Alberta Hospital Edmonton needs more staff, better monitoring of new patients, judge says in fatality report
CBC
WARNING: This story discusses suicide and suicidal ideation.
An Alberta judge has issued recommendations to safeguard patients who may be struggling with thoughts of suicide after examining the death of a 25-year-old woman at an Edmonton psychiatric hospital.
The recommendations come more than two years after a fatality inquiry was held into the death of Kaitlind Credgeur, who took her own life in 2018 at Alberta Hospital Edmonton (AHE).
Fatality inquiries are held to help clarify the circumstances of a death and can lead to recommendations for preventing similar deaths but they are not meant to determine legal responsibility.
Two of Credgeur's family members told CBC News it was difficult listening to her death being discussed in detail during the inquiry but they believe the judge's recommendations, if implemented, will help prevent future tragedies.
"It doesn't bring closure but it brings some comfort that maybe someone else could be saved," said Tina Credgeur, Kaitlind's mother.
Three nurses, a psychiatrist and an AHS executive director for addiction and mental health testified at the two-day fatality inquiry, held in July 2021.
According to the inquiry report, which was recently published, Credgeur had been transferred to AHE from the Royal Alexandra Hospital on June 21, 2018, after an intentional drug overdose. When she was admitted to the psychiatric hospital, she had some personal belongings in a plastic bag.
The psychiatrist who assessed Credgeur shortly after she arrived at AHE testified that she expressed a willingness to remain in the hospital and to accept help.
He determined she should be observed every 15 minutes by a nurse or psychiatric aide.
One of the nurses who had been working on Credgeur's unit testified that Credgeur was very pleasant when they spoke. When questioned about her suicidal thoughts, she said they were there but she had no plans or means to act on them.
Another nurse testified that he saw Credgeur sleeping at 7 a.m. the next morning.
At 8:20 a.m., Credgeur's roommate banged on the nurses' station door and told them there was a plastic bag over the 25-year-old's head.
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