Teen victim of ‘communication breakdown’

NANAIMO – Case referral likely never made it to surgeons, resulting in lengthy wait for treatment.

The medical referral of a teen with autism likely never made it past surgeons’ gatekeepers, according to Island Health’s director of surgical services.

Nanaimo resident Alexandria Stuart launched a formal appeal to the Island Health  Patient Care Quality Office in November, after being told the only medical specialist willing to see her son was in Victoria and couldn’t operate for almost a year. The wait was too long for a vulnerable and disabled child in “obvious pain,” she said, adding she was concerned about infection and diminished quality of life.

Her 16-year-old son, Gabriel, had been suffering from a painful toe condition. Normally happy but minimally verbal, he had started to limp and cry about his poor toes and the need to see “Dr. Hospital.”

According to Stuart, he needed an operation under general anesthetic, but the medical receptionist handling Gabriel’s case called central Island surgeons and no one was willing to take on the operation because either “they don’t do toes or because he was a pediatric case.”

But Island Health now says surgeons might not have played any part in turning away the referral.

Alison Dormuth, director of surgical services for Island Health, said surgeons did not recall seeing Gabriel’s referral and were “more than willing” to help when she approached them to line up an operation with an existing dental procedure scheduled for the teen at the Nanaimo hospital.

She believes the referral was stopped by medical office assistants, whose job is to decide what patients are appropriate for surgeons to see.

“I think obviously having Gabriel referred down to a specialist for ingrown toe nails in the south island, in Victoria, was not the best for that patient and shouldn’t have been done in the first place … it was just not all the right information was reaching the specialists’ office,” Dormuth said.

There was a lot of information that needed to be conveyed about Gabriel’s unique circumstances, and it would have been difficult to do that by phone or fax, she said, adding medical office assistants likely turned away the call based on the fact that surgeons don’t usually handle ingrown toe nails.

“I just know [the surgeons] say they don’t recall getting this information … and in that I think it’s because they don’t typically handle these types of cases so it would have been stopped at getting past the point of their medical office assistants,” she said.

“I guess in a way it’s a break down in communication.”

Stuart, however, has seen the fax sent by her doctor’s office and doesn’t see how the referral could have been any clearer.

She questions how much power gatekeepers are given – and whether they have the training to make make judgement calls. In her son’s case “they failed miserably,” she said.

“I think my GP’s medical office assistant communicated very well and very clearly. I think the surgeons’ medical office assistants overstepped their power in denying a case like this,” she said.

“[They] should have obviously taken the case to the surgeons themselves.”

Stuart said the solution could be to have gatekeepers better equipped and empowered to make judgement calls and take referrals to the next level of decision-making when they recognize red flags. But changes are up to Island Health.

Gabriel was diagnosed 18 months ago with a common condition where the skin grows over the toe nails. But because he compulsively picked at his toes, the nails started to burrow into his toes causing inflammation and bleeding. His condition became so bad, Stuart said she opted to take him to the B.C. Children’s Hospital in the Lower Mainland. The surgery was done in six hours.

Just Posted

According to a staff report, Regional District of Nanaimo has seen some $13.6 million in grant applications approved between Jan. 1 and May 15. (News Bulletin file)
Close to $14 million in money granted to RDN in first half of year

Successful grants include more than $4 million for transit service in Regional District of Nanaimo

A section of the rail corridor on Vancouver Island. (Black Press file photo)
LETTER TO THE EDITOR: Put rail trail right overtop of the tracks

Removing tracks would be a horrendous expense, says letter writer

District of Lantzville Mayor Mark Swain, left, and Snaw-Naw-As Chief Gordon Edwards sign a memorandum of understanding outside Snaw-Naw-As Market on Friday, June 18. (Greg Sakaki/News Bulletin)
Lantzville and Snaw-Naw-As sign memorandum of understanding

District and First Nation create joint working group

Things are looking up for Vancouver Island as zero COVID-19 cases have been reported for the first time since October. THE CANADIAN PRESS/Darryl Dyck
Island records zero new COVID-19 cases for the first time since October

For the first time since October, the province is reporting zero new… Continue reading

Black Press file photo
RCMP seek suspect in Vancouver Island-wide crime spree

Crimes stretched from Deep Bay to Qualicum, Ladysmith, Chemainus and Youbou

A small pod of Pacific white-sided dolphins pass by close to shore in Campbell River June 16, 2021. Still capture from video courtesy of Kimberly Hart
VIDEO: Dolphin sunset captured from Vancouver Island shore

Spectacular setting for view of travelling pod of Pacific white-sided dolphins

People in Metro Vancouver can expect to experience a short wave of heat just in time for Father’s Day, according to Environment Canada. (Black Press Media files)
Short-lived heatwave headed for Metro Vancouver this weekend

Temperatures are expected to be up to 10 degrees higher than average Sunday and Monday

Bruce Springsteen performs at the 13th annual Stand Up For Heroes benefit concert in support of the Bob Woodruff Foundation in New York on Nov. 4, 2019. (Greg Allen/Invision/AP)
Canadians who got AstraZeneca shot can now see ‘Springsteen on Broadway’

B.C. mayor David Screech who received his second AstraZeneca dose last week can now attend the show

New research suggests wolves can be steered away from the endangered caribou herds they prey on by making the man-made trails they use to hunt harder to move along. THE CANADIAN PRESS/Nathan Denette
Culling cutlines, not B.C. wolves, key to preserving caribou herds: researcher

The government has turned to killing hundreds of wolves in an effort to keep caribou around

Janice Coady, left, Aimee Chalifoux and Linda Milford at a vigil for Amy Watts on Wednesday, June 16, outside Nanaimo city hall. (Greg Sakaki/News Bulletin)
‘We need to do better,’ says mother of woman killed in Nanaimo

Vigil held for former outreach worker Amy Watts, whose body was found downtown June 3

Gary Abbott (left) and Louis De Jaeger were two of the organizers for the 2014 Spirit of the People Powwow in Chilliwack. Monday, June 21, 2021 is Indigenous Peoples Day. (Jenna Hauck/ Chilliwack Progress file)
Unofficial holidays: Here’s what people are celebrating for the week of June 20 to 26

Indigenous Peoples Day, Take Your Dog to Work Day, Onion Rings Day all coming up this week

Gwen Spencer Hethey with her uncle and mentor Major Frederick Richardson. (Courtesy of Greater Victoria Sports Hall of Fame)
‘She was a killer’: The B.C. woman who pioneered female sharpshooting

Gwen Spencer Hethey made military men ‘look like turkeys’ says her son

Central Okanagan Grade 12 grads are set to get $500 each after a more than $1 million donation from a Kelowna couple. (File photo)
B.C. couple donating $500 to every Grade 12 student in the Okanagan

Anonymous donors identified as Kelowna entrepreneurs Lance and Tammy Torgerson

Most Read