Some Grand Manan residents are once again voicing concern about the island's air ambulance service following a December 29 medevac in which six hours elapsed between the decision to fly a patient out and her arrival at Saint John Regional Hospital, and during which time the Ambulance New Brunswick (ANB) aircraft that was called in was unable to land on the island. Friends and family are now expressing their frustration to media and government representatives.
Jackee Seeley's mother began vomiting around 6:30 a.m. that morning. She lost consciousness, fell and hit her head, then began having seizures. She was taken to the island hospital, and the local air service, Atlantic Charters, was alerted around 8 a.m. However, a decision was then made in consultation with a provincially appointed "medical control physician" on the mainland to dispatch the ANB plane from Moncton.
The day was overcast. Seeley and family friend Tiffany Trecartin say that on the first approach to the island at 10 a.m. ANB's pilots were unsure it was safe to land and asked one of the ambulance personnel to take photos of the runway. Seeley says they turned back toward Moncton, but a nurse on the phone convinced them to try again. Expecting their mother to be flown out soon, the family got on the ferry to go to Saint John. On their way after noon, they were told that ANB's second landing had been aborted because of "fog." At 1:45 p.m., Seeley was notified that Atlantic Charters had been called, and her mother finally arrived at the hospital at 2:35 p.m. She experienced more seizures after the family got on the ferry, and her condition worsened. The island doctor accompanied the flight, not a usual occurrence. "He could have gone at 8 a.m. when they called [for a medevac] the first time," Seeley says.
Her mother was too heavily sedated to breathe on her own, and when the family reached the regional hospital, "they told us they didn't know if, or when, she would wake up."
"I can't imagine what she was going through," Trecartin says. "If it wasn't for Atlantic Charters she would never have gotten off the island. ... If ANB feels they're not capable and the weather isn't safe to come, why can't they call Atlantic Charters and ask them to do it? [ANB] didn't even get here. They asked the ambulance crew to take photos. That's not in their job description."
Thankfully, Seeley's mother did wake late that night. She doesn't remember what happened, and while she is now on anti‑seizure medication and awaiting tests, she is much improved and was able to come home two days later.
Both Seeley and Trecartin praise the local medical personnel and pilots and credit the head of the Grand Manan hospital for calling Atlantic Charters to finally effect the transfer. Trecartin says, "We're lucky to have the hospital staff we have. It seems to be the people higher up who don't quite fulfill the same level of care."
"I think it should be up to Grand Manan hospital staff to evaluate" patients and make the decision, Seeley says. She has filed a complaint with ANB and been told they will investigate.
"This could very well have been something more tragic," Trecartin argues. "Somebody could die. These are people who are responsible for getting you to safety, and to know that they may or may not show up C how is this allowed to happen? When you dial 911 you want to have that reassurance [that someone is coming]." She would like to see Atlantic Charters doing all the medevacs, as they did prior to the consolidation of provincial services after ANB took over in 2007. "They're reliable, responsible, professional, they have lots of experience. To know someone like that is taking care of you would be very comforting."
Atlantic Charters has flown medevacs for 30 years. In July 2012 their contract expired and was not renewed. That August, following the death of a patient waiting for a flight, and meetings between the village and health ministry officials, a new agreement between ANB and Atlantic Charters was announced, but several similar incidents have occurred since then, and village officials have continued to pressure health ministry officials for a return to the former system.
Atlantic Charters representatives declined media comment on the recent incident because of ANB's contract stipulations.
MLA Rick Doucet says, "It's a ridiculous waste of time, when there is a professional service already on Grand Manan. Look at their history. The staff are well trained to stabilize patients at all acuity levels. It's life and death: every minute, every second counts in that 'golden hour' [for administering treatment]. It's vitally important to get to the facility as fast as possible. If it's critical enough to [fly them out] in the first place, why hold them?" He adds, "In this age of cost savings ... they're not saving money bringing in aircraft from Moncton, or Halifax, or en route to Quebec. It looks like ANB is calling the shots and the province is accepting it. We need a very solid directive from the province [to send] all acuities with Atlantic Charters. Maybe a change in government needs to make it a mandate. We have an ambulance on Grand Manan that happens to have wings. It should be used."
ANB Public Relations Officer Tracy Bell says, "We have two aircraft that service Grand Manan and a provincial medical control physician who consults" with local doctors. She does not speak for that physician who is not an ANB employee and did not know where he or she is located.
In a further e‑mail statement, she wrote: "It is the medical control physician, a doctor appointed by the provincial government, who decides the level of care necessary to transfer a patient from Grand Manan to the mainland. It is not Ambulance New Brunswick's decision. On December 29, the medical control physician, in consultation with the doctor from the Grand Manan Hospital, decided that AirCare's team of critical care flight nurses should complete the transfer ... because of that patient's medical condition. AirCare was dispatched to the call and headed towards the island. As the pilots approached the airport, they made the professional determination that it was unsafe to land. The weather ceiling was very low and represented a potential danger to operations. They circled around and conducted a second approach, but, again, when they arrived at the minimum approach limits and could not make visual contact with the runway, it was not safe to land the aircraft. At that point, the medical control physician and sending doctor decided Atlantic Charters would conduct the patient transfer with appropriate medical escorts. Atlantic Charters completed the transport to Saint John airport."
Trecartin hopes that publicizing the incident will lead to "a discussion where something is done to raise awareness that this is happening and should not be allowed to go on. We're asking for the medical care we pay for as taxpayers. Make it available to us."
Grand Manan Mayor Dennis Greene says, "We feel ANB is not living up to the  agreement with Madame [Madeleine] Dubé when she was [health] minister." Grand Manan village officials are requesting another meeting with the health minister and the island's healthcare committee to discuss the medevac issue.