Ambulance shortage, clinic closure didn't cause 65-year-old Quebec man's death: coroner

An ambulance shortage and reduced clinic hours in Quebec's Abitibi-Temiscamingue region were not critical factors in the death of a 65-year-old man, a coroner has ruled.

Richard Genest of Senneterre, Que. died of a ruptured aortic aneurysm in late 2021.

In the early hours of Nov. 30, Genest called 911 with reports of nausea and intense pain in his back, stomach and thighs.

But only one ambulance was running in Senneterre that night, meaning another ambulance from a neighbouring municipality roughly 30 km away had to be called.

Genest wouldn't arrive at the hospital in Val-d'Or, nearly 70 km away, until over two hours after dialling 911.

Visiting the emergency health clinic in Senneterre (CLSC) wasn't an option at the time. It's normally open 24/7, but hours were temporarily reduced in October of 2021 due to a lack of staff.

However, coroner Geneviève Thériault says these obstacles weren't the cause of Genest's death -- rather, it was because he waited too long to seek medical attention in the first place.

"Unfortunately, the fact that Mr. Genest waited nearly 19 hours between the beginning of his pain and his search for medical assistance via a 911 call was, in my opinion, the most important factor in the circumstances of his death," Thériault wrote.

Genest reportedly complained of his symptoms to friends on the morning Nov. 29, the day before he died. They advised him to visit the Senneterre CLSC before it closed at 4 p.m, but Genest insisted the pain would pass.

That evening, his symptoms worsened. His friends recommended he call an ambulance, but he said he would visit the CLSC in the morning.

At 2:38 a.m. on Nov. 30, Genest's condition became too painful to bear, and he phoned 911. But by the time he called, Thériault said, it was too late.

Genest suffered two cardiac arrests, one en route to Val-d'Or and another after he was transferred to a different hospital, again 70 km away, in the municipality of Amos.

He died in the Amos hospital elevator on his way to surgery.

Had he been sent to Amos directly, Thériault said his chances may have been improved -- but there are "too many factors at play" to say for certain, adding that the "protocols in force had been respected."

REDUCED CLINIC HOURS LIKELY NOT A FACTOR: CORONER

Following Genest's death, Senneterre Mayor Nathalie Ann Pelchat sent a letter to the Quebec Health Ministry claiming that, if he'd been able to see a local doctor, the tragedy may have been prevented.

But according to Thériault's assessment, even if Genest had the option of visiting the Senneterre CLSC before he called an ambulance, it likely wouldn't have helped.

"Would a stop at the CLSC's emergency room have improved his chances of survival? I doubt it," she wrote, explaining that the CLSC wouldn't have possessed the right diagnostic tools.

"The CLSC has simple X-ray equipment, but this type of exam is not very effective at confirming an aneurism," she said.

While it's possible to speculate what might have happened if a CLSC doctor determined the right diagnosis, inadequate equipment notwithstanding, "speculation does not represent facts," Thériault continued.

The clinic's full-time hours were restored in March following protests from the local community.