New Brunswick

Son at a loss for answers after Caraquet senior with stage 4 bedsore dies

Steven Hawkins is still searching for answers and seeking accountability in the death of his mother. Lola Chiasson Hawkins, 82, died in April after being bedridden in hospital for 14 months and developing with a horrific bedsore.

Vitalité Health Network made changes after family told story publicly

Lola Chiasson Hawkins died in April after being bedridden for 14 months because of post-surgery complications, including a horrific bedsore. (Submitted/Steven Hawkins)

Warning: This story contains graphic images 

Lola Chiasson Hawkins was admitted to hospital in February 2018 after falling and breaking her hip at her home in Caraquet — a home she wouldn't see again.

Despite successful surgery, Hawkins remained bedridden. She developed pneumonia, then cycled through four different hospitals over 14 months.

She had several post-surgery complications, the most notable being a horrific bedsore.

The festering, foul-smelling wound cut through Hawkins's lower back right to the bone. Her family discovered the severity of the open sore more than two months after she was admitted, when a nurse set a bowl of cat litter beneath the hospital bed to try to absorb some of the odour in the room.

Warning: Graphic content. Vitalité says more nurses are being trained in wound care and families will be included in care plans. 0:42

Almost a year ago, her son Steven Hawkins described to CBC News the agony of watching the mother of four's deteriorating health and the struggle with hospital staff for adequate care and information.

He, his brother Wayne and sister Natalie worried at the time their mother might never recover. 

Lola Chiasson Hawkins died April 21 at the Dr. Georges-L.-Dumont Hospital in Moncton. She was 82.

Lola Chiasson Hawkins of Caraquet died in April. She was 82. (Submitted/Steven Hawkins)

Steven Hawkins believes the bedsore "contributed to her death."

"To me, it did take her because the woman was very active before this happened," he said. "She was at home, cooking her own meals, doing her own laundry. She was going about her life."

Then she went into hospital. 

"And ever since she broke this hip and contracted this bedsore …" Hawkins said, his voice trailing off. 

Her case prompted Vitalité Health Network to review its practices in addressing bedsores and promise that change is on the way. The health authority said four nurses are being trained in advanced wound care, and it will be including patients and their families in the care plan.

Hawkins said he hopes the changes to their practices are real because his mother told him that preventing anyone from going through what she went though would justify her decision to let her story be told. 

But the grieving son is having a hard time accepting Vitalité's words.

Steven Hawkins is seeking answers from the health authority about his mother's death and the level of care she received in her final months. (CBC)

"Your mom's in the hospital and they won't even talk to me about the bedsore," he said.

"I was not allowed to make decisions for my mom, even though she signed the paper that I had the right to do so. Up to this day, we still don't have no answers."

The family has yet to be told the cause of Lola's death. 

Multiple hospital stays

Within a week of the successful hip surgery in Bathurst, mucus began building up in her lungs. She was sent to the Caraquet hospital for two days but then back to Bathurst after she developed full-blown pneumonia. She remained in intensive care for nine days.

After it cleared, she was transferred to hospital Tracadie in early March 2018 because of lack of space in Bathurst. That's when the family learned a bedsore, or pressure ulcer, had formed.

On April 21, 2018, exactly a year before her death, her sons discovered how severe the sore had become. It was stage four — the worst you can get. It was gaping, infected and almost two centimetres deep.

The bedsore Lola Chiasson Hawkins developed on her lower back after being in hospital. (Steven Hawkins)

"When I took the bandage off the bedsore, there it was," Steven Hawkins told CBC News last July. "And it was, it was just, it totally freaked me out. And I'm talking about it today, and I'm going to cry. It was bad." 

Hawkins said the family's questions and requests their mother be transferred to hospital in Moncton or Bathurst were answered with a growing hostility. He said hospital security was called twice and police once to defuse arguments between him and staff.

The children were denied access to her medical file, which they hoped would help them better understand what happened.

She remained in Tracadie until, her son said, she almost died choking on a piece of food. She was transferred to the Dumont hospital in Moncton.

A preventable wound

Her story sparked outrage from the public and Hawkins was inundated with emails from people sharing similar stories about sores at hospitals and nursing homes.

It also had medical professionals calling for improvements.

The New Brunswick Nurses Union called for a review last summer, while experts explained how bedsores can be prevented in most instances, mainly through constant turning to keep a patient from resting on one spot.

In his mother's case, that job fell primarily to Steven Hawkins. He spent months at her bedside, turning his mother every two hours and helping feed her. He ended up hospitalized for exhaustion.

Lola Chiasson Hawkins and her son Steven at the Dr. Georges-L.-Dumont University Hospital Centre in Moncton. (Catherine Harrop/CBC)

The bedsore improved but remained raw, irritated and painful, said Hawkins, who watched his mother's health deteriorate before her death.

"When you're bedridden for 14 months, her muscles, everything left, she didn't have anything left on her legs," he said.

He and his brother went in for a meeting with the patient advocate at the Dumont on Tuesday. 

Hawkins said the hospital admitted there were mistakes and offered condolences but no apology.

Vitalité review

Vitalité reviewed its standards for treating bedsores in October. It found reporting and tracking of the sores wasn't consistent.

After repeated requests, Vitalité declined an interview with CBC News but agreed to one with Radio-Canada.

"We have subsequently developed a regional improvement plan," Vitalité spokesperson Thomas Lizotte said in a written statement.

"From this plan, various priority initiatives emerge, including staff training and the application of best practices in the care of patients with pressure ulcers."

Lola Chiasson Hawkins was cycled through four hospitals, clockwise from top left: the Enfant-Jésus RHSJ Hospital in Caraquet, Chaleur Regional Hospital in Bathurst, the Dr. Georges-L.-Dumont University Hospital Centre in Moncton and Tracadie-Sheila Hospital in Tracadie. (Vitalité Health Network)

Training will focus on improved treatment and clinical documentation, the statement said, and staff patient information will be more accessible to patients and their families.

"We also reminded staff of the optimal use of written and verbal communication methods as well as the transmission of relevant information during transfers concerning pressure ulcers," the statement said.

The health network reported far fewer bedsores than its anglophone counterpart, Horizon Health Network, between the fiscal years of 2012-13 and 2017-18.

Vitalité reported a total of 174 bedsores — just three categorized as stage 4 — while Horizon reported 393. Both networks saw a drop in the number of recorded cases in the most recent year.