Waiting to Die
How Canadian hospitals built a system that cannot account for the patients it loses
The Old Guardian | Investigative Feature | April 2026
In Ontario, in the 12 months ending March 2023, an average of 33 people died within 30 days of walking out of an emergency room without being seen by a doctor. Pre-pandemic, that number was 20.7. The increase is not explained by sicker patients leaving. It is not explained by patients who chose to follow up elsewhere. It is not explained by the underlying health of the people involved, three-quarters of whom had no hospitalization in the previous five years and whose median age was 41.
Those numbers come from a peer-reviewed study by Dr. Candace McNaughton and colleagues, published in December 2024 in the Journal of the American College of Emergency Physicians Open. The data is drawn from Ontario’s linked administrative health records — the only jurisdiction in Canada with the infrastructure to study the question. The authors’ conclusion, in the most careful academic language available, is that walkouts from Canadian emergency departments can no longer be considered benign events. They are an emerging mortality signal, and the signal is rising.
The patients who walk out are one part of the picture. The patients who stay and die anyway are the other. They have names, and the names are starting to accumulate.
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The names
Heather Winterstein was 24 years old. A member of the Cayuga Nation with ties to Six Nations of the Grand River, she had fallen down a flight of stairs carrying bags. Two days later, on December 9, 2021, she was taken by ambulance to the hospital then known as St. Catharines General. The emergency physician who assessed her, Dr. Emad Nour, ruled out infection because she did not have a fever, did not order bloodwork, and attributed her presentation to social issues. He noted her history of substance use and an anxiety disorder. She was sent home with Tylenol and a bus ticket, with instructions to return if her condition worsened.
She returned the next day. Her father called 911. Paramedics, on learning she had used fentanyl and might be in withdrawal, upgraded her severity rating and brought her to the same hospital rather than to an urgent care centre in Fort Erie. She arrived just after noon on December 10. The triage nurse, Andrea Demery, was one of three working in a department where the normal complement was four. Forty-seven patients were waiting. Demery later testified she looked at Winterstein for three to five seconds from across the room. Hospital protocol required reassessment every 15 minutes for a CTAS 2 patient. Winterstein was not reassessed once over the next two and a half hours. She collapsed on the waiting room floor. Hospital staff worked for hours to save her. They could not. She died of septic shock from a bacterial blood infection whose source the autopsy could not identify.
On April 22, 2026, the inquest jury empanelled to determine the circumstances of her death returned its verdict. Winterstein died accidentally. The jury issued 68 recommendations.
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In Manitoba, in September 2008, Brian Sinclair waited 34 hours in the emergency room of the Health Sciences Centre in Winnipeg. He was 45, Indigenous, and a double amputee. He had been referred to the hospital by a community clinic for a blocked catheter, a treatable condition. He sat in a wheelchair. Staff assumed he was sleeping, drunk, or homeless. He died of a bladder infection that progressed to peritonitis. Rigor mortis had set in by the time anyone realized. The inquest produced 63 recommendations and rejected a homicide finding. Manitoba implemented 55 of them.
In January 2025, 17 years after Sinclair, an unnamed middle-aged man arrived by ambulance at the same Health Sciences Centre shortly after midnight. The emergency department had 100 patients overnight. All six resuscitation beds were occupied. He was triaged as low-acuity. He was declared dead in the waiting room shortly before 8 a.m. Dr. Barry Lavallee, an Indigenous family physician in Winnipeg, told reporters: if you could not hear him asking for help, you were the problem.
In February 2024, Finlay van der Werken, 16, waited more than eight hours in the emergency department of Oakville Trafalgar Memorial Hospital. He had right-side pain. By the time he was transferred to SickKids, sepsis and pneumonia had progressed beyond what could be treated. His family was granted a discretionary inquest in late 2025. They were told to expect a five to seven year delay. The Office of the Chief Coroner has staffing capacity for 55 inquests per year. There are 412 currently in planning.
In July 2022, Darrell Mesheau, 78, was brought by ambulance to the Dr. Everett Chalmers Regional Hospital in Fredericton. He was triaged CTAS 3, urgent, requiring assessment within 30 minutes. Security video later confirmed no one checked his vitals for more than two and a half hours. He was found lifeless about seven hours after arrival. His death prompted Premier Blaine Higgs to fire the Horizon Health Network CEO, replace the health minister, and dismiss the boards of both provincial health authorities. The acting nurse manager testified at the subsequent inquest that the CTAS 3 reassessment standard was completely unrealistic given the staffing he had been given.
In December 2022, Allison Holthoff, 37, a mother of three and the deputy volunteer fire chief at Tidnish Bridge, Nova Scotia, was carried into Cumberland Regional Health Care Centre in Amherst by her husband. She could not stand. She lay on the emergency department floor for hours. She was resuscitated three times. She died at 11:30 that night of an untreated splenic aneurysm. Her husband sued. The hospital’s quality review of her death was not released; only generalized recommendations were shared with the family. Nova Scotia had amended its Quality-Improvement Information Protection Act earlier that year to override its own freedom of information legislation.
Charlene Snow, 67, gave up after a seven-hour wait in a Cape Breton emergency room the day before Holthoff died. She went home. She died about an hour later.
Yvon Brossoit, 80, died at Anna-Laberge Hospital in Châteauguay, Quebec, on November 29, 2023. Triaged Code 3 with abdominal pain, he was supposed to be reassessed every 30 minutes. He was not reassessed. He died eleven hours after his arrival of a ruptured abdominal aortic aneurysm without ever being seen by a medical professional. The coroner’s report cited organizational dysfunction. The criteria that would have placed him in a monitored bed had been mandated by the provincial Ministry of Health nine months earlier. They were not in place on the day he arrived. He was the third patient to die at Anna-Laberge in similar circumstances inside three weeks.
Prashanth Sreekumar, 44, an accountant and father of three, arrived at Grey Nuns Community Hospital in Edmonton on December 22, 2025, with severe chest pain. He was triaged. An ECG was performed and found nothing significant. He waited eight hours. When he was finally called to the treatment zone, he collapsed within seconds and went into cardiac arrest. The Alberta government ordered a fatality inquiry the following month. Around the same time, Dr. Paul Parks, the past president of the Alberta Medical Association, sent the province a list compiled with colleagues of six potentially preventable deaths in Alberta emergency departments over a two-week period in late December 2025 and early January 2026.
These are the cases with names. The cases without names are more numerous. Manitoba has invoked its Personal Health Information Act to deflect questions in the legislature. New Brunswick does not report to the national emergency department database at all. Nova Scotia uses its quality-improvement legislation to seal internal reviews. The provinces with the most public emergency-department deaths are systematically the least visible in the national data.
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The number
The McNaughton study warrants careful attention because it changes what we are allowed to think about emergency department walkouts.
Until 2024, the dominant Canadian research finding — anchored in a 2011 study published in the British Medical Journal — was that long emergency department waits were associated with worse patient outcomes, but that patients who left without being seen were not at meaningfully elevated risk. Hospital systems were free to treat walkouts as an operational annoyance. The patient had chosen to leave. If they were truly sick, presumably they would have stayed.
McNaughton and her colleagues at ICES — the Ontario research institute that links the province’s administrative health data — reopened the question with nine years of records covering more than three-quarters of a million walkout events. They compared the pre-pandemic baseline of April 2014 to March 2020 against the most recent fiscal year available, April 2022 to March 2023. They excluded the acute pandemic disruption from the comparison so the finding would represent the new normal, not the shock.
Pre-pandemic, the median monthly walkout rate in Ontario emergency departments was 3.1 percent. The single highest month in six years was 4.0 percent. In the most recent year, the median was 4.9 percent and the single highest month was 5.7 percent. Of the 36 months following April 2020, the monthly walkout rate exceeded the pre-pandemic high of 4.0 percent in 15 of them. Of the most recent 12 months in the study, walkouts exceeded the pre-pandemic ceiling in 9. This happened with fewer total emergency department visits than before the pandemic, not more.
More patients are leaving. They are leaving from a smaller pool of people seeking care. And they are dying at higher rates than the patients who left in the years before 2020.
Adjusted for age, sex, and prior hospitalizations, patients who left without being seen in 2022-23 had a 14 percent higher risk of death or hospitalization within seven days, a 24 percent higher risk of death within 30 days, and a 46 percent higher risk of death within seven days, compared to the pre-pandemic baseline. In raw numbers, mean monthly deaths within seven days of an Ontario walkout went from 4.9 to 9.0. Mean monthly deaths within 30 days went from 20.7 to 33.1.
A clinician reading the study sees something else: the patients who walked out in 2022-23 were sicker than the patients who walked out before 2020. The proportion classified as emergent rose from 9.2 percent to 12.9 percent. The proportion classified as less urgent fell. This contradicts the most common political deflection, which is that emergency departments are clogged by patients with minor complaints who could go elsewhere. The data shows the opposite. The people leaving without being seen are getting sicker on average. Their median age is 41. Three-quarters have no hospitalization history in the prior five years. They are not the dying-anyway. They are working-age adults with no significant prior illness who go to the emergency department, wait, leave, and then die at a measurably elevated rate.
The authors are careful: they cannot directly link the elevated mortality to specific staffing or crowding metrics, because that data is not consistently available. But they make one observation that closes off the easiest deflection. The mortality risk remains elevated at 30 days, not just at 24 or 48 hours. If the deaths were attributable to a single missed acute intervention, the elevated risk would concentrate immediately after the walkout. It does not. It persists. That points at something larger than a single missed visit. It points at the broader capacity collapse — the missing primary care, the absent specialist follow-up, the post-emergency-department care continuum that has thinned out across the country.
The walkout is the symptom that gets measured, because it is measurable. The underlying capacity crisis is what kills people.
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Protocols on paper
Every named case has the same shape underneath the surface. There is a protocol. The protocol is not followed. Nobody is monitoring whether the protocol is being followed. The patient dies. The institution conducts a review. The review produces recommendations. The recommendations are marked complete. Nobody is monitoring whether the recommendations have actually changed practice.
The Canadian Triage and Acuity Scale has been the national emergency department triage standard since the late 1990s. Every nurse and physician working in a Canadian emergency department knows what CTAS 2 means. They know it requires reassessment every 15 minutes. They know CTAS 3 requires reassessment every 30 minutes. The standards are not obscure, contested, or poorly disseminated. They are foundational.
On April 16, 2026, in the 13th day of the Winterstein inquest, the regional chief of emergency medicine at Niagara Health, Dr. Rafi Setrak, was asked under oath about the recommendations generated by the hospital’s internal review of Winterstein’s death. He confirmed the recommendations had been developed, marked complete, and tracked as green in the hospital’s quality and patient safety system. Asked whether the formal protocols those recommendations were supposed to produce actually existed in his department, particularly the protocols for working with patients who used substances, he conceded he was not aware of any.
The regional chief of emergency medicine at the hospital where Heather Winterstein died, four years after her death and after a formal post-incident review marked the corrective recommendations as complete, did not know whether the resulting protocols operated in his own department.
Earlier in the inquest, Niagara Health’s executive vice-president of clinical operations, Heather Paterson, was asked whether hospital management was monitoring whether the 15-minute reassessments required by CTAS 2 were being conducted in the waiting room. She said: I don’t think so. Asked what system the triage nurses used to track reassessments, she said: I can’t answer that question, I’m not sure what system they would use.
Andrea Demery, the triage nurse who looked at Winterstein for three to five seconds, testified the reassessment requirement still cannot be reliably met. She said she does not feel there are enough resources to complete the task.
On the same day Setrak conceded the post-review protocols did not exist, the hospital’s chief of staff, Dr. Kevin Chan, conceded under direct questioning from the jury that anchoring bias likely played a role in Winterstein’s care. He explained that clinicians, particularly in high-volume environments, narrow their thinking based on prior assessments. Once a patient has been categorized — once social issues has been entered as a diagnostic placeholder — the second clinician who sees the returning patient is reading through that prior frame. Chan also confirmed that on December 10, 2021, Niagara Health was still operating on paper-based records, and Winterstein’s prior-visit context may not have been readily visible to the triage nurse on her second presentation. She came back because she was told to come back. The instruction she followed assumed her first visit would inform her second assessment. The assumption was not built into the information architecture.
These are not contested facts. They were conceded under oath by the senior clinical leadership of the hospital.
The pattern is identical at the other named cases. At Anna-Laberge, the criteria that would have placed Brossoit in a monitored bed had been mandated by the provincial Ministry of Health in February 2023. They were not operative on the day he arrived in November 2023. The Quebec coroner described the gap between mandate and operation as organizational dysfunction. At the Dr. Everett Chalmers Regional Hospital, Horizon’s own internal quality review, obtained through New Brunswick’s right-to-information legislation, used the phrase: lack of consistent patient monitoring and the inability to meet standards in the emergency department waiting room decreases the likelihood for early recognition in patient health decline. That is institutional language for: the protocol exists, we cannot make it operate, and people die because we cannot.
Sinclair’s inquest in 2014 produced 63 recommendations. Manitoba implemented 55 of them. A working group led by the University of Manitoba’s Dr. Barry Lavallee published an interim report in 2017 titled Out of Sight, examining what those recommendations had actually changed in the nine years since Sinclair’s death. Their conclusion was direct: the recommendations had not protected Indigenous patients in the way they were intended to. No staff member had received any disciplinary action from a workplace or a professional governing body. The College of Registered Nurses Investigation Committee had referred zero cases from the Sinclair file to its Discipline Committee. The Sinclair family appealed six Investigation Committee decisions to the Board of Directors. All six were dismissed.
The institutional accountability machinery exists. It is intricate, well-documented, and elaborately tiered. It does not produce accountability.
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The second harm
There is a question that almost nobody covering these cases asks honestly. What happens to the nurse who does not do the 15-minute reassessment because there are 47 patients and three nurses where there should be four? What happens to the physician who declines bloodwork in the 14th hour of a shift in a department running at 200 percent capacity? What happens to the paramedic who has to choose, in the 45-minute wait outside an emergency entrance, which of the two patients in the back of the rig will see a doctor first?
The answer has a clinical name. It is moral injury. It is distinct from burnout, which is exhaustion. Moral injury is what happens when someone is placed, structurally, in a position where they cannot act in accordance with their own training and conscience, and is then held responsible for the outcomes of being placed in that position. The term originated in military psychology, applied to soldiers who could not save what they were ordered to protect. It applies, with growing weight, to Canadian healthcare workers.
Andrea Demery cried on the stand. She described the day Winterstein arrived as very, very difficult, in the middle of a pandemic where many nurses were being told to stay home if they had any COVID symptoms. She knew the protocol. She knew CTAS 2 patients can deteriorate quickly. She had three to five seconds to glance at a young woman in a wheelchair and triage her against 46 other people who all needed to be seen. She did not have the hands. She did not have the minutes. Heather Winterstein collapsed in front of her. Four years later, a lawyer for the family asked her, on the record, why the reassessment protocol had not been followed. The honest answer was that 47 patients and three nurses cannot produce 15-minute reassessments. There is no clean way to say that in front of a grieving family without sounding like an excuse.
Dr. Alika Lafontaine, the first Indigenous president of the Canadian Medical Association, has made the structural argument about this for several years now. He has described what front-line clinicians have been carrying: it is not normal for physicians and learners to be witnessing preventable death and disability at this scale. He has also described the response of the system to its own clinicians’ distress as a form of design choice, not nature: we have normalized the fact that people are burned out because that’s just the way that things are, when in reality, that probably isn’t the way things are, we’ve just designed systems to provide those outputs.
This is the same argument, in clinical language, that the Winterstein inquest’s evidence makes about patient safety. The protocol exists on paper. The conditions to execute it do not exist. The institution writes the protocol, designs the staffing, and absorbs neither the failure of the patient outcome nor the harm to the clinician who could not deliver it. Both losses are pushed downward — onto the families of the dead and onto the workers who watched it happen.
The feedback loop is closed. Nurses leave the profession. Many of those who leave name moral injury, in language or in substance, as the reason. Their departure increases the staffing gap, which increases the impossibility of executing the protocol, which produces the next preventable death, which produces the next inquest, which produces the next set of recommendations marked green. The clinicians who remain at the bedside know all of this. They are not blind to what the system is doing to them. They simply have not yet been offered, by anyone with authority, an exit ramp from the loop.
The accountability machinery, in addition to producing no accountability, also produces no protection for the people executing the impossible task. Demery was asked, in a virtual courtroom four years after the worst day of her professional life, to explain to a coroner’s jury why she had failed to do something she was structurally prevented from doing. The hospital’s chief executive officer, Lynn Guerriero, who oversees the institutional decisions about staffing and resources, did not testify on the same day. The chief of emergency medicine, Setrak, conceded that the post-review protocols he was supposed to be operating did not exist in his department. None of them stood where Demery stood. None of them were asked to account for their part of the chain in the same room as the family.
The patients who died are the first harm. The clinicians who watched them die — and who continue to be sent into shifts that the institution knows it cannot resource to its own published standards — are the second.
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Accidental
The Winterstein inquest jury returned its verdict on April 22, 2026. They found her death was accidental, caused by septic shock from sepsis with delayed treatment. They issued 68 recommendations, more than any comparable Canadian inquest. The family had asked for a homicide finding. The presiding officer, Dr. David Eden, had instructed the jury that an inquest homicide finding required non-accidental actions resulting in injury that caused or substantially contributed to death. He had also instructed them, in language that effectively foreclosed the option, that it was not enough to conclude that care could have been better, and not enough to conclude that a death may have been preventable.
By that standard, no Canadian emergency department death in this pattern can be called a homicide at inquest. By that standard, every one of these deaths will be called accidental. The system the inquest is designed to scrutinize has been pre-defined as incapable of homicide as long as the failure is structural rather than personal.
Heather Winterstein’s mother, Francine Shimizu-Orgar, issued a statement. The truth has come out, she said, about the biased and unfair treatment her daughter received because she was Indigenous and had a history of substance use disorder. The system must change, she said, for people like Heather and for Indigenous people across Canada.
Her father, Mark Winterstein, called for Niagara Health and the regional paramedic service to begin implementing the recommendations immediately. If this inquest spares even one family the loss we have suffered, he said, it will have been worth it.
The recommendations will be tracked. There is no provincial body responsible for monitoring their implementation. There is no enforcement mechanism if they are ignored. There is no audit infrastructure to confirm that any protocol generated in response to them is operative at the bedside. There is no mechanism to prevent Niagara Health from marking them green and finding, four years from now, that the chief of emergency medicine cannot confirm whether they exist.
This was the path Manitoba walked after Sinclair. New Brunswick walked it after Mesheau. Quebec is walking it now after Brossoit. Alberta is at the front of the path with Sreekumar. The path always ends in the same place. The recommendations sit on shelves. The next family arrives at the next emergency department. The next nurse looks at them for three to five seconds. The next post-mortem review is conducted, and marked complete, and filed away, and forgotten.
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What the numbers will not tell
The Canadian Institute for Health Information published its annual emergency department report on February 19, 2026. There were 16.1 million unscheduled emergency department visits in Canada in the year ending March 2025, up from 15.5 million the year before. For patients who were eventually admitted, nine out of ten visits were completed within 48.5 hours. For patients who were eventually discharged, nine out of ten were completed within 8 hours. The report does not say how many of the patients in either bucket left without being seen. It does not say how many died within seven days, or 30 days, of doing so. The data linkage that made McNaughton’s Ontario study possible does not exist nationally.
What the report does say, for those who read it carefully, is which provinces are participating in the national database and which are not. Quebec, Ontario, Saskatchewan, Alberta, and Yukon report more than 95 percent of their emergency department visits to the National Ambulatory Care Reporting System. British Columbia reports 76 percent. Manitoba reports 75 percent. Prince Edward Island reports 73 percent. Nova Scotia reports 57 percent. Newfoundland and Labrador, New Brunswick, the Northwest Territories, and Nunavut do not participate at all.
New Brunswick, where Mesheau died, where two more patients died in the following weeks, where the death cluster prompted the firing of a health authority CEO and the dissolution of two provincial health authority boards, does not contribute its emergency department data to the national database. Nova Scotia, where Holthoff and Snow died in consecutive days, where the province amended its quality-improvement legislation to override its own freedom of information act, contributes barely more than half of its data. The provinces with the most public emergency department death stories are systematically the least counted.
This too is design, not accident. A system that does not measure something cannot be held accountable for it. A jurisdiction that does not report its data to the national aggregator cannot be benchmarked against its peers. A coroner’s jury that is told it must find a death accidental unless someone intentionally caused it will, every time, find the death accidental. A hospital that marks its post-incident recommendations green and is not audited on whether the underlying protocols operate at the bedside will, every time, mark them green.
The emergency department is the most visible part of the queue, but it is not the longest part. Beyond the waiting room there is the wait for the inpatient bed, the wait for the surgical slot, the wait for the specialist consult, the wait for the diagnostic image, the wait for the long-term care placement that frees the hospital bed for the next admission. The Second Street think tank, drawing on freedom-of-information requests submitted to provincial health authorities, counted 23,746 Canadian patients in fiscal 2024 who died while on a healthcare waitlist of some kind. The figure aggregates surgical, diagnostic, specialist, and long-term care queues without distinguishing whether the wait itself caused the death, and Second Street’s own methodology presents it as a system-stress indicator rather than a direct mortality count. The number is contested for that reason. The contest does not change the underlying point. The country has not chosen to build a measurement infrastructure that would let it know which of those 23,746 deaths the wait was responsible for.
The Commonwealth Fund’s 2024 Mirror Mirror international comparison ranked Canada last out of ten high-income countries on timely access to care. The same report ranked Canada among the highest spenders on health per capita in the same group. The combination — high spending, last-place access — is not new. It has been the Canadian position in the Commonwealth Fund rankings for more than a decade. The deaths described in this piece are one register of what that combination means at the level of an individual patient on an individual day. The 23,746 are another. The architecture that produces both is the same architecture.
The architecture that produced 33 deaths a month in Ontario’s walkout cohort is the same architecture that prevents the country from learning whether that number is higher elsewhere, and the same architecture that prevents the country from learning what fraction of the 23,746 broader queue deaths the wait itself caused. It is the same architecture that converts every individual death into an accidental one. It is the same architecture that asks Andrea Demery, four years after the fact, to explain a failure that was engineered above her pay grade. It is the same architecture that produces, after every death, a report that says the protocol was in place, and that everyone followed the recommendations, and that improvements are continuing to evolve.
Heather Winterstein went to the hospital for help, her mother said. She was turned away.
She was not the first. She is not the last. The emergency rooms of Canada are not failing. They are operating exactly as they have been designed to operate — with protocols that exist on paper, audits that do not happen, recommendations that produce no operational change, accountability findings that find nothing accountable, and data infrastructures that ensure the next family will arrive at the next hospital believing, for the same reasons her family believed, that someone is keeping count.
Someone has to start keeping count.
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Editor’s note
The Old Guardian publishes last with verified facts rather than first with incomplete information. This piece draws on inquest testimony, coroner’s reports, peer-reviewed research, federal health data, and contemporaneous reporting from CBC News, the Globe and Mail, the Halifax Examiner, and regional outlets. Where direct quotations are used, they have been verified against the primary source. Where institutional decisions or admissions are described, they have been verified through inquest transcripts, freedom-of-information disclosures, or official reports. No claim is advanced that has not been anchored to a named primary source.
The author’s editorial position is that the institutions named in this piece — Niagara Health, Manitoba’s Health Sciences Centre, Horizon Health Network in New Brunswick, Anna-Laberge Hospital in Quebec, Cumberland Regional Health Care Centre in Nova Scotia, Grey Nuns Community Hospital in Alberta — bear varying degrees of operational responsibility for the deaths described. The position taken here is that institutional responsibility is structural and systemic, that the same governance failures appear across every named case in every province, and that the policy response to date has been recommendation-driven rather than enforcement-driven. The author does not advance any claim of criminal responsibility against any individual clinician. The position taken here is that front-line clinicians, including those whose specific actions are described in inquest evidence, are themselves victims of an institutional architecture that is designed to displace responsibility downward.
The author has been monitoring this pattern for several months and intends to publish further pieces tracking the implementation status of the 68 Winterstein recommendations, the still-pending Sreekumar fatality inquiry in Alberta, the discretionary inquest into the death of Finlay van der Werken in Ontario, and the broader question of why provinces have not been required to report consistently to the national emergency department database. Readers with relevant primary-source documents, including hospital-specific quality-improvement records, internal incident reviews, or freedom-of-information disclosures from any province, are invited to make contact through The Old Guardian’s secure submission channel.
Principal sources
McNaughton CD, Austin PC, Chu A, et al. Turbulence in the system: Higher rates of left-without-being-seen emergency department visits and associations with increased risks of adverse patient outcomes since 2020. Journal of the American College of Emergency Physicians Open. 2024 Dec 18;5(6):e13299.
Office of the Chief Coroner of Ontario. Inquest into the death of Heather Ashley Winterstein. Verdict and recommendations released April 22, 2026. Presiding officer: Dr. David Eden. Inquest counsel: Julian Roy, Christina Varrette, Vivian Sim. Daily proceedings covered by CBC News (Paul Forsyth, reporter).
Brian Sinclair Working Group. Out of Sight: An Interim Report of the Sinclair Working Group. September 2017. Lead author: Dr. Barry Lavallee, University of Manitoba.
Canadian Institute for Health Information. NACRS Emergency Department Visits and Lengths of Stay. Annual release, February 19, 2026.
Coroner’s Bureau of Quebec. Reports of Coroner Dr. Jean Brochu (Yvon Brossoit, June 2025) and Coroner Dutil (Anna-Laberge, 2024).
Inquest into the death of Darrell Mesheau. New Brunswick. April 2024. Coverage by CBC News (Bobbi-Jean MacKinnon, reporter).
Government of Alberta. Fatality inquiry into the death of Prashanth Sreekumar. Ordered January 2026. Documentation of preventable-death cluster compiled by Dr. Paul Parks, past president, Alberta Medical Association, January 11, 2026 (obtained by CBC News).
Halifax Examiner. Coverage of Quality-Improvement Information Protection Act amendments and the Allison Holthoff case, 2022-2023.
Second Street. Annual report on patients who died on Canadian healthcare waitlists, fiscal 2024. Methodology based on freedom-of-information requests submitted to provincial health authorities; the figure aggregates surgical, diagnostic, specialist, and long-term care queues and is presented by the publisher as a system-stress indicator rather than a direct mortality count.
Commonwealth Fund. Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System Compared Internationally. International comparison of ten high-income health systems, including Canada, on access, quality, and equity measures.
Canadian Medical Association. Public statements and writings of Dr. Alika Lafontaine, CMA President 2022-2023, on physician moral injury and Indigenous health.