Communication and 

protocol need to be improved

 

By Kathy O'Reilly, North Island Eagle, November 22 2024

​

A Malcolm Island woman is hoping that going public with her daughter’s story inspires meaningful improvements in the Island healthcare system, especially in rural areas.

“Sabrina’s (Douglas) experience highlights gaps that could have devastating consequences if not addressed,” Michelle Jensen said. “I would like to see increased accountability, more streamlined processes for accessing specialized care and better advocacy for people facing urgent medical issues,” Jensen said. If Sabrina had not eventually, largely due to her mom taking on the role of her health advocate, received the necessary medical attention she needed, her condition could have worsened leading to potentially irreversible long-term health complications including permanent paralysis with loss of bladder and bowel function. 

“People should not have to navigate layers of red tape and endure lengthy waits with little to no communication when their health is at stake. My hope is that by sharing Sabrina’s story, we can move toward a rural healthcare system that prioritizes timely and effective care for everyone.”

In March, Sabrina visited the Campbell River hospital with back pain and was told to go home and rest for a week. 

She didn’t receive medical intervention until May, two months and two hospital visits later, and was referred for an MRI that wasn’t scheduled until Aug. 3. 

By this time, she had lost feeling in her right leg and both feet were purple and numb and could barely stand unassisted due to pain.

At 2 p.m. on Aug. 13, Jensen took Sabrina to the Courtenay hospital. When she checked in, Sabrina explained she was there to obtain the results of her MRI as she did not have a family doctor. 

“The only contact we had the entire time was at two points where we were moved to different waiting areas,” Jensen recalls. 

“At 10 p.m., I checked to see if they could give me an idea of how long until she would be seen. It was then I was told that they were waiting for a callback from the neurosurgeon. I could only assume that we were not going to get a call back from a neurosurgeon at that time of the day,” she said

“We had been there for eight hours with no assistance or communication and finally we had to leave without seeing a doctor.”

On their way out, the triage nurse explained that Sabrina could only receive her test results and next steps through her family doctor, the hospital, or by travelling to Victoria General Hospital, where the neurosurgeon is located.

Sabrina moved back home with her mom and was able to get a family doctor.

Jensen brought her concerns regarding significant delays in accessing an MRI and subsequent referrals to a neurosurgeon for treatment of a herniated disk sustained in February 2024 to the Island Health Patient Care Quality Office in August 2024.

The letter highlighted concerns regarding Sabrina’s care at the Port McNeill Hospital’s emergency department. 

“Sabrina suffered over 60 hours of excruciating nerve pain at levels fluctuating between six and 10 (10 being the worst pain she has ever experienced in her life) with inadequate medical support and communication between Oct. 10 and Oct. 12, 2024.”

Sabrina arrived at Port McNeill Hospital by ambulance from Sointula in severe pain due to a herniated disk the MRI had revealed that had worsened since February. Her symptoms included severe lower back pain, bilateral sciatica, saddle anesthesia, and bladder dysfunction. 

The doctor diagnosed Sabrina with cauda equina syndrome. Cauda equina syndrome is a medical emergency that happens when an injury or herniated disk compresses nerve roots at the bottom of your spinal cord and is a condition that requires immediate medical intervention to avoid permanent paralysis, incontinence, and other debilitating symptoms. 

“By mid-afternoon they had secured a bed for her at the Victoria General Hospital Neurology Unit for the next 24-48 hours and arranged air transport for 10 a.m. the following day.”

Overnight, Sabrina’s condition deteriorated. She began experiencing pain-induced delusions and hallucinations. 

“Despite the severity of her condition, there were multiple failures: delays in transport, poor communication, and insufficient medical attention. The 10 a.m. air transport never materialized, and no explanation was provided. By the afternoon, there were no staff updates, and Sabrina continued to suffer.”

Reaching her breaking point, Jensen called 911 from the emergency department.

“After explaining the situation, I received a call back from dispatch but was told they could not provide any information and that I had to inquire at the hospital, which had been uncommunicative,” she said. 

“By this point, it became evident that no one was advocating for Sabrina. Despite multiple missed transport opportunities, the medical team displayed no urgency,” she said.

At some point a doctor briefly checked on Sabrina after she slipped and fell in the shower due to her compromised mobility. 

“His assessment was minimal - a basic pressure test on her foot. When I raised concerns about the urgency of her cauda equina syndrome diagnosis and the closing 48-hour window for her bed at Victoria General Hospital with him, the doctor dismissively stated, ‘I’m no neurologist, but nerves regenerate, and at 48 hours the timer just restarts’.” 

At 5:40 p.m., Jensen was advised the final helicopter was diverted for an emergency and there would be no transport.

“The overall tone of the medical team had shifted, and it became clear that I was left alone to care for my daughter. Despite my concerns, the hospital staff offered minimal assistance. When Sabrina was unable to lie flat for a bladder scan due to intense pain, the nurse’s frustration was palpable, and she abandoned the effort abruptly,” Jensen said. 

“It was at that point (10:30 p.m.) I made the very difficult decision to drive Sabrina to Victoria myself. There was no way we could endure another sleepless night at this hospital.”

Upon arrival at 4:30 a.m., Sabrina was swiftly taken to the Neurology Unit.

“Hours later we were informed by Sabrina’s assigned Registered Nurse and the Unit Manager that, due to my failure to follow proper transfer protocol, they had no orders for Sabrina and could not assist her until her paper-based records arrived from Port McNeill.”

As she waited, Sabrina’s condition continued to deteriorate, and her skin began to feel like it was burning. She suffered from more hallucinations and psychotic episodes due to the prolonged pain and sleep deprivation.  It would be another 12 hours of intense pain and psychosis before Sabrina was taken into surgery.  To date, the long-term effects of these delays in Sabrina’s care remain unknown. 

“However, the potential consequences are deeply concerning and underscore the urgency of addressing the failures in communication and protocol that led to this situation.”

Sabrina is still healing and had her first physiotherapy session Nov. 19.

Jensen encourages people to escalate their serious healthcare concerns to the Patient Care Quality Office at Vancouver Island Health Authority, which is equipped to address such matters directly and urgently by contacting 250-370-8323; Toll-free: 1-877-977-5797 or via email: patientcarequalityoffice@islandhealth.ca