Lakeshore Hospital nurse suspended for 5 months after patient's death

A nurse has been suspended for five months from the Lakeshore General Hospital after a patient died on his watch.

The 81-year-old man, called F.C. in the document, was ringing a bell and calling his partner in a panic while suffering from severe chest pain at the hospital in Pointe-Claire in 2022, according to a March 1 Quebec Order of Nurses Disciplinary Council ruling.

Kishore Baijoonauth was suspended for "having demonstrated negligence in providing care and treatments provided to a client, in particular by not carrying out the assessment and follow-up required by their state of health," the judgment reads.

Baijoonauth pleaded guilty on Jan. 24 to the disciplinary complaint made in September and has been suspended and ordered to pay all expenses related to the complaint investigation.

• Listern on CJAD 800 Radio: A Lakeshore Hospital nurse has been suspended after the death of a patient. What happened?

The ruling recounts F.C.'s trying two days from June 14 to 16, 2022 when he was admitted to the Lakeshore emergency room while waiting to be transferred to the Royal Victoria Hospital to undergo heart surgery.

On June 15, the document says that the patient complained of chest pains, and Baijoonauth noted it in his file and gave him a Tylenol.

Later, the patient "explains that he has pain in his chest, arms, and jaw, that he informs the staff, but that they do not listen to him."

The ruling reads that F.C. called his partner over a dozen times in a panic but that Baijoonauth noted that he was calm and did not have chest pains or palpitations.

"This note is contradictory with the number of calls made by Mr. F.C. during the same period and the content of his exchanges with his relatives," the document reads.

At 2:40 a.m., the patient's condition deteriorated, and resuscitation manoeuvres began.

He was pronounced dead just before 3:30 a.m.

The ruling from the Order of Nurses says that Baijoonauth "did not carry out the assessment required by his state of health even though the client presented, during the night, with chest pain, was known to have heart problems and was awaiting treatment."

"He did not provide the follow-up required by his state of health since he did not adequately reassess the client's condition and did not inform the doctor of the change in his condition, namely the appearance of pain to the chest and taking nitroglycerin," it reads.

The document says that the nurse "feels a lot of remorse, is sorry for the family of Mr. F.C., and apologizes."

Baijoonauth practised as a nurse for two years before the incident and had no history of negligence.

F.C.'s death was one of the series of deaths investigated by The Montreal Gazette that resulted in Quebec Health Minister Christian Dube ordering an investigation and report in 2023.

The report made 135 recommendations for improving the situation at the hospital, including building a replacement for the aging critical care unit.

• WATCH: Investigator releases report into Lakeshore ER

The Lakeshore is currently constructing a $13 million modular ER. 

Patients' rights advocate Paul Brunet said when the nurse is reinstated, he should be given better training, adding that all hospitals in Quebec need to do better.

"We need more efficiency. We need a lot of better things in terms of coordination and better accountability on the part of managers," he said.

Montreal Gazette reporting brought death to light

The man's death was one of six Montreal Gazette health reporter Aaron Derfel brought to light in an investigative series into Lakeshore's ER last year.

"Every step of the way, there had been errors that were made," he said. "There have been cases where nurses have been suspended for as many as five months, but this is relatively rare. And what it shows is just it underscores the severity of what has happened."

Derfel's reporting on the Lakeshore prompted Quebec's health ministry to open an investigation.

Staff there are under tremendous pressure, he said.

"I think this points to systemic negligence in that ER, which, as we know, is chronically overcrowded. There's a high turnover staff, there's improper training – or there had been. Now they're beginning to address these issues. And so it's in this context that you're going to get these deaths that that could have been prevented," he said.