Family blames hospital, Ontario for death of GTA woman

November 1, 2012 - All News

One Sunday two years ago, Laiq and Badrunnisa Khurshid set out for a midnight stroll. The couple walked hand in hand through their suburban Vaughan neighbourhood, chatting about their children, reflecting on life.
Their son had just bought a new home in Mississauga, their eldest daughter was about to have her second child, their younger children were doing well in university. And they all lived close enough to each other that family gatherings were a weekly event.
How lucky we are, Laiq said to his wife.
The next day, Badrunnisa woke up with a headache and nausea. When she began vomiting non-stop, Laiq drove her to the local emergency department. By the next afternoon, she would be dead.
Badrunnisa’s husband and children have been fighting for answers ever since. The family believes she would still be alive if not for what they allege were numerous delays in treatment and diagnosis at York Central Hospital and a shortage of neurosurgery beds in the province that led to Badrunnisa being sent to Buffalo, N.Y. The 52-year-old died of a brain hemorrhage before getting there.
York Central would not speak specifically about the case for this story, but in correspondence with Laiq Khurshid the hospital president said an internal review showed all expected treatments and tests were completed and staff provided the “best clinical care possible.”
The explanation was not enough for Badrunnisa’s husband and children. Two years later, the Khurshids are still determined to get more information, but are running out of options. They say Ontario’s Ministry of Health and Long-Term Care has not responded to their demands for an inquiry. A statement of claim has been issued with the Ontario Superior Court, but has not yet been served on the hospital. The Khurshids haven’t decided whether to proceed. They say a lawsuit would drain their savings.
Legal experts say the family’s story underscores the need for an independent third-party investigator in the Ontario health system.
“There isn’t anywhere to go other than inside a hospital if a patient has a concern, and obviously the people who work in the hospital work for the hospital, so you’re talking to an employee of the hospital about a bad experience with (another) employee,” says Amani Oakley, a health and medical malpractice lawyer in Toronto. “If you are not satisfied there is absolutely nowhere to go with that complaint.”
Badrunnisa arrived at York Central Hospital on July 19, 2010. The following account of her stay is reconstructed from hospital records obtained by the family and correspondence between York Central and Laiq Khurshid.
Monday 11:30 a.m.: Laiq and his wife arrived at the hospital just before noon. A little over an hour later, Badrunnisa was taken to a treatment room, had blood work drawn and was given Gravol for nausea and vomiting. Her vital signs were stable.
3 p.m.: Badrunnisa underwent a chest x-ray and a CT scan. A radiologist determined the tests showed nothing of concern.
8 p.m.: Badrunnisa was diagnosed with gastroenteritis — an infection commonly referred to as the “stomach flu” — and given a discharge, which was cancelled after Laiq protested.
Throughout their night at the hospital, Badrunnisa continued vomiting and complained of a severe headache. Laiq had been at the hospital with his wife for more than 12 hours and believed there was something seriously wrong with her. He says he begged hospital staff to treat his wife’s case with a greater sense of urgency and was treated like a nuisance. “It seemed I was committing a crime for requesting help,” he later wrote about the experience.
Tuesday 12:40 a.m.: A second physician diagnosed Badrunnisa with viral gastroenteritis. She was given medication for nausea as well as a sedative, which causes drowsiness.
4:30 a.m. In the early morning hours of their second day in hospital, Laiq noticed his wife was having difficulty breathing, so he called a staff member into the room. The staff member examined her, said everything was fine and left. Ten minutes later, Laiq called the same staff member in again. This time, his wife was unresponsive and incontinent of urine. Badrunnisa began having seizures and was intubated.
6 a.m.: An urgent CT scan was performed. This time doctors noted suspicion of a brain bleed, but said the scan was not conclusive. A repeat scan was ordered.
9 a.m.: A lumbar puncture revealed blood in Badrunnisa’s cerebral spinal fluid — a sign something was wrong. A repeat CT scan confirmed a stroke and a hemorrhage.
York Central Hospital does not have neurosurgeons, so a call for a consult was placed through CritiCall, a government-funded emergency referral service that helps track available beds in the Ontario health system.
11:30 a.m.: A consult was obtained and it was determined Badrunnisa needed emergency surgery. There were no neurosurgery beds available in the province, so it was decided she would be sent to a hospital in Buffalo by road ambulance. According to Laiq, hours went by before the ambulance picked her up.
4:45 p.m.: Badrunnisa arrived at Millard Fillmore Hospital in Buffalo, but was already brain dead.
Laiq, 60, is furious at the memory of those two days in hospital. He alleges the very first CT scan was misread and staff did not take Badrunnisa’s case seriously until it was too late.“I believe that initially if they recognize the seriousness of the case, my wife would still be alive,” he says.
None of the family’s allegations have been proven in court.
In a written response to the family’s concerns, York Central Hospital CEO and president Altaf Stationwala outlined some of the actions his staff took duringBadrunnisa’s time in hospital. “Your wife presented in the emergency department without the usual signs and symptoms of a subarachnoid hemorrhage and our tests came back negative,” he wrote. “All the expected treatments and tests were completed and the best clinical care possible was provided.”
Stationwala also offered his condolences, said he was “distressed” by the family’s description of the attitude of his staff and apologized “for the pain and suffering caused to you and your family by this experience.”
As a result of the review of the Badrunnisa’s case, Stationwala said the hospital would be “reviewing the threshold for when a lumbar puncture is performed.” Stationwala also said the hospital shares the family’s concern about the lack of neurosurgical beds in the province and time it takes to “access the appropriate resources.”
He did not respond directly to their allegations of misdiagnosis and delay.
The hospital would not comment on the case for this story, even with permission of the Khurshids, though Stationwala did say his correspondence with them should speak to “how thoroughly we reviewed the case.”
He did agree to an interview about accountability and transparency in hospitals and said he would be open to the idea of an independent third party stepping in when patients and their families aren’t satisfied with hospital investigations, so long as it didn’t create duplication in the system. “Transparency ultimately makes the system better,” he said.
A spokeswoman for Ontario Health Minister Deb Matthews said the ministry could not speak about specific cases or confirm whether the office ever received or responded to the Khurshid family’s emails, but said “our heart goes out to any family who has lost a loved one.”
About 150 Ontarians were transferred to U.S. hospitals for emergency neurosurgery in 2009-2010, according to government figures. Since 2010, measures have been taken to decrease the need for out-of-country neurosurgery transfers and the number has been “significantly reduced.”
The Khurshid family wants more answers than the hospital has provided. To them, the letter from the CEO felt like a brush-off. They want a full report so the same thing doesn’t happen to others.
Laiq sought help from Ontario’s ombudsman, whose office investigates complaints against provincial government organizations, but was told the office did not have the authority to look into their case. Ontario is the only province whose ombudsman doesn’t have jurisdiction over hospitals.
In Quebec and most other provinces, the Khurshid family’s case is exactly the type of situation in which an ombudsman might step in — where the hospital has provided a response and the patient or family members still have questions. Ombudsman offices do not have powers of enforcement, but they can make recommendations and address underlying problems that lead to systemic change. In Quebec, more than 98.5 per cent of recommendations made by the provincial ombudsman are accepted by hospitals.
Badrunnisa Khurshid would have been 55 this week. Laiq is not sure where to go from here. He has few options left is his two-year quest for answers, short of spending his retirement savings on a lawsuit.
“Justice is so costly,” he says bitterly. “It is not affordable for normal people.”
— Torstar News Service