A Winnipeg woman says she believes the actions of some hospital staff and a long emergency room wait at Health Sciences Centre contributed to her mother's death, and she worries the same thing will happen to someone else under upcoming changes to health-care services in Manitoba.

"Here is an amazing lady who went through hell going through war, coming here for a better life. Somehow she survived the war but could not survive the health-care system here at HSC," said Sandi Hrem.

On June 14, Hrem's mother, 91-year-old Hildegard Pauls, was scheduled for an angiogram intended to check on a previous surgery that removed two blood clots from her leg. Hrem said she and her husband expressed concern about the procedure because her mother appeared weak from a bad nosebleed the night before and was showing symptoms of pneumonia.

"They said, 'Well, you know what, we need to go ahead with the surgery and we think she's fine,'" said Hrem.

Hrem said after the surgery, her mother was unable to stand or speak. She said staff advised them to take Pauls out of the hospital and re-enter through the emergency room. Hrem says it was storming outside.

Hildegard Pauls - HSC ER

Hildegard Pauls sat slumped over and barely conscious for two hours and 45 minutes at Health Sciences Centre before a nurse advised the family to seek medical help at another emergency room, her daughter says. (Sandi Hrem)

"It was freezing cold that day and they put her in her hospital nightgown in the wheelchair with a few blankets and we rolled her out.

"We asked if they would be able to at least put her on a stretcher and have someone accompany her because she was too weak to even sit. She was slouched over and they said no," said Hrem.

The transition between departments is something Health Science Centre acknowledges needs work.

"The program teams have met to review what happened and how to prevent it in future. Specifically, they recognized that nurse-to-nurse communication between the sending and receiving departments must occur when the patient's condition requires that they be placed in a treatment space," said Katherine Fox, director of communications at HSC Winnipeg.

Advised by nurse to leave

Hrem said once in the emergency room, her mother waited 40 minutes to be triaged, despite being told by staff in the day-surgery unit that they would call ahead to emergency so she wouldn't have to wait as long.

Altogether, Hrem said they waited two hours and 45 minutes in HSC's emergency room. She said at one point, a nurse came to take blood but was unsuccessful because Pauls's veins were almost collapsed.

"She was slumped over in the wheelchair, she was conscious but she wasn't able to speak. She was so severely dehydrated, though she was able to drink, and we kept purchasing iced teas from the vending machine because she was just so parched," said Hrem.

She said eventually, she was advised by a nurse to take her mother to another hospital emergency room.

"She was giving us her honest opinion and saying, 'You gotta get out of here and go somewhere else where they can take care of her,'" said Hrem.

Hildegard Pauls and family

Sandi Hrem says her mother loved spending time with her grandchildren, and at the age of 91 was still an active part of caring for her family. (Supplied/Sandi Hrem)

She and her husband carried Pauls out into a rainstorm and transported her to Concordia Hospital's emergency room. Hrem said once there, her mother was seen within 15 minutes and quickly given a bed. From there, Pauls was put on intravenous fluids and hospital staff began running tests, Hrem said.

In the end, the care Pauls received at Concordia Hospital came too late.

"That night we left her, she had a stroke. They said the stress of everything she had gone through, the fact she had this pneumonia and all these other things, these stressors — they don't know 100 per cent but they could have contributed," said Hrem.

Concerns as ER closures approach

HSC would not respond to Hrem's concerns about the decision by staff in the day-surgery department to go through with Pauls's initial surgery, but Fox said the hospital is aware of concerns about emergency-room wait times — particularly as of Oct. 3, when the emergency room at Victoria Hospital will be closed and the urgent-care centre at Misericordia Health Centre will begin converting to a community IV clinic.

"We regret the experience this family has shared about their time in HSC's emergency department. The WRHA has every confidence that all emergency departments, including HSC's, are ready to take on any additional patient volumes come Oct. 3," said Fox.

According to Fox, the new intake process will have patients assessed by a doctor and nurse at the same time, a move the hospital expects will decrease the length of stay for many patients.

Given her recent experience, Hrem said she thinks the closure of emergency rooms will only make matters worse.

"[Manitoba Premier Brian] Pallister needs to take a look seriously at what he's doing to the health-care system in Manitoba because it's only going to get worse," she said.

"And I worry about my father and my children and my friends and my family, and the health care they're going to receive going forward."