WINNIPEG — A judge says the death of a senior hours after she was sent home from a Winnipeg hospital in a cab was not preventable.
But Judge Margaret Wiebe says in an inquest report that Heather Brenan's death was still a tragedy that has raised concerns about her medical care.
The judge made 25 recommendations, including one calling for more patient beds at the Seven Oaks hospital.
Brenan, who was 68, spent four days in the emergency room at the hospital before she was discharged on the night of Jan. 27, 2012.
She collapsed at her back door and was rushed back to Seven Oaks, where she died the next morning of a blood clot in her lung.
Months later, two other patients were sent home in taxis from a different hospital and died on their doorsteps.
The judge noted that the Winnipeg Regional Health Authority has since made several changes and is planning to move 19 geriatric patients in Seven Oaks into a long-term care facility. It will then convert that space to 30 medicine beds.
She said she understands it will take time but hopes the plan will be made a "higher priority."
The judge added that the health region now requires patients staying in the ER longer than 24 hours be admitted so they can be placed under the care of a dedicated doctor. It also has a protocol for safe discharges for elderly and vulnerable people.
"Heather Brenan is responsible for many of these changes," wrote Wiebe in the report released Tuesday.
"Her experience at (Seven Oaks), and the circumstances of her treatment and discharge, has resulted in a number of positive changes in policies and protocols which will benefit other people going forward."
