Joyce Echaquan died of pulmonary edema, could have been saved, inquiry hears

An Atikamekwwoman who died after livestreamingthe abusive remarks of hospital staff could have been saved if she'd been more closely monitored, an expert witness told a coroner's inquiry inTrois-Rivires, Que., on Thursday.

Joyce Echaquan died of pulmonary edema, an excess of fluid in the lungs, according to the testimony ofDr. Alain Vadeboncoeur, an emergency physician at the Montreal Heart Institute.

Vadeboncoeur examined Echaquan's medical background, autopsy report and hospital records, to give recommendations to coroner Ghane Kamel.

He said the 37-year-old mother of seven had serious health problems, includingsevere cardiomyopathy, which had been treated since 2014.

Vadeboncoeursaid Echaquan wasn't properly supervised on the morning of Sept.28, 2020 the day of her livestream after she was given powerful sedatives. She went into cardiac arrest later that day and died.

Her case made international headlines after her Facebook video showed hospital staff verbally abusing her. The coroner's inquiry is looking into her death and how the health-care system treats Indigenous people.

Vadeboncoeur said he was troubled by anothervideo, one thatEchaquan's daughter captured that morning,that started at 11:39a.m.

He says the video, which has not been released, shows Echaquanbarelybreathing, very paleand probably in a coma.

Vadeboncoeursaid he doesn't understand why a resident gastroenterologistwho, according to recordstook her vital signs at 11:35 a.m., reported she was "calm."

"There is a differencebetween calmand a coma," he said.

The lawyer representing Echaquan's family, Patrick Martin-Mnard, asked Vadebocoeur if it would have made a differenceif she had been more closely monitored.

With proper monitoring, Vadeboncoeur said the answer was likely yes.

Inexperienced staff

The nursing candidate who was in the emergency room that day had only a few months of experience, and had yet to obtain her nursing permit.She had nine patients under her care that morning at one point,including several who were in unstable condition, testimony revealed this week.

The hospital's head nurse,Jose Roch,said Thursdaynursing candidateswitha college educationweren't allowed to workin the ER prior to the end of 2019, when the policy changed.

Vadeboncoeur saidexperienced staff would have recognized right awaythatEchaquanwas not doing well.

He said he hopes the inquiry will address the chronic staffing shortages in Quebec's health-care system.

"This needs to be fixed, because this have consequences on real lives, onpatients there is something to learn about this," he said.

Rare heart condition

The pathologist who conducted her autopsy also testified today about Echaquan's heart.

Dr. Richard Fraser, from the McGill University Health Centre, said Echaquan had a very rare condition,rheumatic heart disease, which issometimes brought on by an earlier infectionsuch as strep throat

He said this was the first time he'd seen it in the 3,500autopsies he's performed.

Fraser said he did not, however, detect any acute cardiac problemsthat would explainwhy Echaquan went into cardiac arrest.

Achemist and judicial toxicologist who testified earlier in the day said Echaquan may have been, in general,"strongly medicated,"but was not, as some health-care workers have implied during the inquiry, addicted to opioids.

The coroner's inquiry also heard more about employee attitudesat theCentre hospitalier rgional de Lanaudirein Joliette.

Only five of its 200 employees signed up for atraining program on Atikamekw culture that was offered in 2018, according to the nurse who offered it.

Alexandre DeslauriersSt-Jean, a nursefromManawan who was completing his master's degree, says he wanted to address communication failures between the Joliette hospital and the health clinic in Manawan.

Employees were paid to follow the training.