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Quebec coroner says delays in getting to hospital 'very likely' led to baby's death

MONTREAL — A seven-month-old baby from a northern First Nations community who died of meningitis in April might have survived if it hadn't taken so long to get her to hospital, a Quebec coroner has concluded.
An ambulance is shown outside a hospital in Montreal, Saturday, Jan. 15, 2022. A Quebec coroner is calling on the province to review its pre-hospital services after a seven-month old from a remote First Nations community died after an hours-long delay in getting her to hospital. THE CANADIAN PRESS/Graham Hughes

MONTREAL — A seven-month-old baby from a northern First Nations community who died of meningitis in April might have survived if it hadn't taken so long to get her to hospital, a Quebec coroner has concluded.

Niteïyah Chilton died of bacterial meningitis after it took about five and a half hours to bring her to a regional hospital by ambulance, and more than eight and a half hours to get her to a specialized pediatric centre in Montreal.

Coroner Géhane Kamel wrote in her report that the delay in accessing care "very likely" affected the child's chances of survival.

“It seems very likely that the delays of this significance had an impact on the survival of the infant and warrant a reflection on ways to reduce them and prevent this from happening again," she wrote in a report dated Oct. 21. 

A nurse from the community of Manawan, about 250 kilometres north of Montreal, called 911 on the night of April 2 after the baby was suffering from convulsions and breathing problems. The child had begun showing symptoms on March 31, but her parents were initially told by the nurse to give her Tylenol, the report read.

The local ambulance service was overwhelmed, which forced the family to wait more than an hour and 45 minutes for an ambulance to arrive from another community.

The child arrived at the regional hospital at 2:30 a.m. Soon after, doctors decided to transfer her to Montreal's Sainte-Justine hospital, which led to another 30-minute wait for an ambulance. She only arrived in Montreal at 5:30 a.m., more than eight and a half hours after the 911 call. By then, her prognosis was grim.

She was declared dead on April 4. 

The cause of death was bacterial meningitis, "following emergency treatment received too late," Kamel concluded in her report. The death was deemed accidental.

Kamel highlighted staffing shortages and scheduling challenges in the ambulance sector, particularly in remote areas, which "unfortunately contributed to the lack of services provided to the population of Manawan."

Given the lack of resources in distant communities, she urged the province to "reflect on solutions that fall outside the established framework."

That could include, she wrote, a team of health professionals who provide pre-hospital care in First Nations communities. She said there also needs to be a faster way of getting critically ill patients to hospital. 

While airplane transport is available in some communities, helicopters would be "more versatile" for patients in remote areas, she said.

Kamel noted that the province has already promised a "vast project" to transform its pre-hospital services, including the possibility of helicopter transport, following another coroner's report last year. She urged the province to speed up the process as much as possible in order to avoid more deaths.

In a statement, a spokesperson for Quebec's Health Department offered condolences to the child's family and loved ones. 

The government is committed to responding to the coroner's report in the coming months, Noémie Vanheuverzwijn wrote in an email Tuesday. In the meantime, Vanheuverzwijn said, many changes are underway, including from an $800,000 investment announced this summer to improve pre-hospital services in the region that includes Manawan. 

At the provincial level, the government said it has adopted a policy to improve pre-hospital services, and an action plan — including a heliport service — is in "preparation," Vanheuverzwijn wrote.

 This report by The Canadian Press was first published Nov. 8, 2022.

Morgan Lowrie, The Canadian Press