Nova Scotia

David Benedict needed an ambulance. It never came.

Karen Dehmel says her husband missed out on the chance to make decisions about his own care because an ambulance did not arrive in time to take him to a regional hospital for tests.

'Unfortunately, David passed away. And I'm hoping that this will not happen to anyone else,' says wife

Karla Dehmel and David Benedict waited for the ambulance to arrive.

Benedict was at Soldiers Memorial Hospital in Middleton, N.S., the evening of Aug. 9, his second trip there in as many days. He and his wife knew something wasn't right.

Complaining of a severe headache, he'd been sent home the evening before by the attending doctor after treatment for a migraine, but without tests.

When he arrived that second time, Benedict was weak and disoriented and was mixing up his words, said Dehmel, his wife.

The doctor working that evening ordered blood work and, thinking it could be a brain infection, started antibiotics and antivirals. The doctor wanted Benedict taken to Valley Regional Hospital for a CT scan and lumbar puncture, also known as a spinal tap.

David Benedict was a carpenter and loved working with his hands, a joy multiple sclerosis took from him. (Submitted by Karla Dehmel)

The ambulance would be there in a few hours, at 11 p.m. they were told, to take Benedict about 35 minutes along Highway 101 to Kentville.

"I held his hand a lot," said Dehmel. "I was used to hospital visits with him."

Ambulance availability has been a recurring issue in Nova Scotia for several years.

The union representing paramedics has drawn attention to ambulances being tied up at hospitals waiting to drop off patients. It leads to delays getting back into service, ambulances from other areas having to be redirected to provide coverage and paramedics working large amounts of overtime.

It is a domino effect the union has warned is a risk to public safety and to the safety of paramedics whose job is to be there when the public needs them most.

Karla Dehmel is calling on the government to ensure front-line health-care workers have the resources they need. (Michael Gorman/CBC)

The Nova Scotia Health Authority, in response, recently made changes at five of the province's busiest hospitals in an effort to bring down patient offload times and keep ambulances on the road rather than waiting outside emergency departments.

It's unclear what delayed the ambulance for Benedict, but at 11 p.m. word was received that the transfer would be pushed back to 2 a.m. Dehmel went back to the couple's home in New Albany to pack a bag for the trip to Kentville.

When she returned to the hospital in Middleton around 12:45 a.m., she found two nurses trying to reposition Benedict in the bed. They'd found him with his legs dangling over the foot of his bed and he was flat on his back.

He wasn't conscious, his pupils weren't reacting to light and he wasn't responding when his sternum was rubbed.

In recent months the Nova Scotia Health Authority has made changes at five of the province's busiest hospitals to help reduce the time ambulances spend waiting to drop off patients. (Andrew Vaughan/Canadian Press)

"I'm not a doctor, but I'm thinking, personally, what happened [is] maybe he was in a lot of pain and he was trying to get out of bed and that's when he had the main stroke that rendered him unconscious," said Dehmel.

The doctor that night told her it appeared Benedict had a brain bleed, something an autopsy would later confirm, and that she needed to make a decision: if more could be done it would likely mean months in hospital in Halifax.

You get to know a person pretty well when you spend most of 15 years together. Benedict and Dehmel knew each other well. They met through an online dating website in 2004 and hit it off instantly, drawn by a mutual sense of humour.

The ambulance entrance to Soldiers Memorial Hospital in Middleton. (Michael Gorman/CBC)

She admired the way he didn't let health problems define him. Benedict had polycystic kidney disease and was also diagnosed with primary progressive multiple sclerosis, something that would eventually rob him of his ability to work as a carpenter, although not before he was able to complete the kitchen in the home they built together.

"He was a trooper through it all. He was so courageous," said Dehmel.

"He finished that kitchen in March before I could start to see a little bit of a decline in his mobility. So that's his gift to me."

Dehmel knew her husband's wishes.

He didn't ever want to be a burden on his family or be bedridden and he didn't want heroic measures used if his health ever took a sudden turn for the worst. She reminded Benedict's primary nurse of that before she went home that night to pack a bag.

"It was just a habit I had, expressing his wishes to his health-care team."

David Benedict was 54 when he died. (Submitted)

Knowing those wishes, when the doctor came to her to make a decision, Dehmel requested palliative comfort measures and called family members to the hospital. Benedict died at Soldiers Memorial later that morning. He was 54.

'I wasn't expecting it at this age'

"I wasn't expecting it at this age," said Dehmel. "I knew with his health issues that we would not grow into retirement together, but I didn't expect it this soon or so fast."

In an email statement, the health authority said the agency relies on its partnership with EHS for patient transfers.

EHS officials, who have previously said the system needs an overhaul, were not able to provide detailed information about ambulance availability in the Annapolis Valley area on the night in question.

EHS said they're aware of the situation and are looking into it further.

"We can say the system was very busy with emergency calls during this timeframe, resulting in EHS operations following normal protocols, delaying non-emergency patient transfers," the statement said.

Dehmel said she's sharing her story because it's an issue that needs to be addressed, an issue that makes her angry.

She's angry that she had to make a decision she believes her husband could have made himself had an ambulance arrived at 11 p.m. and he was able to get the CT scan as the doctor wanted. She is angry that the resources front-line workers need aren't guaranteed to be there.

David Benedict was supposed to be taken by ambulance to Valley Regional Hospital in Kentville for a CT scan and lumbar puncture. But the ambulance did not arrive in time. (Michael Gorman/CBC)

At around 2 a.m. that morning, the updated arrival time for the ambulance, Dehmel said she overheard nurses saying there was no longer an estimate of when one could get there.

"I was speechless," she said.

"I thought, 'Oh my God. What about other people?' How many more deaths have to happen or serious outcomes where somebody may be a paraplegic, quadriplegic, or have some type of disability because there was no ambulances available?"

Dehmel will get the written autopsy results in the next few months, at which point she wants to pursue the matter with the health authority to find out exactly what happened with her husband. She's also requested a more in-depth neuropathic report.

"Not that it's going to change the outcome, but I need to know."

She wants more action from government to ensure health-care workers have the support they need. She wants fixes to a system she says is failing people.

"Things need to change. Unfortunately, David passed away. And I'm hoping that this will not happen to anyone else."

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About the Author

Michael Gorman is a reporter in Nova Scotia whose coverage areas include Province House, rural communities, and health care. Contact him with story ideas at michael.gorman@cbc.ca

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