"There is a difference between elective surgery and urgent surgery," Quebec Health Minister Gaétan Barrette said Monday, questioning a decision by St. Mary's Hospital vascular surgeon Dr. Carl Emond last November to transfer a dying patient rather than operate on the spot.

Barrette commented for the first time on the death of Mark Blandford, 73, last Nov. 2.

Blandford was diagnosed with a ruptured abdominal aortic aneurysm – or a "triple-A" rupture – by emergency room physicians at St. Mary's but died before he could undergo surgery at the MUHC.

Emond, the sole vascular surgeon at St. Mary's Hospital in Côte-des-Neiges, told colleagues he had no choice but to transfer Blandford.

He said he had been told repeatedly since last summer by the hospital's senior administrators that he was no longer entitled to do triple-A rupture surgeries as part of the reorganization of the hospital's services.

'There was a doctor who has the capacity to operate, and there is no reason he didn't operate on the patient. Period.' - Quebec Health Minister Gaétan Barrette

"The way things happened are very, very debatable," Barrette said in an in interview on CBC Montreal's Homerun. "My point is quite simple: There is a difference between elective surgery and urgent surgery. We were in a situation that obviously was the second category."

"There was a doctor who has the capacity to operate, and there is no reason he didn't operate on the patient. Period."

'Turf war' at St. Mary's

Barrette said Emond's decision not to do the emergency operation is distinct from the decision by senior administrators at the Montreal West Island Integrated University Health and Social Services Centre (known by its French acronym CIUSSS de l'Ouest-de-l'Île-de-Montréal) to stop doing vascular surgery at St. Mary's Hospital.

"That's a turf war," Barrette told Homerun's Sue Smith.

He said each hospital has its own mission, and CIUSSS senior administrators have the right to decide what kind of services will be offered on site and which are to be transferred.

"If at some point we define that vascular surgery has to be concentrated because of cost efficiency in one given hospital, well, that's the way it is," he said earlier Monday, in response to a question from CBC News.

Under investigation

Barrette said he still has his own questions about what happened – for instance, why Blandford was not transferred to the Jewish General Hospital, which is only a few blocks from St. Mary's, instead of to the MUHC Glen site.

Sources have told CBC that there was no transfer protocol for triple-A rupture surgery signed between St. Mary's and the Jewish General Hospital nor with the MUHC Glen site.  

Those same sources say they are not aware of any such transfer protocols having been signed since the Nov. 2 incident, leaving some doctors fearing that the situation that contributed to Blandford's death could happen again.

The CIUSS de l'Ouest-de-l'Île-de-Montréal has not confirmed the status of those transfer protocols, nor will it comment on any other aspect of the Nov. 2 incident while it is under investigation.

Quebec's College of Physicians said last week it is gathering facts on what happened before it decides whether further investigations are warranted.

On Friday, the Quebec coroner's office announced it would be conducting an inquest into Blandford's death.