combination of circumstances which meant that the only vehicle in the Senneterre area was already on its way to Val-d’ ‘Or with another patient before Mr. Genest called 911’.
After Mr. Genest called 911, it took 1 hour 11 minutes before an ambulance picked him up and 2 hours 12 minutes before he passed through the doors of the Val-d’Or hospital. If an ambulance had been available earlier, could this tragedy have been avoided? “There are far too many factors at play to conclude that Mr. Genest could have been saved but his chances of survival would possibly have been better […] “says the coroner.
She nevertheless concludes that “the partial closure of the CLSC de Senneterre, the emergency call services, the ambulance services, the pre-hospital protocols and the transport corridors are not at stake in this death”.