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Moncton patient asking for hospital protocol for lesser-known neurological condition after leaving ER without being seen
Published Jan 05, 2026 • Last updated 4 hours ago • 5 minute read
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Tammy Dunston, of Berry Mills, said she wants to see Horizon Health Network incorporate a protocol for patients that present to the ER with postural orthostatic tachycardia syndrome (POTS), a lesser known neurological disorder. Dunston, who is suspected to have POTS, said she left The Moncton Hospital ER without being seen. SUBMITTEDArticle content
A Moncton patient is speaking out about a lack of awareness and protocol in the emergency department for a lesser-known neurological disorder.
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Tammy Dunston, of Berry Mills, suffered a concussion in June and since then her health has deteriorated. After multiple visits to her family doctor, she was told two months ago she has suspected dysautonomia or postural orthostatic tachycardia syndrome (POTS).
She is waiting to meet with specialists such as a cardiologist and neurologist for more tests in order to get a formal diagnosis.
According to the National Institute of Neurological Disorders and Stroke, POTS is part of a group of disorders that feature orthostatic intolerance, or difficulty to regulate blood pressure while in a standing position. Symptoms include a fast heartbeat, fatigue, headache, trouble breathing, dizziness or fainting because not enough blood flows back to the heart when the person moves from a lying down or seated position to standing up.
POTS commonly begins after a pregnancy, major surgery, puberty, trauma, or a viral illness, the institute stated on its website. Diagnosing it can be challenging because it resembles other neurological disorders.
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“I went from being a mom who volunteers, who’s very outdoorsy to bedridden. I can’t drive. I can’t stand for long periods of time,” she said. “My life has changed dramatically.”
Though there is no cure for POTS, patients can work on managing low blood volume and problems with blood flow, as well as taking certain medications. Symptoms may come and go over time and in most cases POTS symptoms improve over time, though some symptoms may remain or last a long time, the institute said.
Dunston said she was at a physiotherapy appointment to work on exercises on Dec. 11. When she went to stand up, she could feel her heart rate and blood pressure shoot up.
Her physiotherapy team called an ambulance and monitored her vitals until the paramedics arrived to take her to The Moncton Hospital around 11 a.m. She noted at the time she was sensitive to light and shivering with a fluctuating heart rate.
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Dunston requested for a chair or bed to elevate her legs and she was placed in a recliner near the staff break room.
She asked a nursing supervisor if the hospital had any ER protocol for POTS and dystaumia and was told there was no protocol.
This was not Dunston’s first ER visit. She had been to The Moncton Hospital several times before. Once she was able to get seen by a physician and receive IV fluids. On another occasion the doctor did not know about POTS and she had to explain what the condition was.
During her 4-5 hour wait, Dunston asked nursing staff for several things, including vital signs monitoring, pain management, and IV fluids to help with low electrolytes, another common POTS symptom.
Nurses had told her they could help her with those things but did not return, she said. At one point she was told her location had not been recorded, so staff were unaware where she was. She also asked to speak to a patient advocate, but an advocate did not come.
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“I felt alone like no one was listening,” she said, noting in her distress she raised her voice at staff. “As my condition deteriorated, I felt increasingly unsafe.”
A nursing supervisor eventually told her she had to either return to the waiting room or leave the ER.
“At this time I couldn’t. My hands were numb. My feet were numb. I was in distress,” said Dunston.
Paramedics removed the IV port they had inserted in case she was given fluids and Dunston said she left the ER without seeing a physician or receiving a discharge plan.
Dunston is one of thousands of Horizon patients who have left the ER without getting treatment.
Brunswick News reported in September that more than 41,000 patients walked out of Horizon Health Network hospital emergency rooms without being seen during the 2024-2025 fiscal year, according to a report from the Montreal Economic Institute, a non-profit think tank.
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When the report came out, Greg Doiron, Horizon’s vice president of clinical operations, said the health network takes MEI’s “report and the data that was shared very seriously.”
“Every patient who leaves without being seen represents someone who needed care, and that’s unacceptable. It reflects numbers. The numbers reflect the systemic pressure that we have in the entire system,” Doiron said.
Dunston has since been in contact with the hospital’s patient advocate and filed a complaint with Horizon about her most recent ER visit, hoping her efforts will prevent similar situations from happening to other patients.
She would like to see the health authorities establish a protocol for when patients with POTS or dystaumia present to the emergency departments, so those patients can have access to vital sign monitoring, pain management, and IV fluids.
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“I just want people to be more aware of the matter, not only for me but for everybody that’s living with autonomic disorders,” she said. “There’s no cure for POTS I understand that, but there is standardized care and I don’t think that I even got standardized care.”
Pam Power, Horizon’s clinical executive director of emergency medicine and critical care, said in a statement Horizon is aware of the concerns Dunston raised about her ER experience and is taking it seriously.
“While we cannot comment on the specifics of an individual patient’s care due to privacy considerations, we encourage any patient or family member with concerns to connect directly with our Patient Relations team so the situation can be reviewed thoroughly,” she said.
Power said emergency departments triage patients using the Canadian Triage and Acuity Scale, which is based on presenting symptoms and clinical assessment rather than a specific diagnosis alone.
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Patients presenting with symptoms consistent with conditions such as POTS or other forms of dysautonomia are assessed and prioritized based on the severity of symptoms at the time of presentation, including vital signs and overall clinical stability, she said.
“While Horizon does not have a condition-specific triage protocol for POTS, symptoms commonly associated with the condition – such as dizziness, syncope, tachycardia, or neurologic complaints – are well recognized and addressed through existing emergency assessment standards,” said Power.
She noted Horizon has processes in place to monitor patient flow and ensure patients in waiting areas are tracked and reassessed appropriately.
“Any breakdown in these processes is taken seriously and reviewed through our quality and safety frameworks to identify opportunities for improvement,” Power said, adding that Horizon remains committed to providing “safe, timely, and respectful” emergency care and reviewing feedback to improve patient experience.
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