By INGRID PERITZ
Globe and Mail
April 23, 2009
MONTREAL — The patient sat in the clinic’s waiting room, apparently dead, yet even that wasn’t enough to get him medical attention.
In a scene that combined tragedy with Monty Python farce, a 77-year-old man in acute respiratory failure turned up at a private medical clinic in Montreal only to be told to wait his turn.
Jean-Jacques Sauvageau waited until his heart stopped and his dentures fell out onto the floor. Even then, the famous doctor who came to tend to him did a cursory exam and didn’t try to revive him, leaving him instead before the horrified eyes of fellow patients.
The events were depicted in a report issued yesterday by Quebec coroner Catherine Rudel-Tessier. And the doctor taken to task for his failure to try to resuscitate the patient is private-care crusader Jacques Chaoulli.
In 2005, he made history by persuading the Supreme Court to overturn Quebec’s ban on private health insurance.
In this case, Dr. Chaoulli was on duty at a private clinic last year when Mr. Sauvageau showed up. His face was bluish-purple and he had severe trouble breathing. Though the clinic advertised itself as providing emergency care, he was told to take a seat.
After about a half hour, the increasingly alarmed fellow patients could see Mr. Sauvageau was unconscious and alerted the receptionist. Dr. Chaoulli came out, did a cursory examination and concluded the patient was already dead.
He left him sitting in the chair, and told the nurse to phone 911 to report the death.
But the 911 operator pleaded with the nurse to try to revive Mr. Sauvageau. Dr. Chaoulli got on the phone and tried to argue the patient was dead; however, the 911 operator insisted.
Meanwhile, the other patients grew increasingly alarmed, seeing the apparently dead man, his mouth and eyes wide open. Sarah Twain-Lagarde, in the clinic with her feverish toddler, called 911 herself and tried to resuscitate Mr. Sauvageau, but nurses told her to stop.
Eventually, ambulance medics arrived and tried in vain to revive the patient.
An autopsy later revealed that Mr. Sauvageau died of a pulmonary embolism and would not have survived anyway. But the coroner said that Dr. Chaoulli had no way of knowing that, and should have tried to perform CPR.
“[Mr. Sauvageau] had been alive just a few minutes earlier. Suddenly, he loses consciousness and his pulse stops. You have to throw yourself on him and get everything going again, and that wasn’t done,” Ms. Rudel-Tessier said in an interview. “[Dr. Chaoulli] should have done so.”
The coroner urged Quebec’s College of Physicians to write guidelines so private health clinics provide a safe environment for patients. She also urged the college to probe the quality of medical care given to Mr. Sauvageau.