Hospital ‘nightmare’ in B.C. for Quebec patient denied surgery: father | Canada News Media
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Hospital ‘nightmare’ in B.C. for Quebec patient denied surgery: father

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VANCOUVER — A Quebec man who fell and broke his jaw, cheekbone and a bone around his left eye while visiting British Columbia says his surgery was cancelled after he was told his home province “won’t pay” for the procedure.

Patrick Bélanger, 23, said his experience is a warning for residents of Quebec and all Canadians who take pride in a universal health-care system because doctors in other provinces could deny treatment to Quebecers by maintaining they won’t be compensated.

Bélanger’s ordeal began when he and his girlfriend were walking along a trail in the resort town of Sun Peaks, B.C., on the evening of June 10. He tripped andstumbled backwards in the dark, hitting his face on a boulder.

He was taken by ambulance to Royal Inland Hospital in Kamloops just before midnight and was told he needed surgery for a “broken face.” But a surgeon was not available on Saturday, so he was discharged with a prescription for the opioid-containing drug Percocet to manage his pain, Bélanger said.

The following morning, he and his girlfriend, Beth Cooper, returned to the hospital for surgery. But Bélanger said that just as he was being prepared for the operating room, the surgeon cancelled the procedure.

“He said that the hospital would not let him do the surgery because I was from Quebec,” Bélanger said, adding he’d presented his provincial health card when he arrived at Royal Inland.

“I was kind of in shock. As I thought about it more, I thought that doesn’t make sense. Normally, you’d do the surgery and figure out billing afterwards, or at least I thought that’s what was going to happen,” he said.

“I was pretty scared. I was still pretty out of it because I was in quite a bit of pain and on pain medications. And I was calling my parents trying to figure out what to do.”

Bélanger said he offered to pay for the surgery through his family’s private insurance, but the surgeon rejected that option, saying he first needed to speak with a hospital administrator who was not available on the weekend.

“When he told me that the surgery couldn’t be done today, he suggested that I fly back to Quebec City to go get the surgery done,” Bélanger said.

He was given a window of 10 days before his facial bones would start to fuse.

“We thought it was just completely absurd that I, with a broken face, was to take a commercial airline to go get a surgery done in my own country.”

Bélanger’s father and mother arrived in Kamloops later that week and tried unsuccessfully to speak with an administrator at the Interior Health authority about the best options for their son, Richard Bélanger said.

“We were baffled about his basic rights as a Canadian,” he said, calling his son’s experience a “nightmare.”

Richard Bélanger said he went to the surgeon’s private clinic to provide information on the family’s insurance plan as well his credit card in case the surgery could be done there. But staff told him the serious facial fractures his son suffered meant the surgery had to be performed in a hospital, he added.

Four days of anguish since the surgery was cancelled had Bélanger managing “excruciating pain” with prescription opioids and morphine before his case was passed on to another surgeon, he said.

“I would wake up in the middle of the night crying and screaming in pain.”

The second doctor said he needed quick intervention, and the surgery was done seven days after he fell, said Bélanger, an economics student at Bishop’s University in Sherbrooke, Que.

His family said they are still puzzled about why the original surgeon did not do the surgery.

“It’s gross incompetence on the part of the hospital and a failure on the part of the Canadian health-care system,” said Bélanger’s mother, Martha Ferris.

Both Patrick and Richard Bélanger say the end result was “discrimination” against a patient from Quebec, which pays hospital costs but does not participate in a reciprocal billing agreement for physician fees involving all other provinces and territories.

Doctors of BC, an association representing physicians, said an agreement allows its members to bill their own provincial Medical Services Plan for patients from outside the province and the plan is then reimbursed by the patients’ home jurisdiction.

“The doctors get paid as if the patient is a B.C. resident,” it said in a written statement.

“When a Quebec resident needs medical care in B.C., doctors are not able to bill MSP for it and get paid,” the association said.

However, physicians providing services to Quebecers can either bill that province or bill the patient, who would seek reimbursement from their government.

The Health Department in Quebec said doctors elsewhere are paid at rates as if the patient received the same treatment in their home province. Patients must pay any difference in cost and could apply to have the money reimbursed through private insurance, if they have it, the department said in a written response.

The department recommended Quebecers get private insurance before travelling outside the province.

Richard Bélanger said the family’s private insurance company refused to pay any costs after the first surgeon wrote in his son’s medical chart that he could return to Quebec and have the surgery there within 10 days.

The insurer had also initially refused to pay costs when an emergency room doctor noted possible intoxication in his son’s chart, Bélanger said. But that was later ruled out when the family asked why a test to determine the presence of any substances, including alcohol, was not done, he added.

Dr. Peter Stefanuto, the original surgeon, declined requests for an interview.

He said in an email that he could not speak about any specific case but that “care is provided to all patients regardless of their province or country of origin on an emergency basis.”

Issues involving compensation for services would be best addressed through the B.C. and Quebec governments, Stefanuto added.

Dr. Bob Rishiraj, who ended up doing the operation, said he was not concerned about any “politics” surrounding billing, especially after learning the patient had been taking opioids and methadone for days, and a longer wait for surgery carried the risk of infection.

“It became very concerning for me that he was using a lot of morphine and his pain was not well controlled. If we don’t do it, we have a problem of possibly having somebody with narcotics abuse potential down the road,” he said.

“I think a patient is a patient and it doesn’t matter if they’re from Quebec or Ontario or wherever. I think they should just be treated,” Rishiraj said.

The risk of a patient who is billed not paying a physician is low, and cost did not appear to be an issue for Bélanger’s family, he said.

Interior Health did not respond to a request for an interview but said in an email that physicians are not employees of the health authority.

Ferris said the family paid Rishiraj $2,563 and will apply for reimbursement from Quebec.

The irony is that the family has used its private health insurance while travelling outside the country but did not expect they would have to rely on it in Canada, she said.

“It’s mind-blowing to me, kind of shocking.”

British Columbia’s Health Ministry did not respond to questions about patients from Quebec being denied surgery.

Dr. Katharine Smart, president of the Canadian Medical Association, said Canada’s universal health-care system is intended to provide care to all Canadian citizens and permanent residents.

“We strongly encourage provincial and territorial governments to work together to ensure Canadians receive the care they need, when and where they need it, and the federal government to enforce the principles of the Canada Health Act uniformly across the country,” she said in a written statement.

Health Canada said the reciprocal billing agreements are administrative arrangements between provinces and territories to help facilitate the portability criterion of the act while people are temporarily away in another part of the country and need care.

“These agreements are voluntary and not a requirement of the Canada Health Act,” it said in a written response.

Bélanger, who had trouble speaking because his jaw was wired shut for six weeks following surgery, said the emotional toll he has suffered is “incalculable,” on top of the physical pain, which still includes migraines.

Damien Contandriopoulos, a University of Victoria nursing professor and health policy researcher, said that regardless of Quebec’s billing scheme, the province pays, on average, higher physician rates than other jurisdictions for the same care, a reversal from its practice years ago.

It’s common for thousands of patients from Quebec to get care from family doctors in Ontario border towns and for their province to reimburse the cost, he said, adding he is “shocked” that services would be denied to a patient based on billing issues.

However, doctors in British Columbia, where relatively few Quebecers get care, may be deterred from seeking information on rates paid by that province because they’re listed on about 3,000 pages in some complicated categories, and in French, said Contandriopoulos, a former resident of Quebec.

In Bélanger’s case, the surgeon could have contacted his insurance company’s 24-7 phone line to get information from a representative, rather than saying administrators were not available on the weekend, Contandriopoulos said.

He called Bélanger’s weeklong wait for surgery “insane.”

This report by The Canadian Press was first published July 7, 2022.

 

Camille Bains, The Canadian Press

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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