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Health

Manitoba judge calls for review of health care at remand centre following death

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WINNIPEG — A Manitoba judge is calling for an independent review of health services at the Winnipeg Remand Centre following an inquest into the death of an epileptic inmate who had not been given anti-seizure medication.

Provincial court Judge Heather Pullan also wants the province to transfer responsibility for inmate care at all provincial jails from the Justice Department to the Health Department, and to train nurses and guards on how to deal with people with seizures.

Pullan made the recommendations after hearing evidence about the death of Errol Greene.

Greene, 26, had been arrested for breaching a bail order not to drink alcohol. He was brought to the remand centre on April 30, 2016, to await a bail hearing. He notified staff he used valporic acid to control his epilepsy.

It was a Saturday. No doctor was scheduled to visit the centre, which serves as a temporary holding facility for close to 300 inmates, until Monday.

The next day, Greene was on the phone with his partner, Rochelle Pranteau, who told the inquest Greene complained about not being given medication. He started having a seizure during that call and collapsed.

A second seizure followed an hour later. Greene was restrained by staff and became unresponsive. He was taken to hospital and died a few hours later.

“Had Mr. Greene been given valporic acid in the 48 hours prior to his death, he likely would have had a higher blood level than the 6.9-micrograms at autopsy, and be better protected from seizure,” Pullan wrote in her report released Tuesday.

A nurse at the centre dealt with Greene shortly after his arrival but was a new employee and did not have access to the prescription drug database that would have confirmed his medication, the inquest report said.

A second nurse who later dealt with Greene did not give him valporic acid, partly because she did not know what else he may have consumed.

Corey Shefman, the lawyer who represents Greene’s widow, said he welcomed the report.

“For a person living with epilepsy, having access to their anti-seizure medications is crucial. And so them having not given it to him exposes a number of really serious problems with health services in corrections,” Shefman said.

Pullan also said the province should bolster recruitment and retention of nurses to address staff shortages and reduce the number of times nurses work alone.

Justice Minister Cliff Cullen said the government has set up a team of senior officials to review the recommendations, and has already taken steps to improve care at the remand centre.

“These improvements include ensuring that a physician is scheduled to attend the remand centre every day,” Cullen said.

“We have also improved record-keeping and file storage at the facility to ensure that health information is meticulously recorded.”

Greene was one of five people who died at the remand centre in 2016 — the highest annual number in recent years.

Among the others was Russell Spence, who struggled with guards while being processed. A pathologist attributed the death to cardiac arrhythmia combined with the effects of methamphetamine.

Robert McAdam, 53, also died in custody. His family told the Winnipeg Free Press McAdam committed suicide after years of alcohol abuse.

 

 

Steve Lambert, The Canadian Press

Note to readers: This is a corrected story. An earlier version said Greene had been arrested for breaching a probation order.

Health

Fear mounting that changes to drug pricing in Canada could stifle innovation

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prescription drugs

OTTAWA — Some Canadian patients and groups that advocate on their behalf are sounding the alarm about the federal government’s recent changes to the way it regulates the cost of patented medicines.

Toronto lawyer and longtime Liberal supporter Chris MacLeod, who lives with cystic fibrosis, said Thursday that it pains him to speak out against the government but he fears lives could be on the line as a result of what he calls a “wholly irresponsible” approach.

“It will be delayed access at best; denial or no access at worst,” MacLeod said.

Health Canada recently finalized its long-awaited changes to the process of establishing drug prices, which include providing the Patented Medicines Prices Review Board with the market price of medicines rather than an inflated list price.

The department says the board — first created 30 years ago to ensure companies don’t use monopolies to charge excessive costs — can now consider whether the drug price actually reflects the value it has for patients.

Earlier this month, board chair Dr. Mitchell Levine also said the body now has the tools and information it needs to meaningfully protect Canadian consumers from excessive prices.

Health Minister Ginette Petitpas Taylor issued a similar statement Thursday, noting the objective of the changes, which have taken three years to implement, was to ultimately lower prices while making sure Canadians get access to the medicines they need.

The government has billed the changes as an effort to establish the groundwork for a national pharmacare program.

MacLeod, however, fears the changes will ultimately drive the list prices down to the point where drug companies will not seek to bring new, game-changing medicines to Canada.

The Canadian Organization for Rare Disorders said it shares MacLeod’s concern, adding that while everyone wants to have access to medications at affordable prices, it risks making new therapies less available.

In a letter to Prime Minister Justin Trudeau sent in April prior to the finalization of the regulations, the organization co-signed a letter urging the government to change its course.

“We all want to have access to medicines at affordable prices,” the letter said. “However, these proposed changes by the PMPRB will mean that many new therapies will not be available in Canada.”

President and CEO Dr. Durhane Wong-Rieger said the organization is worried about the signal the decision sends in terms of Canada’s willingness to provide competitive pricing for drugs.

“If we end up being a country that is priced so very low that companies are afraid it is going to impact their ability to actually market elsewhere, they won’t come to us first,” Wong-Rieger said.

—Follow @kkirkup on Twitter

Kristy Kirkup, The Canadian Press

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Community

Edmonton community members explore using the Emergency Room as an entry point to transitional housing

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Is there a better way than simply releasing a person experiencing homelessness from the hospital back onto the street? It creates an endless cycle of emergency room visits and escalating costs, not to mention the challenges the patients face in having a successful recovery.

As we continue to look for solutions to homelessness in our city, a group of community members from different fields and backgrounds met recently to brainstorm and discuss alternatives to the practice of releasing patients into a state of homelessness.

That’s a long way of saying that if someone experiencing homelessness comes to an emergency room with a need for medical aid, the only alternative once treated is to release the patient back onto the street.  The chances of recovery are greatly diminished, while the probability of return visits increases.  The costs are severe, both to the person experiencing homelessness and to our ever-more expensive health care system.

Spearheading the initiative is Dr. Louis Hugo Francescutti, a veteran emergency room physician at the Royal Alexandra Hospital and a Professor at the School of Public Health at the University of Alberta.

Watch this short video to hear from some of those involved and to better understand the concept and learn why there is a growing groundswell of support for this idea.

 

There are many ways that people can get involved with this initiative.  It’s common sense that housing and health are interconnected. Finding solutions to chronic homelessness and easing pressure on our health care system is something we can all get behind.

Please contact Dr. Louis Hugo Francescutti directly to learn more about the project and how you can help:

Phone 780.932-7187

lfrances@ualberta.ca

 

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august, 2019

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