The Toronto Star
ONTARIO — John Chasczewski had just retired to spend more time with his wife, Millie.
But three days before Christmas in 1996, she collapsed at their Whitby home. With her heartbeat dangerously slow, every minute and every second mattered. Yet paramedics remained at the house for at least 12 minutes before setting out for hospital.
Millie Chasczewski died in the back of the ambulance, en route to an emergency department.
Now, after a 15-year-battle for answers, the Ontario Court of Appeal has given her husband, a former platoon chief in charge of emergency operations for the City of Oshawa, along with her two sons, Gary and Tod, the right to proceed with a negligence lawsuit against the Whitby Ambulance Service, its former owner and two paramedics.
The decision reverses a ruling by a Superior Court judge.
That judge threw out the case without a trial, reasoning that even if the paramedics fell short of accepted standards, Millie Chasczewski would have died anyway.
With the case winding its way to trial, the family’s lawyer, Amani Oakley, said she will ask the Ontario Ministry of Health to reopen its investigation, which had concluded Millie Chasczewski, 60, received appropriate care.
Two medical experts retained by the family found otherwise. Dr. Steven Shilling, a U.S. cardiologist, says the evidence shows she suffered a complete heart block, which he described as “extremely treatable.”
Shilling said she likely would have survived had she made it to hospital while her heart was still beating and been treated with a drug or an external pacemaker.
Paramedics arrived at the Chasczewski house at 12:53 p.m. The drive to the hospital took about four minutes. The ambulance arrived at the emergency department at 1:17 p.m.
Millie Chasczewski’s heart stopped beating at 1:07 p.m and she went into cardiac arrest.
Why the paramedics stayed at the house as long as they did is largely unexplained in the court record, Justice John Laskin said in the court’s 3-0 decision Monday, sending the case to trial. Chasczewski, called it “a very good thing for our family.”
“After all these years, we’re still looking for justice. My wife was very precious to me and I think she deserves every bit of consideration we can give her.”
Oakley said the appeal court ruling is important for plaintiffs in medical malpractice cases because it leaves them better equipped to fight defendants’ attempts to have cases thrown out before a trial.
That’s what happened with the Chasczewski’s case. Justice Mark Edwards of the Superior Court of Justice dismissed their action last year, ruling that even if paramedics breached expected standards of care, their shortcomings did not cause Millie Chasczewski’s death as she would have died anyway.
Edwards relied on a statistic in an affidavit filed by an emergency medicine expert retained by the defendants, Dr. Douglas Munkley, who said a New England Journal of Medicine study found just 2.4 per cent of patients with complete heart block survive if they go into cardiac arrest precardiac arrest before reaching hospital.
But Laskin said this misses the point of the Chasczewski’s lawsuit, which alleges Millie Chasczewski’s cardiac arrest would not have happened outside a hospital if they had left the house sooner.
Munkley never bothered to attach the study to his affidavit, so it’s impossible to know the details or underlying assumptions, Laskin added, saying denying the family their day in court on the basis of that lone statistic was “unsatisfactory.”
In occurrence reports and in interviews with a health ministry investigator, the paramedics initially blamed Chasczewski for the delays and ultimately for his wife’s death, alleging he interfered with their work. Chasczewski denied the allegations. While being questioned under oath in connection with the lawsuit, one paramedic backed down from those claims, saying Chasczewski wasn’t to blame and didn’t interfere.
Copyright 2012 Toronto Star Newspapers Limited