Coroner calls for better medevac services after Salluit woman dies on flight
Recommendations part of report into death of Kitty Kumakaluk, who died in 2022 after 6-hour wait for hospital transport
A Quebec coroner’s report calls for better medevac services in Nunavik after the death of a Salluit woman who waited six hours for a flight to Purvirnituq’s health centre. (Photo by Cedric Gallant)
A Quebec coroner is calling for better medevac services in Nunavik after a woman died following a six-hour wait for a flight out of Salluit.
Coroner Julie-Kim Godin’s recommendations are found in a report, released Aug. 14, into the death of 61-year-old Kitty Kumakaluk on Aug. 11, 2022.
Kumakaluk was admitted to Salluit’s health centre on the morning of Aug. 11 because she was coughing and vomiting blood. Medical officials hypothesized she either had pneumonia, cancer or tubercolusis.
At around noon, a doctor requested she be transferred to Puvirnituq’s Inuulitsivik health centre. Kumakaluk received oxygen and medication to prevent blood loss during the wait.
A medical evacuation team arrived in Salluit at 5:30 p.m. and 30 minutes later Kumakaluk was transported to the plane.
Kumakaluk coughed a great quantity of blood during the flight and fell into cardiac arrest. Paramedics and nurses in the plane attempted resuscitation until they reached the Purvirnituq health centre.
A doctor declared Kumakaluk’s death at around 8 p.m. that day. An autopsy confirmed her death was caused by an acute pneumonia infection that developed in her right lung.
Godin’s report highlights the six-hour delay to Kumakaluk’s medical evacuation and recommends improvements to the province’s medevac services.
“In the case of Kumakaluk, the issues were in the organization of services, prioritization of demands and availability of human resources and materials that contributed to the important delay of the transfer,” Godin said in her report, which was published in French.
She gave two recommendations to Quebec’s Ministry of Health. The first is to ensure the availability of qualified staff and aerial transport in sufficient numbers to answer requests in an opportune time.
The second is to put in place, within six months, a call centre that would manage and prioritize requests for medevac flights.
Nunatsiaq News asked to Quebec’s Ministry of Health about the government’s timeline in answering the coroner’s recommendations.
“The [ministry] acknowledges the contents of the report and is taking action on the coroner’s recommendations,” said Marie-Claude Lacasse, a ministry spokesperson said in an email.
She added the government has 45 days to respond to the recommendations.
Lacasse said the creation of a call centre for medevacs is included in an plan created by the Ministry of Health in 2023.
The plan says the call centre, which would cost approximately $7.4 million, would be completed between 2023 and 2025.
Nunatsiaq News also reached out to the Nunavik Regional Board of Health and Social Services for comment and received a joint statement from Nunavik’s health board and the region’s health centres and hospitals.
“We firmly believe that the more efficient evacuation services provided by the province of Quebec are, the greater the benefit to our communities,” the statement said.
“The NRHBSS, along with health centres of Nunavik, are committed to collaborating on suitable improvement projects to ensure that the medevac system serves Nunavimmiut in the safest and most effective manner possible.”
The coroners recommendation says: The first is to ensure the availability of qualified staff. This is a serious joke to all Inuit and Non-Inuit living in any Nunavik community. The qualified staff they are suggesting are the new nurses who are still completing their education while examining our people. Today, most young francophone nurses are ill equipped in dealing with the Inuit of Nunavik. They are supposedly preparing airline tickets for the patients and their escorts and most of the time the escorts have to fly a day or two later because the nurses do not complete their jobs properly. They also misdiagnose older patients (men/women) and most Inuit patients are in pain and agony due to the lack of specialties treatment not shown by these younger nurses. In our community a few years back, the local nursing station refused to see an intoxicated Inuk woman only to send her back to her apartment while she sobered up. Within hours this young Inuk woman died alone in her apartment. Also, we have non Inuit nurses and the nunavik police service officers soliciting criminal charges against the Inuit because the Inuit are vocal and the new southern nurses feel threatened so they call the police to have the Inuit arrested, charged and then the person who was arrested is made to feel like a criminal and are not wanted inside the clsc nursing station. NRBHSS has to do a better job in their hiring practices and explaining to the non Inuit who are hired should be given a course in Inuit culture and Inuit Traditions before being sent to work inside a Nunavik community. I know many Inuit who were charged for verbal assaults and they are awaiting trial. In the meantime, the patient has to be escorted by the police the next time they want to have a check up with the local clsc nursing station staff.
The comment about “Non-Inuit” learning about culture and traditions, how do you plan on getting that executed? I had friends learn about that in a short 15 min video and a 10 page power point presentation. it was a laughable presentation that needs to be properly re-evaluated for better education. I don’t have any plans on making the presentation about Inuit culture better, that isn’t my job, but what I do is when I meet such people is that, teach them what they’re interested in and this and that if I’m able to answer.
Can’t believe the entitlement in this comment.
Obviously screaming and harassing health practicioners will result in charges. Maybe if you want people to stick around and not all be young recruits, work on some manners and gratitude. This has nothing to do with Inuit culture and everything to do with just being a functioning person in society.
Perturbed. It is apparent that your problems would be solved if all of the nursing positions in Nunavik were staffed by Inuit nurses.
So where are they?
It’s not as if there is no opportunity for local Inuit in every community to go through school and then have their advanced education completely paid for if they wish to take a medical degree, whether that be in nursing, dental technician, lab technician, dentist, or doctor.
I whole heartedly agree that Inuit should be in all of these positions. The government needs to do a better job of promoting these careers, schools need to do a better job of educating students so that they can do these jobs, and parents need to instill in their children the desire to aspire to these positions.And lastly youth needs to believe that they can grow up and be a nurse, doctor, dentist.
I hope some of the experts in Nunavik realize this is an opportunity for a regional emergency services center. Integrate all emergency responses under one roof and share resources.
I hear that the Cree use air inuit twin-otter for camping/hunting, it’s time the Air inuit and KRG do something about this. I have seen few complaints about medivac in the Hudson Bay area where they had to cancel a medivac flight when a baby was in serious condition, the cree people were using all the available twin otters that time when people needed medical attention!!!
” FIRST NATIONS ” come first !!
This 61-year-old woman had pneumonia in her right lung, and coughed up a great deal of blood during the medevac flight. Definitely a tragedy, a young life cut short, a family ripped apart.
The topics of staffing and human resources have been touched on both by the article and by other commenters.
That being said, the underlying medical situation merits more in-depth thought not merely in terms of what the coroner saw on autopsy (since the coroner merely ascertains cause of death), but rather the wider picture that would be gleaned by delving deeply into the medical history (which ultimately would be a topic for health researchers to pursue).
Firstly, it’s not clear what the actual pathogen was (i.e. pneumonia is a lung infection, but a range of pathogens can cause that, including bacteria, viruses, and fungi).
Secondly, it is worth thinking about how the pathogen (or pathogens) got into her lungs. Pneumonia does not simply arise on its own out of nowhere.
To get a more fulsome picture of the precursors to this death, it would have been useful to look at her medical history:
– Any smoking history (very common in Nunavik, just like in Nunavut). Smoking greatly facilitates pathogen ingress because it paralyzes the cilia that normally transport pathogens upwards and out the bronchi.
– Also any history of other drugs usage (prescription and non-prescription), including an analysis of underlying causes for such drugs to be used.
– Living conditions (For example, was she living in crowded housing, with mould and stale air, and with pathogens from others? Also consider air quality in general, including diesel exhausts and other particulate sources. What was the ventilation and air quality where she lived? Were there any dedicated air-exchange or filtration arrangements? Also consider exposure history to pathogens from daily activities and settings.)
– Prior lung-infection history (influenza, Covid, RSV, etc — all of which leave damage in some form, like any infection does!)
– Dietary history, including general nutrition and also including history of ultraprocessed foods (UPFs) and fried foods (e.g. if she fried daily, then that is another cause of lung issues…both the fried food itself plus the PFAS fluorochemicals from Teflon-coated frying pans).
– History of general physical activity, also any history of injuries.
– Any other health issues (e.g. diabetes affects capillary tissues throughout the body, not just in the legs).