GJ and Hazel van der Werken hold a picture of their 16-year-old son Finlay in their Burlington home. Finlay died following a visit, in February 2024, to the emergency room at Trafalgar Memorial Hospital in Oakville.Nick Iwanyshyn/The Globe and Mail
The evening of Feb. 7, 2024, Hazel van der Werken knew something was very wrong with her eldest son.
Finlay, an active 16-year-old who loved playing hockey, was experiencing intense pain on his right side.
As the six-foot-two Grade-11 student cried out, Ms. van der Werken drove him as fast as she could to Oakville Trafalgar Memorial Hospital, about 20 minutes from their Burlington, Ont., home. In the vehicle, he kept looking at her, obviously in agony. She was terrified.
At triage, hospital staff determined that Finlay was a patient who needed rapid medical intervention. But hospital records show that instead of seeing a doctor right away, he waited more than eight hours. His mom said he could be heard making noises in a hallway while his condition deteriorated. She said she alerted nurses several times to his decline.
Finlay, who was eventually diagnosed with pneumonia, sepsis and hypoxia, suffered cardiac arrest that afternoon. He was transferred to Toronto’s Hospital for Sick Children and, at 1:35 a.m. on Feb. 9, was taken off life support. Amazing Grace would be piped at his funeral.
GJ van der Werken holds a picture of his 16-year-old son Finlay. An active Grade 11 student who loved playing hockey and dreamed of becoming a veterinarian, Finlay died of pneumonia on Feb. 9. 2024.Nick Iwanyshyn/The Globe and Mail
His mother relives the circumstances of his death over and over.
What occurred before Finlay died is now part of a lawsuit against several defendants, including Halton Healthcare Services Corp., a network of hospitals that includes Oakville Trafalgar Memorial.
The statement of claim filed through the family’s lawyer, Meghan Walker, alleges that Finlay’s pain, suffering, emotional distress and death were caused solely by negligence. The allegations have not been proven in court. A statement of defence has not been filed.
Finlay’s story echoes broader concerns from patients, medical organizations and countless physicians and nurses about the state of emergency care in Canada. They warn that many hospitals are overcrowded, understaffed and underfunded – and that this could have dangerous and even deadly consequences.
A recent Globe and Mail investigation – part of its “Secret Canada: Your Health” project – looked at another dimension of the ER crisis. It found that, collectively, Canadian ERs closed their doors for at least 1.14 million hours since 2019, the equivalent of 47,500 days.
Canadian ERs closed their doors for at least 1.14 million hours since 2019, records show
Ms. van der Werken said there is a great deal of awareness that the health care system is not working properly, but there seems to be much complacency, too. She doesn’t believe this issue is unsolvable.
On Aug. 14, her family asked the Office of the Chief Coroner of Ontario for a rare discretionary inquest into Finlay’s death. Inquests are not automatic when a child dies in hospital, like they are if someone dies in prison. A coroner can, however, decide to grant such a process.
While not legally binding, an inquest would develop recommendations and see measures implemented that could help prevent what happened to Finlay from occurring again.
“I can’t let his death be for nothing,” Ms. van der Werken said.
Finlay’s cries for help
When Finlay arrived with his mom at the Oakville hospital, she said he was doubled over and could be heard saying, “Please help me.”
Hospital records show he was triaged at 10 p.m. as a “Level 2” on the Canadian Triage and Acuity Scale. The CTAS system is used by emergency departments to prioritize patients based on the type and severity of their symptoms. At “Level 2,″ a patient should ideally be seen within 15 minutes 95 per cent of the time.
But that didn’t happen with Finlay. He waited until 6:22 a.m. the next morning to see a doctor.
The statement of claim includes a reference to a note from the physician who attended to Finlay on the morning of Feb. 8. It describes how the teenager arrived at the ER shortly after he developed acute pain on his right side and adds that, “unfortunately, there have been long wait times overnight.”
“Current wait times are over 10 hours,” the note referenced in the claim says. “He had waited 8 hours to be assessed and had some blood work drawn at 0020. I had arrived to start my shift at 0400 and was notified by nursing at 0600 about the patient and assessed him immediately thereafter.”
Nursing had become concerned because the patient was experiencing “increased pain, elevated respiratory rate and low oxygen saturations,” the note adds.
“In retrospect his oxygen saturations had been decreasing throughout the morning. 100% at 2200, 96% at 2245 and 93% at 0300.”
The statement of claim also details how Finlay went on to suffer cardiac arrest at 3:05 p.m. and that CPR was performed. “The contributing cause of arrest was listed as septic shock, pneumonia,” it says.
Finlay was transferred by ambulance to SickKids, arriving at 5:21 p.m. with what the statement says was hypotensive shock. He was put on a specialized machine, his only hope for survival.
But as the hours passed, his condition did not improve. There was fear he would wake up only to die in tremendous pain. Having already watched him suffer so much, Ms. van der Werken said she and her husband made a decision no parent should ever have to face.
They decided to take Finlay off life support. Their first-born child, who wanted to become a veterinarian and made friends with dogs and cats alike, did not get to live out his dreams.
Finlay would never come home. Now, instead of hearing his laughter reverberate through the vents of their home, his parents are haunted by silence.
Long-standing concerns about ER care
Ms. Walker, the family’s lawyer, says there is no doubt that overcrowding in hospitals is real. But she says it is never acceptable to allow a patient triaged at Finlay’s level, particularly a child, to wait more than eight hours to see a doctor.
“We have to enforce triage time limits, add surge capacity and monitor patients in real time more effectively so no one else deteriorates, unseen in a waiting room, like Finlay did,” she said.
For years, physicians have sounded the alarm about the state of Canadian emergency rooms, including in an open letter signed by nearly 200 Calgary doctors in 2023.
The same year, Catherine Varner, an assistant professor in the University of Toronto’s Emergency Medicine Division, wrote in the Canadian Medical Association Journal that the capacity of ERs to provide care had been outstripped. Dr. Varner warned that the situation carries “lethal consequences” and will continue to exhaust services and providers.
Dr. Brian Day predicted the health care mess we’re in today
In response to what occurred at the Oakville hospital, Cheryl Williams, the executive vice-president of clinical operations and chief nursing officer of Halton Healthcare, said in a statement that the organization does not comment on individual cases to respect patient privacy, confidentiality and legal requirements.
She said the hospital, like many others, is “seeing more patients presenting with increasingly complex health conditions and co-morbidities, often requiring longer stays and more intensive care.”
“This places significant demand on our emergency departments, patient flow, bed availability and the patient experience.”
Ms. Williams also detailed a series of initiatives, such as a new “command centre” to co-ordinate daily operational activity, including patient flow and staffing.
Ms. Walker said her team is “cautiously optimistic some changes in the hospital will come as a result of this.” But she added: “It doesn’t change the fact that, sadly, Finlay’s life is gone.”
She also said her office has heard “horror stories” from individuals, in 86 calls and e-mails, who heard about Finlay’s story and believe their loved ones also died awaiting medical care.
GJ and Hazel van der Werken sit on a bench, made in memory of their son Finlay, at their Burlington home.Nick Iwanyshyn/The Globe and Mail
Finlay’s voice
The van der Werkens have launched a campaign called “Finlay’s Voice,” hoping to promote reform of ER care, particularly for pediatric patients. They say there must be a policy in place to ensure that kids, a vulnerable group, receive urgent medical care when they need it.
“What if this was your child?” Ms. van der Werken said.
She does not lay blame at the feet of Ontario’s Progressive Conservative government, adding that the state of ER care in the province has deteriorated for decades under different provincial governments tasked with the administration of health care. But she wants to share her family’s story face to face with politicians.
As for the push for an inquest, the van der Werkens are hopeful Ontario’s Chief Coroner will hear their plea.
Stephanie Rea, a spokesperson for the Office of the Chief Coroner, said Tuesday that a request for a discretionary inquest was recently received and is being reviewed and considered.
Ms. van der Werken said it would be easier for her family to focus on healing rather than share their story and relive the trauma every time they do so.
“But I can’t live like that,” she said. “We won’t be silenced.”