Danny M.

In the four years before his death, Danny Makhoul had had a history of periodic but increasingly severe, short-lived upper abdominal pain incidents which had eluded diagnosis. On the second day of a Maritime vacation in August 2023, he suddenly became extremely ill. He collapsed on the floor of his hotel room, retching and vomiting, and experiencing pain in his lower abdomen. Earlier attacks had subsided within 30 minutes but, this time, there was no relief and his wife called 911 at 11:30 pm on a Saturday night. Ambulance attendants heard that Danny had consumed some odd-tasting chicken soup in the mid-afternoon and latched onto a diagnosis of food poisoning. On route to a hospital 50 km away, they administered fluids and pain medication, which were ceased and the IV abruptly removed without explanation at the Moncton Hospital ER. Doctors in the Trauma unit were very busy and no physician entered Danny’s ER waiting room until 8:30 am the next morning

Danny spent the night without treatment, vomiting and suffering multiple bouts of diarrhea which were not tracked by ER nurses. By 9:30 am the next morning, IV pain medication was recommenced, but his pain level had been at 10/10 for hours and his body so dehydrated that finding a vein required an ultrasound scanner.

At 10 am Danny was rushed into the ER Trauma area. Ninety minutes later, a surgeon stated that Danny’s was not a surgical case. By noon he was declared in critical condition. Hospital records stated that Danny was admitted in an obtunded or semi-conscious state, and the ICU doctor said that his unconsciousness defied explanation. Despite every possible ICU intervention, Danny died 36 hours after his admission to the hospital.
An autopsy showed that Danny’s cause of death was necrotic/ischemic enterocolitis. The best explanation his wife was able to get from doctors and nurses in Ottawa who reviewed his autopsy report and hospital records was that he had essentially experienced a stroke in the blood vessels serving his abdomen. A blockage cut off blood and oxygen and resulted in a gangrenous infection (sepsis) that led to heart, kidney and liver failure. They believe that had his symptoms been recognized and treated surgically in a timely manner, he may have survived.

Danny was like a lot of people who prefer to minimize their medical issues. He had altered his diet, avoiding excessively fatty foods and consuming digestive enzymes as he felt necessary. He didn’t pursue a suggestion by a nurse friend to meet with a gastroenterologist and his family doctor was not aggressive in pursuing a diagnosis. As his widow, I would plead with all Canadians that ignoring symptoms comes at a price. Sepsis ultimately killed Danny, but there were warning signs that something serious was brewing.

At the hospital, two things of which I was completely unaware might have changed the course of my husband’s life. First, I could have demanded verbal orders from a doctor and, if the nurses refused to get them, I could also have insisted that a more senior nurse be involved.

Second, that the Canadian Triage and Acuity Scale (CTAS) would have put Danny at a Level 2 instead of the 3 he was assigned in the ER. CTAS is a five-level system used in emergency departments to prioritize patients based on the urgency of their condition. Patients are assigned a level from 1 to 5, with Level 1 being the most critical (Resuscitation) and Level 5 being the least critical (Non-urgent). The scale is used to evaluate patient needs and guide the allocation of resources to ensure timely care.

I will forever feel deep sadness that I was ignorant of Danny’s patient rights and that he was unwilling or unable to push for a diagnosis of his underlying condition. Sepsis killed him and a sepsis protocol might well have meant that he would be here today with all who loved him.

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