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Health authority provides clarity over home deaths

Dec 24 2011

Vancouver Island Health Authority has reviewed 1,011 deaths in residential care homes on the Island that were reported for the year ending March 2011 and found only seven were accidental.

The Times Colonist reported last month that there had been 3,496 deaths in Island care homes between 2008 and October this year in about 100 facilities funded by VIHA. However, the health authority was unable to say how many were unexpected and due to negligent care or accidents, if any.

VIHA's licensing department and the coroner have now reviewed their statistics and reports, and found about 89 of the 1,011 deaths reviewedwere unexpected, at least by the facilities.

The number of unexpected deaths is slightly inflated because of some overly cautious and erroneous reporting by the facilities, according to the coroner's service.

Barb McLintock, a former coroner and now the spokeswoman for the B.C. Coroner's Service, reviewed the unexpected death reports. She has no concerns about the number of accidental deaths.

"I was very impressed, is the honest answer," McLintock said. "Obviously you'd like to have none with any issues, in a perfect world, and that's what we're working towards - no preventable ones.

"I thought the numbers were remarkably small, three maybe, four out of 1,000. You're never going to eliminate all human error in the world."

Most deaths involving the elderly are expected to be due to natural causes. However, in the past VIHA has not been able to provide data on how many of the deaths in residential care facilities were unexpected and why they occurred.

The lack of available, specific data means that it is almost impossible for the public to evaluate, track and compare the quality or risks associated with seniors' care homes in the region or across the province, critics say.

NDP health critic Mike Farnworth maintains it's easier to access and compare information on the quality of restaurants in B.C. than it is care homes.

VIHA says it reports all incidents and deaths according to the Residential Care Regulation under the Community Care and Assisted Living Act. There is no requirement to refine data to show unexpected versus expected deaths, for example, the authority says.

At the request of the Times Colonist the statistics were reviewed and refined by VIHA's licensing branch and the coroner's service.

There were 1,011 deaths reported to VIHA's licensing branch from April 2010 to March 2011.

Eighty-nine were considered unexpected by the reporting facilities and reported to the coroner's office.

The coroner's service found of the 89 deaths that 82 were due to natural causes and seven were accidental.

Of the seven deaths classified as accidental, three were deemed accidental "with issues," three were accidental with no issues, and one was unearthed as part of the review and found to have probably been accidental. The latter is now under investigation.

Of the three with issues, one involved Mt. Edwards Court Care Home on Vancouver Street in Victoria. In April, 2010, patient Dora Parry, 86, who had Alzheimer's disease, died after she got past a security-locked door leading to a stairwell and tumbled, strapped in her wheelchair, to the landing below.

VIHA and the coroner's service conducted a full review.

In a second accident with issues, in the central Island, the extent of a patient's head injury, sustained while on blood-thinning drugs, was underestimated by nursing staff. It turned out to be serious and the patient died.

The facility's doctor immediately proposed, then implemented, a new training program around blood-thinning drugs and better evaluation of injuries, in particular head injuries, suffered by patients.

In the third accident with issues, a patient in the central Island was properly restrained in a wheelchair, but the restraint did not suit the unique design of the wheelchair and the patient stood up and fell, suffering a fatal head injury.

The matter is still under investigation by the Coroner's Service. "This was a design fault in matching restraint A with wheelchair B," McLintock said.

The Coroner's Service could report the incident to an inspector with the product safety review branch in Ottawa.

The injury-prevention improvements in the past six or seven years, during which McLintock was a coroner, have been remarkable, she said.

ceharnett@timescolonist.com

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