A family says their son was a patient who died in the waiting room of an Edmonton hospital’s emergency department earlier this month, but still has questions about the circumstances surrounding his death.
Penny Smith said her 33-year-old stepson, Travis Smith, died in the Royal Alexandra Hospital on May 8. She said her family learned from police that he died in the emergency department’s waiting room.
She said the family is speaking to media out of frustration. They feel politicians and health officials are politicizing Travis’ death, while they are struggling to get the full story about what happened to him.
“Now that we have his ashes, we’re going to bury him and we’re going to have a place [where] he could finally rest in peace, where we could go and see him … and his pain will be over,” Penny told CBC News.
“But we cannot get this to rest until we know the truth from the hospital.”
Doctors previously told CBC News that a patient died in the Royal Alex’s ER waiting room on May 8. They said the person presented to the emergency department, got assessed and received some treatment, but was then left in the waiting room.
Alberta Health Services (AHS) did not directly confirm a death occurred at the time. But the provincial agency told CBC News it started an initial investigation, that a quality assurance review — done when system problems may have factored in an incident, or when there’s opacity around a situation — would be conducted, and that the Office of the Chief Medical Examiner had reviewed the case.
Penny said her family believes that patient was Travis, her husband Allan’s son.
She said Allan received a call on May 9 saying Travis had died.
Penny said police later told her and her husband that paramedics had picked up Travis and administered naloxone. He was reportedly responsive, she recalled an officer saying. At the hospital, Travis was given medication before being left in the waiting room, according to Penny.
The Edmonton Police Service can’t disclose personal health information to journalists, a spokesperson told CBC News on Friday. But they confirmed officers were called to the hospital at 3:30 a.m. on May 9 because a man died suddenly.
It’s standard practice for police to respond to any sudden death that happens outside of a health-care setting, the spokesperson said. The man hadn’t been admitted when he died, so officers were dispatched and they’re now investigating.
Investigators currently believe his death was non-criminal, the spokesperson added.
Searching for answers
Penny said Travis experienced homelessness for the last few years of his life, after losing access to Assured Income for the Severely Handicapped (AISH). She said the family tried finding him on the streets but couldn’t.
“If it wasn’t for [the police], we would not know that Travis was the boy in the waiting room who died,” she said.
Penny and her husband, accompanied by a social worker, later went to the Royal Alex to try to see Travis’ body, she said. But they were informed he was moved to the medical examiner’s office for an autopsy.
The social worker couldn’t provide more information about Travis’ case, but directed further questions to a patient relations department, Penny said.
When she called AHS’ patient relations department, she was told the family had to file an application through the Court of King’s Bench before the hospital could release Travis’ information, Penny said.
An AHS spokesperson told CBC News via email that privacy laws prohibit the agency from providing specifics about a patient’s case, although it acknowledges a parent’s desire for information.
The spokesperson confirmed AHS has connected with Travis’ family and said the health authority encourages them to keep working with patient relations.
Alberta’s Health Information Act details when and to whom hospitals, for one, can disclose someone’s personal health information. When someone has died, diagnostic, treatment and care information can be shared with family members or loved ones, if it relates to circumstances around the person’s death and the deceased didn’t express a desire to keep the information secret.
Certain people can also exercise rights, granted in the legislation, on behalf of someone who has died: personal representatives — if it relates to administering the deceased’s estate — or the deceased’s “nearest relative,” to process an insurance claim.
“It says a custodian may disclose; doesn’t say they have to and it doesn’t say they can’t,” said Erin Nelson, a health law professor at the University of Alberta.
“It allows them to decide whether it would be appropriate, in their opinion [and] based on who knows what information, to disclose that information,” she said, adding that there could be numerous reasons to withhold information.
In this case, Nelson said it sounds like the hospital intends not to release the information unless directed to by the court. But she said it could also be possible that hospital staff misunderstood what they can share under the law.
Ultimately, without knowing more about the circumstances, it’s hard to know why the hospital is choosing to limit the information it shares, Nelson said.
Part of the problem could also be that the man wasn’t admitted to the hospital, according to Dr. Warren Thirsk, an emergency physician at the Royal Alex who also serves as the Alberta Medical Association’s (AMA) section head of emergency medicine.
Once an ER patient is diagnosed by a doctor and — if needed — is referred to another unit or specialist, they become someone’s responsibility, Thirsk said. The doctor who assumes responsibility then has the power to talk to the patient’s family.
But people in the waiting room are considered to belong to no one, he added.
“It is a lack of system-wide accountability that refuses to acknowledge or own those patients,” Thirsk said.
In the Smith family’s case, however, Thirsk said he is worried the hospital may be putting administrative process ahead of giving a grieving family closure.
“You need to approach families with the compassion they deserve,” Thirsk said. “They’ve lost a loved one — regardless of how it happened.”
AHS is calling for patience from the public as it completes its examinations of the incident, the spokesperson said. If the agency finds the patient should have been cared for differently somehow, or ways to better serve patients in the future, AHS said it will “take meaningful action.”
The agency added that it is committed to sharing findings from the quality assurance review with the family, within the confines of the law.
Playing politics
Medical professionals have been raising concerns about the province’s emergency departments for months, ever since Prashant Sreekumar, 44, died in the Grey Nuns Community Hospital’s ER in December. His family said he waited hours for care.
Acute Care Alberta, the provincial agency responsible for delivering emergency health care, investigated the circumstances around his death and made 16 recommendations to improve the system.
Paul Parks, an emergency physician in Medicine Hat, Alta., who once served as AMA president, sent a letter earlier this year to the provincial government that detailed examples of six hospital deaths reported over two weeks in January. It also listed 30 cases that he said he believes almost resulted in deaths. In his letter, Parks said he believes most of those cases occurred, at least in part, because of hospitals being overburdened.
CBC News analyzed emergency department wait times data published by the Canadian Institute for Health Information (CIHI), a national non-profit that releases a variety of information about public health care.
In Alberta, the maximum wait time for 90 per cent of ER patients to get an initial assessment nearly doubled in five years, from 2.9 hours in fiscal 2020 to 5.4 hours in fiscal 2024 — the most recent year for which data is available via the CIHI.
That wait for most ER patients in AHS’ Edmonton Zone rose from 3.7 hours to seven hours in that span.
The recent death at the Royal Alex ER has provided more fodder for debate about the issue. On May 13, Sarah Hoffman, the Opposition NDP’s hospital and surgical facilities critic, mentioned the case in the Legislative Assembly of Alberta, as part of a member statement about incidents in ERs this year.
Over the next week, she and at least one other NDP MLA posted on social media about the death, as well as broadly about conditions in emergency departments.
Penny said she became upset after seeing a Facebook post by Hoffman, detailing the incident she believes involves her stepson.
“I really think that nobody cared about him there, but they’re using this as an example of our terrible health system,” Penny said.
In a statement sent to CBC News through an NDP spokesperson on Friday, Hoffman offered condolences to the family and apologized for her social media post.
Hoffman said she intended to highlight the circumstances of this person’s death and the need for accountability, but recognizes public attention added to the family’s pain.
Penny said her family wants an inquiry into Travis’ death. She told CBC News the family has lingering questions, including about the state of Travis’ health when paramedics picked him up, why he was treated for a narcotic overdose and why he wasn’t observed more at the hospital.
The Justice Ministry can’t comment on this case at the moment, an Alberta government spokesperson told CBC News.
But whether a case goes to a public inquiry stems from a recommendation from the chief medical examiner to the justice minister. The spokesperson said that hasn’t happened yet.
