A man died after waiting 8 hours in an Edmonton ER. How did the system get here?

The death of a father of three who spent eight hours in an Edmonton emergency department waiting room is an illustration of the dire state of Alberta’s health care system, a physician and longtime provincial political figure says.

Prashant Sreekumar, 44, died at the Grey Nuns Community Hospital Dec. 22 after visiting the emergency department complaining of chest pains.

His wife, Niharika Sreekumar, said Prashant continued to wait for care despite worsening pain that made it difficult for him to stand, sit, and breathe. He collapsed and died a short time after being admitted to a room.

Dr. Raj Sherman, a veteran Edmonton emergency physician and former Alberta Liberal Party leader, called Prashant’s death “absolutely horrendous and tragic.”

He said the outcome was likely preventable had steps been taken sooner to relieve pressure on Alberta’s overcrowded hospitals.

“Us in the front lines — make no bones about it — every day we walk into our shift and go, ‘Oh, God help us, I hope nobody dies in the waiting room,'” he said.

‘We’ve been saying this for decades’

According to his wife, Prashant Sreekumar’s last day began unremarkably. After a few hours at work, though, he left with extreme chest pain. Staff at the Grey Nuns performed an ECG test to assess his heart, but the results “unremarkable,” Niharika Sreekumar said. He was given Tylenol as well as a blood test, which also showed no abnormalities.

After being assigned a bed, though, Prashant complained of dizziness and collapsed with Niharika and his father at his side.

Sherman said emergency room staff assess patients based on the 5-1 Canadian Triage and Acuity Scale. Patients assessed at a 5 are considered the lowest priority, while those deemed a 1 should be given a bed “immediately.”

People with chest pains are usually a 1, 2 or 3 on the scale, Sherman said. Chest pains can indicate heart attacks — which sometimes appear normal on an initial ECG — or other serious conditions like pneumonia, a collapsed lung or aortic dissection.

“If you’ve got chest pain, you should be into an emergency bed at the back within 30 minutes, nine times out of 10,” Sherman said.

The problem, according to Sherman, is that many Alberta emergency departments are operating at or over capacity. Part of that stems from the fact the system can’t clear sick patients from ERs to more appropriate care settings fast enough.

As a former Progressive Conservative assistant health minister, Sherman said Alberta’s issues aren’t unique, though he believes the province is “a bit” worse off than other parts of Canada.

“We’ve been saying this for decades, us ER doctors: we’ve got 50-60 beds in the back, but 60 to 100 per cent are plugged up with people who should have been upstairs (in the hospital) yesterday, two days ago.”

Capacity issues

In a weekend statement, the Alberta Medical Association (AMA), said it is “deeply saddened” by Sreekumar’s death. It also raised concerns about emergency room capacity.

“The AMA remains concerned about the pressures facing emergency care in Alberta and whether the system is adequately resourced to support patients safely, sustainably and with accountability,” the statement reads.

“Those who work on the front lines of our strained health care system every day experience very real feelings of helplessness, loss, fear, sadness and anger — yet they show up to do their best to care for their patients.”

Sherman said another problem is a system that’s failed to keep pace with a growing, aging population.

In the 1990s and 2000s, Alberta had around 11,000 hospital beds for two-and-a-half million people. Now, there are around 8,700 acute care beds for double the population. Edmonton’s problems are exacerbated because it serves as the catchment area for “a massively under-serviced north,” he said.

In August, Sherman resigned as chair of Health Quality Alberta, a provincial health care research agency, citing concerns that recommendations to improve health care capacity weren’t being implemented.

“The health system, especially in the Edmonton zone, was already at crisis levels in August, and now the flu’s hit,” Sherman said. “So these very unfortunate, tragic events are predictable. They’re very predictable.”

Sherman — whose own father died in 2011 after complications from delayed care for a heart attack years earlier  — said he feels for the Sreekumar’s wife and children.

He also extended sympathies to the medical staff on shift that day.

“I’m also thinking about that triage nurse, everyone’s going to want to blame this poor individual,” he said. “But at the end of the day, this is a system crisis and a system problem.”

Premier Danielle Smith extended condolences to Sreekumar’s family in a post on X. She said the minister of hospital and surgical health services, Matt Jones, has directed Acute Care Alberta to work with Covenant Health on a “complete review of this matter.”

The AMA said resources are available for physicians, resident physicians and medical students “struggling with this, or other, patient care events over the past weeks or months.” 

jwakefield@postmedia.com

x.com/jonnywakefield 

@jonnywakefield.bsky.social

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