New Brunswick

'We know better': Medical professionals react to Caraquet woman's stage 4 bedsore

A Caraquet woman’s development of a stage four bedsore has medical professionals seething.

Lola Chiasson Hawkins developed a bedsore after being hospitalized for a broken hip

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

Warning: This story contains graphic images 

A Caraquet woman's development of a stage four bedsore has medical professionals looking for answers and calling for improvements.

Lola Chiasson Hawkins developed a bedsore months after being hospitalized for a broken hip.

It was categorized as a stage four, the worst a bedsore can get. It was gaping, infected and to the bone.

Her family says the fact that what is typically a preventable wound was able to get so bad is "a tragedy."

Paula Doucet, the president of the New Brunswick Nurses Union, said any time something like this happens it should be reviewed.

"I'm hoping that the facilities involved, and health-care workers involved, would be looking at this case and going through the documentation and evolution of when she first came into hospital, when she first fell, to where she is today," said Doucet.

Lola Chiasson Hawkins first went into hospital because she broke a hip, but a bedsore has been keeping her there. (Steven Hawkins)

Health Minister Benoît Bourque refused an interview on the case. In an emailed statement he called the situation "unfortunate."

"I can tell you that there are policies in place to deal with providing health care services in all our hospitals, including how to prevent and treat bedsores," Bourque said.

"Due to the fact that is this is an operational issue, I am going to defer all comments to the regional health authority."

Vitalité Health Network cannot comment on specific cases, because of privacy regulations, and therefore can't answer how exactly the protocols may have failed Chiasson Hawkins. 

What's acceptable

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

Corrine McIsaac, an associate professor at the University College of Cape Breton, has developed a system to better identify patients at increased risk of bedsores, and to better prevent them.

She said hospitals in the United States consider anything above zero per cent an unacceptable number of bedsores in a facility.

While McIsaac doesn't believe zero percent is a realistic goal she said it needs to be lower than it is now.

"It should be a rare event in our health-care system today," said McIsaac, adding that up to 12 per cent of bedsores in Canadian medical facilities are stage four.

Crystal McCallum, a registered nurse and instructor at the University of Western Ontario in London, said most instances of bedsores, or "pressure injuries" can be prevented.

"We know what causes a pressure injury, we know that it's prolonged pressure, we know that it's intense pressure over a bony prominence like the sacrum, as in this situation," she said.

"Because we know better, we need to be doing better, and we can't continue to have these wounds occur, and to forward excuses for these wounds occurring, when we certainly know better, and can do more."

Multiple causes

Lola Chiasson Hawkins has a stage 4 bedsore that she got at the hospital. 2:11

Doucet said events like this shouldn't happen, but multiple causes are often to blame.

"It's just not one thing," she said.

"It's just not the staffing. It's just not the back and forth and transfer inter-hospitals, the diseases that she has, but there's a multitude of issues that can cause somebody to have a stage four wound."

Doucet said staffing is a continuing concern, whether it's how many nurses are on staff or the qualifications of those nurses.

Paula Doucet, the president of the New Brunswick Nurses Union, says she hopes the case will be reviewed. (CBC News)

"Depending on what the staffing makeup is for that day, they have to set priorities," Doucet said.

"Although this patient seems like a very high-priority patient, there could have been others that had higher priority. I don't know the makeup of this unit the patient was on, but those priorities can change, shift to shift, hour to hour, sometimes."

McIsaac said it's necessary to better track cases of bedsores, which isn't being done well at the moment.

"We need to be tracking these more diligently," said McIsaac.

"Every place I've been into … I would say 'how many pressure injuries do you have' … 'I don't know' is the answer [given.]"

Vitalité wouldn't confirm whether an investigation is underway.

"Bedsores are always reported and followed by a thorough examination once discovered on a patient," a spokesperson said in a statement.