N.B. mother applauds recommendations from review into daughter's death within N.B. hospital's psychiatric unit

Final day of testimony at hospital suicide inquest There are several recommendations from a coroner’s inquiry in Saint John examining the death of a woman in a hospital psychiatric unit.

Warning: This article contains references to suicide.

A New Brunswick mother says jurors were “brilliant” with recommendations offered Wednesday at the end of a coroner’s inquest, examining the circumstances of her daughter’s death inside a hospital psychiatric unit.

Hillary Hooper died on Dec. 9, 2020, a week after a suicide attempt by hanging inside the Saint John Regional Hospital’s 4D North on Dec. 2, 2020.

Hooper was admitted as a patient on Nov. 13, 2020, following a suicide attempt.

A panel of five jurors made 11 recommendations at the end of the three-day inquest, with the aim to prevent similar incidents.

Coroner Emily Caissy, who presided over the inquest, also made four recommendations.

Hooper’s mother said jurors “nailed it” with their analysis of the evidence and testimony presented.

“I think we can let my girl rest in peace now,” said Patty Borthwick, when thanking jurors in court.

"The jury was so smart, and so brilliant, and so bright," Borthwick later told reporters.

A FOCUS ON 4D NORTH BEDS AND DOORS

The jurors made multiple recommendations related to doors and beds within 4D North.

On the evening of Dec. 2, a hospital bed inside Hooper’s private room was moved to block the door. Jurors heard testimony on Tuesday that it wasn’t uncommon for that particular door to be blocked with smaller objects, because it didn’t shut properly.

Jurors made a recommendation for the unit’s door to be repaired. A recommendation for immediate attention to be given to any private room discovered to be blocked was also given.

The jurors made a recommendation for hospital beds to be secured with locking mechanisms, preventing them from being moved.

Jurors also made a recommendation for patient doors in 4D North to be replaced with pocket or accordion style doors, “or doors that open out into the hallways equipped with quick release hinges to prevent patients from locking doors.”

Jurors made a specific recommendation for 4D North to consider using bedding “that tears easily” and wouldn’t support a person’s weight “if used as a noose.”

SEARCHES, STAFFING, AND SURVEILLANCE

The jury heard testimony that Hooper told staff she had cut herself in the hospital’s emergency department, when first admitted on Nov. 13, 2020. The jury also heard testimony that a cell phone was later found inside Hooper’s private room.

The jurors made a recommendation to search patients entering 4D North, with specific attention to possession of any potential weapons, drugs, or mobile phones.

Jurors also said the installation of security cameras inside patient rooms should be considered, along with staffing being increased within 4D North during evening and overnight hours. Jurors made note of privacy concerns and staffing challenges for those individual recommendations.

Testimony was heard earlier on Wednesday from Michael Kennedy, a respiratory therapist who was amongst those who responded to the ‘code blue’ on Dec. 2, 2020.

Kennedy, who was the 16th and final witness, said it was a standard ‘code blue’ response aside from the circumstances of how Hooper was found.

Kennedy also testified that different units within the hospital were equipped with ‘code baskets’ holding specialized tools to maintain a patient’s airway during cardiac and respiratory emergencies. Kennedy said some units had a ‘code cart’ containing additional tools. The jury made a recommendation for a ‘code cart’ to be added to 4D North.

PUSH FOR ‘SHORT-STAY UNIT’

Both the jury and presiding coroner Emily Caissy supported a recommendation for the Horizon Health Network to create a ‘short-stay’ crisis stabilization unit inside Saint John Regional Hospital.

On Tuesday, Horizon’s director of addiction and mental health services testified a prior internal recommendation to create specialized spaces for patients in crisis still hadn’t been achieved. Renée Fournier said a suitable space hadn’t been found.

Fournier said another internal recommendation, to remove the tops of bathroom doors in private rooms within 4D North, had been achieved.

Coroner Caissy also made a recommendation for Horizon to provide information sessions to physicians about local resources available for the treatment of borderline personality disorders.

Caissy made a recommendation for Horizon to introduce a reporting form in medical clinics and emergency departments to track any patient who reports being suicidal with continuous assessment.

Caissy is also recommending support from the Department of Justice and Public Safety in establishing a suicide fatality review committee.

The Horizon Health Network said it would carefully review all recommendations made from the coroner’s inquest, in a written statement sent Wednesday afternoon.

MOVING FORWARD

Patty Borthwick said she’s been waiting two years to learn several pieces of information shared during this week’s inquest.

“We now know what happened, truthfully, from the boots-on-the-ground, and we have a great jury. They were so smart.”

Borthwick said she’s working with Progressive Conservative MLA Andrea Anderson-Mason to change legislation, which would automatically trigger a coroner’s inquest for patients who died by suicide.

“Although it was very hard to hear what happened, I needed to know what happened,” said Borthwick.

“Now as a family I feel we can move forward.”

A progress report on the status of each recommendation will be featured in the provincial coroner’s next annual report.

If you or someone you know is in crisis, here are some available resources:

If you need immediate assistance, call 911 or go to the nearest hospital.