Earlier wait led senior to delay return to ER

A senior's "understandable" hesitation to return to an Edmonton emergency room because of an earlier eight-hour wait contributed to his death from surgical complications, a fatality inquiry judge has found.

Samuel Takyi, a 73-year-old patient from Sherwood Park, died on March 17, 2009, at the Grey Nuns Hospital, one week after he had surgery to remove part of his large bowel.

"The lack of emergency room resources at the Grey Nuns Hospital resulted in a lengthy wait for Mr. Takyi," Judge Robert Philp wrote in his report that was released on Monday.

"Because of this wait, he was dissuaded from returning when his condition became critical."

Despite this finding, the judge declined to make recommendations about staffing in emergency rooms.

"Resources in emergency rooms are indeed scarce, but how a hospital decides to allocate those scarce resources is something that is outside the scope of recomendations which can appropriately be made by this inquiry."

Three days after surgery, and on the evening of the day he was discharged, Tayki experienced increased pain in his abdomen. Following instructions from his surgeon, Takyi called an ambulance which brought him the ER at the Grey Nuns hospital.

It was a busy Friday night, and Takyi waited six hours for a nurse to examine him. It was another two hours before he was seen by an ER doctor.

Takyi was sent home with pain medication after the doctor determined that he didn't appear to have any complications and that his pain was normal for someone who just had surgery.

In the ensuing three days, Takyi's wife was in touch with a doctor who advised her to take him to the ER if his condition worsened. But the couple was hesitant about enduring another lengthy wait, the report says.

Takyi's condition deteriorated on March 17th. His wife called an ambulance at 5:37 p.m. after she was unable to get in touch with his surgeon.

Takyi died shortly after he arrived at hospital. The cause of death was found to be a leak in his bowel that the surgeon later said could have been fixed if it had been found earlier.

In his report, the judge notes that given the long wait he experienced on his first visit to the ER, it was "understandable" that Takyi endured the pain and resisted going back.

"It is unfortunately Mr. Takyi's endurance of this pain that resulted in his death," the judge writes. "Had emergency treatment been received earlier he may well have survived."

Tayki's wife was not present when he was given discharge instructions. The judge recommends that in the future, such instructions should be given to the patient while a responsible family member is present.

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