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    Hospital cuts blamed for ward deaths

    Staff is burned out: union head; Chief of psychiatry says suspect showed no signs of violent behaviour

    The recent deaths of two patients and the brutal attack of a third in the psychiatric ward of Montreal’s Notre Dame Hospital are a sure sign that “something isn’t working,” says the head of the union representing staff working in the department.

    Guy Brochu, president of the Syndicat des professionnels en soins de santé du CHUM, explained that recent multimillion-dollar cuts to the network of hospitals affiliated with the Centre Hospitalier de l’Université de Montréal have meant that nurses and other frontline health-care workers are stretched thin – which could explain how a 31-year-old psychiatric patient managed to gain access to a room on a closed floor last Friday and attack a 71-year-old patient inside.

    Idelson Guerrier was allegedly strangling the woman when staff went in and restrained him.

    Guerrier is now a suspect in the suspicious deaths of two other patients in the same unit.

    “Do (staffing issues) have a link with these incidents? We don’t know,” Brochu said Thursday. “We will have to wait for the coroner’s report. But (the union’s) thinking is that this probably contributed.”

    Brochu said the union had expressed concern about staff burnout in the psychiatric ward following $7 million in cuts to the CHUM’s budget last year, but those warnings seemed to fall on deaf ears.

    “The tasks were too numerous,” he explained. “The clientele in those units varies. You can have a week when the therapy is working well and people are cooperating well, but the next week the level of care might be much higher; the patients might be more aggressive.”

    Next year’s budget will likely bring even more cutbacks, Brochu added.

    “We can’t always do better with less,” he said. “Something isn’t working if this event has happened. If everyone was doing their work properly, then we are missing someone to fill a void.”

    Speaking to reporters Thursday, the hospital’s chief of psychiatry denied understaffing had anything to do with the deaths.

    “The security staff, as far as doing their rotation and the level of surveillance in place, was on par with any other psychiatry department in Quebec,” Paul Lespérance said. “I think that this was a cunning individual that was able to do these terrible things in a very subtle and peculiar way.”

    The series of attacks have triggered an internal investigation, which may cause Notre Dame Hospital to change the way it assesses its patients, Lespérance said. But the doctor insists Guerrier showed no signs of violent behaviour prior to his alleged assaults of a fellow patient.

    “There’s a lot of our nursing staff that are completely in shock because they never saw it coming, it’s just that the patient didn’t look the part,” Lespérance said. “As far as evaluating that this patient was a potential killer, this was a very strange, specific case which slipped through our fingers.”

    When police responded to the call from hospital staff last Friday about the assault on the woman, officers learned there had been two other sudden deaths in the same department within the last two weeks, the first on June 16 and the second on June 21. Initially, those deaths were believed to have been from natural causes, but autopsies performed this week confirmed both patients died of asphyxiation. Police are not releasing their names, saying only that they were two men age 69 and 77.

    As of Thursday, Guerrier has only been charged in connection with the woman who was strangled on June 22. He is charged with attempted murder while breaking into a room at the hospital. He also is charged with using a weapon while the woman was assaulted.

    “That’s perfect. Thanks,” was all Guerrier said to Quebec court Judge Hélène Morin when he appeared before her via a video link-up between a Montreal police holding cell and the Montreal courthouse on Saturday. Morin had just ordered that Guerrier be examined by an emergency room psychiatrist and that he not communicate with the woman he allegedly tried to kill.

    His lawyer, Daniel Couture, did not enter a plea and asked that the charges not be read into the official court record. The case returned to court on Tuesday for a brief hearing during which a judge ordered Guerrier undergo a full psychiatric evaluation, at the Philippe Pinel Institute, to determine if he was suffering from a mental health disorder when he allegedly strangled the woman. The case returns to court on July 30.

    It appears Guerrier was admitted to the hospital sometime after June 7. On that day, he appeared before a judge at the Joliette courthouse, where he pleaded not guilty to a series of charges alleging he harassed a man between Feb. 1 and March 16 of this year. He also is charged with threatening and assaulting the same man, as well as dangerous operation of a vehicle.

    He has had several run-ins with the law, but most of the cases brought against Guerrier ended in acquittals, including when he was accused of conjugal violence in 2003 and 2006. Earlier this year, a Joliette law firm filed a small-claims lawsuit against Guerrier for nonpayment of legal fees.

    In 2005, he was arrested by Montreal police and charged with breaking and entering, mischief and assault. He pleaded guilty to the latter two charges and received an 18-month suspended sentence. The same year, he was fined $250 for providing false information to a police officer.

    The incidents at Notre Dame Hospital come on the heels of the leaking of a scathing final report into a hostage-taking at the highsecurity Philippe Pinel Institute in April 2011. The investigation into that incident reportedly revealed dozens of security lapses that could have left staff and visitors vulnerable to attacks by mentally unstable patients.

    Yvan Gendron, the associate director-general of the CHUM, told the media Wednesday evening that, contrary to the beefed-up security in place at the Pinel Institute, Notre Dame’s psychiatric ward is “an environment for rehabilitation, for evaluation, for care. It is not an incarcerating environment, so the patients have a certain amount of liberty.”

    He went on to say there is “always” surveillance on the unit, and that it is “adapted according to the conditions of the patients.”

    Christopher Curtis and Kamila Hinkson of the Gazette and Canadian Press contributed to this report

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