Disciplinary action pending after ED patient turned away
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* Brenda Branswell

The Quebec College of Physicians' disciplinary committee will soon hand down disciplinary action against Dr. Linda Cloutier, a Shawinigan-Sud general practitioner.

The committee found Cloutier guilty in late June of not coming to a patient's assistance in June 2002. The patient, Claude Dufresne, died after an ambulance was turned away from the hospital 300 metres from his home. Dufresne, 51, was pronounced dead at a hospital in Trois-Rivières, about 20 minutes away.

Faced with a doctor shortage, the Centre Hospitalier du Centre-de-la-Mauricie in Shawinigan-Sud had recently instituted a policy of closing its ED after 9 p.m. for walk-in cases and midnight for ambulances, until 8 a.m. the following morning.

An internal branch of the College lodged the complaint against Cloutier. The agreed statement of facts between the 2 parties noted that the ambulance services had been previously advised that, without exception, no ambulance should be directed to the hospital between 11:59 p.m. and 8 a.m.

At 12:07 a.m. on June 20, the ED received a call asking whether an ambulance carrying a cardiac arrest patient could be brought there. Given the hospital's policy, Cloutier indicated the ED was closed. 

The statement also noted that Cloutier had the necessary skill for Advanced Cardiac Life Support and was aware that refusing to admit Dufresne would result in an additional delay of about 20 minutes.

Cloutier pleaded not guilty to the complaint. Her lawyer declined comment about the case. A lawsuit launched by the Dufresne family against Cloutier and the hospital has not yet gone to court. 

Yan Dufresne, 27, told the *CMAJ* how he and his father had previously discussed the impending closure of the hospital's ED. “We said what will happen if a pregnant woman arrives at the hospital and the ED is closed. We never thought of a case like my father's.” Doctors must always be conscious that they have a duty to fulfill, he added. 

Following the controversy surrounding Dufresne's death, the Quebec government implemented legislation to ensure that EDs remain open around the clock. — *Brenda Branswell*, CMAJ