An Ontario woman whose husband died in a New Brunswick hospital while on vacation is urging Canadians to advocate for any loved ones in an emergency room — and she’s calling on candidates in New Brunswick’s provincial election to address what she calls a crisis in health care.
Anne Makhoul, and her husband, Danny, 64, were drawn to the Maritimes: she has roots in Nova Scotia, they honeymooned in P.E.I., brought their children there, and have visited New Brunswick on various occasions.
“I’ll never not love the Maritimes, but it’s certainly been coloured by my experience in Moncton,” she said in an interview from her home in Ottawa.
Makhoul said she spent a terrifying 36 hours at the Moncton Hospital with her husband of 40 years in August 2023.
“Compassion fatigue slapped me in the face,” she said, of her time in the emergency department, and she believes her husband didn’t receive appropriate care there.
Three people died while waiting in emergency departments in New Brunswick in 2022 — one of whom was at the same hospital as Makhoul’s husband would be the following year.
The first death prompted Premier Blaine Higgs to say the province was in a crisis and to overhaul its health-care leadership, including firing the CEO of one of New Brunswick’s health authorities. The death of Darrell Mesheau ultimately led to an inquest that resulted in recommendations to improve emergency room services.
Health care is a major issue in the Oct. 21 election.
Makhoul and her husband were on the second day of what was to be a two-week vacation, on a stopover in Sackville, N.B, on Aug. 12, when Danny began experiencing abdominal pain. They had eaten some soup that didn’t sit right with either of them, she said, so they thought that might be the culprit.
But Danny’s pain intensified: he had diarrhea and started throwing up. The emergency department at Sackville Memorial Hospital only operates from 8 a.m. to 4 p.m., so at 11:43 p.m., Makhoul called 911.
Ambulance New Brunswick records show paramedics arrived within eight minutes, recorded Danny’s pain as an eight out of 10, put in an IV and administered fluids and medication. They wrote in their notes that they did not give him Tylenol or Advil since he was vomiting.
After providing care for an hour and 46 minutes, paramedics took Makhoul’s husband to the Moncton Hospital; it took another 35 minutes to get there.
Makhoul said she was pleased with the treatment the paramedics provided, but not by the emergency department.
“They really didn’t seem to be very interested,” she said. “They just made a decision that, you know, ‘This guy has food poisoning. Why is she bothering us?'”
Makhoul said her husband was put in a small room off the ER that had a bathroom, but other than being given diapers to help with the diarrhea, she said from around 2 a.m. to 8:30 a.m., they received little attention. She noted there had been a cardiac arrest as they were arriving in the ER.
Makhoul spent the night repeatedly asking for pain medication and fluids — the IV inserted by the paramedics had been removed in the ER without explanation, she said. But her husband was only offered Tylenol, which she thought wasn’t logical since he was vomiting. His medical records show the IV was reinserted at 8:45 a.m. when ordered by a doctor.
Danny Makhoul’s intake form shows he was triaged at Level 3, which the Canadian Triage and Acuity Scale describes as “urgent,” meaning there are “conditions that could potentially progress to a serious problem requiring emergency intervention.”
The triage scale states patients in waiting areas assessed at Level 3 should be reassessed every 30 minutes but that the extent of the reassessment depends on the symptoms.
Records show Makhoul’s vital signs were taken just after 2 a.m., when he arrived, again just before 6 a.m. and at 7:15 a.m., when his wife says she went to the nurses’ station and begged them to do so.
She said they didn’t see a doctor until 8:30 a.m. Less than two hours later, her husband was rushed to the trauma centre.
Danny Makhoul died at 2:38 p.m on Aug. 14.
An autopsy report, provided to CBC News by his widow, shows he died of “necrotic/ischemic enterocolitis,” gangrene in his intestines due to lack of blood and oxygen flow.
CEO apologizes for ‘lack of communication and compassion’
Makhoul later wrote to the Horizon Health Network to share her experience.
In a statement to CBC News, Horizon Health’s president and CEO Margaret Melanson said, “I spoke with the family of the deceased to offer a sincere apology on behalf of our organization for the lack of communication and compassion they experienced, while sharing my condolences for their loss.”
She also said Horizon Health “remains aggressive” in its recruitment and retention efforts to improve staffing levels.
She did not respond to questions about whether anyone had been disciplined as a result of this case.
Makhoul filed a complaint with the Nurses Association of New Brunswick (NANB) more than a year ago. She has not heard the outcome.
In a statement, Kate Sheppard, interim CEO and registrar of the NANB, said she cannot discuss matters that have been referred to the association but not yet determined. The NANB takes all complaints seriously, the statement said, and summaries are published online when decisions have been rendered.
Makhoul has also contacted the main parties in the New Brunswick election to share her story, urging them to use it to improve the province’s health-care system.
Widow calls on election candidates to create change
Before the election campaign began, Makhoul wrote to Progressive Conservative Health Minister Bruce Fitch. He replied saying he recognizes that improvement is necessary.
“New Brunswick, like other jurisdictions in Canada, is facing unprecedented and complex human resource challenges,” Fitch wrote. He is not seeking re-election.
The PC Party did not respond to a request for comment from CBC News. PC Leader Blaine Higgs has said if re-elected he would expand the services provided by nurses, pharmacists and paramedics.
The N.B. Liberal Party replied to both CBC News and Makhoul outlining its plan to tackle health care, including building at least 30 collaborative health-care clinics and $15,000 retention bonuses for nurses.
Green Party Leader David Coon called Makhoul directly. In a statement to CBC News, Coon repeated his commitment to a “generational investment” to prevent avoidable deaths, “even if it requires us to go into deficit.”
The NDP has not been able to elect an MLA in New Brunswick in more than two decades.
Gabriel Arsenault, a political scientist at Université de Moncton, who has been tracking party promises through a tool called the Polimeter since 2019, said some of the boldest pledges in the campaign so far concern health care. He noted the Greens are offering full-tuition bursaries to medical and nursing school students.
“The Green Party originally was a party whose main mission was the defence of the environment. Now, its number one priority is health care,” said Arsenault.
Dr. Chris Goodyear, a general surgeon at the Dr. Everett Chalmers Regional Hospital in Fredericton, has issued a tongue-in-cheek challenge to the election winners to spend 48 hours in an ER.
In an interview, he said he has had candidates call his office saying they are willing to accept his challenge, but he said he wants to see that same enthusiasm after New Brunswickers elect a new government. He then wants political leaders to come together to outline how and when they’re going to fix the issues in a transparent way.
“New Brunswickers and Canadians are frustrated,” he said. “And when they don’t have access to the system via family doctor or nurse practitioner, you’re going to see overcrowded emergency rooms.”
Makhoul supports his challenge.
She said she wants all Canadians to know they should be prepared to keep asking for what they or their loved ones need when waiting in an emergency department.
“If it’s a crisis in New Brunswick, it’s becoming a crisis everywhere,” she said.