A two-month-old boy with bacterial meningitis suffered a stroke and nearly died recently when he was sent home from Abbotsford Regional Hospital’s crowded emergency room after what his mother says was a cursory exam.
The infant survived, but remains in BC Children’s Hospital and may have permanent symptoms from his brush with death. His mother, meanwhile, wants an apology from health officials after being told staff should have done more to diagnose her son.
On Jan. 27, Liz Georgelin brought her son, Lucas Lacasse, to a Mission clinic. Lucas had a fever of 102 degrees F, and Georgelin says a doctor told her to head immediately to Abbotsford Regional Hospital (ARH). The physician said he would phone ahead to communicate the urgency of the matter and that Georgelin shouldn’t go to Surrey, because that would add up to a half-hour to her drive.
Georgelin – a first-time mother from Maple Ridge – heeded the doctor’s advice. She drove to ARH, where she says she waited more than seven hours to see a physician.
“After I’ve been sitting there for six hours, I thought, ‘I should have gone to Surrey because I don’t know how much longer I’m going to be sitting here for.’ “
When she did see a doctor, Georgelin says the physician apologized for the wait and for being busy. According to Georgelin, the doctor then took Lucas’s temperature – it had dipped slightly to 101 F – and declared he likely had a cold. Georgelin was told to give her son Tylenol and to return to the hospital in five days if Lucas’s condition didn’t improve.
“The emergency doctor was so busy,” Georgelin told The News by phone from BC Children’s Hospital. “Everything every other doctor has told me is that: ‘You should not have been sent home for five days. You should have had a lumbar puncture that night. You should have been admitted that first time.’ “
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Fraser Health’s own website says that babies under three months old who have a fever with no obvious underlying cause should see a doctor “as soon as possible.” The site says such babies “can get very sick quickly and require an aggressive approach to investigate the underlying cause.”
Georgelin said she didn’t see any such “aggressive” steps taken at ARH. So she did as the doctor instructed and went home.
Lucas didn’t improve over the next couple days. On Friday, Jan. 31, his condition seemed to worsen, so Georgelin brought her son to Surrey Memorial Hospital’s pediatric emergency department. The reaction from staff was much different than four days prior in Abbotsford.
“The triage nurse said, ‘Oh my God! Your baby!’ ” Georgelin said.
Lucas began to have seizures and underwent a battery of tests as doctors began suspecting he had bacterial meningitis, a potentially fatal illness. Georgelin could only watch as her son’s condition deteriorated, and it was unclear whether he would survive.
“I kept watching him dying in front of me.” Georgelin remembers thinking: “I’m going to lose him. I’m going to lose him.”
The meningitis diagnosis confirmed, Lucas was rushed to Children’s Hospital to have a PICC line installed so intravenous antibiotics could be delivered directly to his blood stream. At Children’s – where Georgelin said the care has been “amazing” – Lucas underwent an MRI, from which doctors found he had suffered a stroke and had a blood clot at the base of his brain.
Georgelin said she was told her son had suffered “an intensive brain injury.” She says she was also told her son should not have been sent home in Abbotsford.
Lucas has survived and is recovering, but it remains unclear what long-term damage he might have suffered.
“We are so, so happy that he’s responded to the antibiotics and that he is continuing to fight this,” she said. But she is distressed that the meningitis did so much damage after her first visit to a hospital.
“Because the infection was left for five days, this kid is going to have permanent neurological damage from it,” she said. “This was avoidable.”
Catching meningitis early is key to preventing significant damage, and Georgelin said doctors told her they believed Lucas had been sick for at least five days. Georgelin said staff were upset when they learned she had been sent home from the hospital without being admitted.
The News has extensively covered challenges at Abbotsford Regional Hospital, which is one of the two most-crowded large hospitals in the province. It has the highest standardized mortality rate among large B.C. hospitals, and one in 10 admitted patients wait three days or longer in the emergency room for space to free up elsewhere in the facility.
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A 2015 Fraser Health report warned that the risk of errors increased in hospitals that operated at above 95 per cent capacity. Last winter, ARH operated at above 120 per cent capacity.
Health Minister Adrian Dix acknowledged earlier this year that the hospital faces “extraordinary” challenges. Although work is currently being built to expand the hospital’s emergency department and Fraser Health has added 20 beds over the last three years, the acute-care wards in ARH have fewer beds than they did in 2014.
Dix told The News on Tuesday that he can’t comment on the specifics of a medical case. But he pointed to the new beds in Abbotsford and hospital construction elsewhere in the region as evidence that the province is trying to increase hospital capacity.
Dix acknowledged that Abbotsford and the Fraser Valley are growing quickly and said the number of acute-care spaces hasn’t kept up. He said Fraser Health and the government are working on other initiatives to reduce congestion across the health-care system.
“I think people want to know we’re taking the problem seriously, and we are,” he said. Dix said the government is also working to improve other areas of health care, including long-term care and primary care in Abbotsford.
“I think our staff in the hospital do an extraordinary job. That doesn’t mean they’re right all the time – they deal with the information in front of them,” he said.
“One of the things I believe we need to do is to give our frontline staff the support they deserve and [give] people the sense this is a place they can go in a crisis.”
Dr. Neil Barclay, Fraser Health’s emergency network regional medical director, confirmed in an emailed statement that Lucas had been assessed and discharged from ARH, with his mother told to return if his condition worsened.
“When an individual presents to an emergency department themselves or for their child, they are assessed and the nurses and physicians make the best care decisions based on what they see at that time,” Barclay said in the statement. “The nurses and physicians work incredibly hard every day, and any time there is an unexpected outcome from an emergency department visit, it is taken seriously and we discuss the steps taken and decisions made. When any case has a significant and unexpected outcome, the case is reviewed and discussed by the care team involved and learnings shared between staff.”
Fraser Health said the median length of time to see a doctor in Abbotsford’s ER was 90 minutes in January, although that figure can vary depending on the time of month and the time of day. One of five ER patients are children.
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Georgelin and Lucas expect to be in hospital another three weeks. (Lucas’s father, Quinton, has also been involved in his son’s medical struggles.) If and when Lucas is released, he will continue to be on medication for at least another three months.
Georgelin’s mother, Joanne Leeder, has begun a GoFundMe page to raise money to assist her daughter and aid Lucas. She has pledged to donate half of the funds raised back to BC Children’s Hospital, where she said her grandson has received “phenomenal” care.
Georgelin says she wants some acknowledgment from Fraser Health that her son’s care wasn’t adequate.
After seeing the first doctor in Mission, Georgelin said she focused on getting her son to the hospital.
“I just thought, once I got to the hospital, we’re safe. I’m good. They’ll take care of me and my son. They’re doctors, they’ve got this … They’re going to run the tests and they’ll tell me he’s fine and I’ll go home. That’s what I fully anticipated.”
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