Posted at 5:00 am.
Hugo Jonca’s investigative team, La Presse
Back and forth in his son’s file
What have psychiatric staff done dozens of times in the case of Isaac Lajeunesse, months after his suicide? This is the question asked by the parents of the young man who died in May 2020 at the age of 19, shortly after leaving the University of Quebec’s Department of Mental Health.
Horrified, his family wanted to know why the facility had let him out on that fateful day. In addition to his medical records, they brought his “diary”: the list of people who had consulted him. “We had gagging,” said his mother, Geneviève Déziel.
She sent the document to La Presse. The list includes 11 names of people who had access to Isaac’s medical secrets up until last February, almost three years after his death. Some of them have never worked with their son, she says.
A known suicide
The young man’s death caused a stir in the capital. In November 2020, Le Soleil investigated how the Quebec University Institute of Mental Health (IUSMQ) had handled his case. “Could Isaac have been saved?” asked journalist Marc Allard in one of the daily newspapers.
The next day, access to the young man’s medical records skyrocketed, according to the access list. Six months after his death.
PHOTO PROVIDED BY GENEVIÈVE DÉZIEL
Eleven people at the Quebec Mental Health University Institute accessed Isaac Lajeunesse’s file after his suicide.
Knowing that people are looking at the records of my son who died by suicide and did not receive the care he needed disgusted me. These individuals have violated their code of ethics out of curiosity or to protect themselves from a potential complaint.
Genevieve Deziel
“That really bothered me,” says Geneviève Déziel. It hurt because your child is actually not being looked after properly and there are people who allow themselves to rummage through the file. »
PHOTO PATRICE LAROCHE, LE SOLEIL ARCHIVE
Staff at the University of Quebec’s Institute of Mental Health consulted Isaac Lajeunesse’s file months after his death, which outraged his mother, Geneviève Déziel.
Isaac’s mother has made a number of inquiries to the trustees of the orders who oversee the work of these professionals. Two employees were convicted for their indiscretions. However, orders prevent La Presse from naming her in this article and giving more details.
According to the medical record log, one of those professionals returned there by February 15, almost three years after Isaac Lajeunesse’s death. The IUSMQ therefore granted him access to files during the investigation, then the preliminary proceedings and the hearings before its Disciplinary Board.
Unsuccessful complaints to the CIUSSS
Geneviève Déziel has had less success with the CIUSSS de la Capitale-Nationale Service Quality and Complaints Officer, which oversees the IUSMQ. She got the impression that the organization did not want to impose sanctions on staff responsible for breaches of medical confidentiality.
In a letter seen by La Presse, CIUSSS Deputy Complaints Commissioner Marjorie Dumas nevertheless acknowledges “a departure from professional practice” by an unidentified staff member against whom a complaint has been filed.
The professional even admitted that her inspection of the file was “not optimal or permissible in the context”.
However, the deputy commissioner adds that this worker was “motivated for quality reasons” and ultimately her letter does not mention any specific disciplinary action taken against any of the staff members reported.
Geneviève Déziel unsuccessfully requested a review of that decision. Isaac Lajeunesse’s mother also contacted the Quebec Ombudsman and the Commission d’accès à l’information, who declined to investigate.
public relation
Among the 11 people against whom his complaint was directed, an assistant to the management of the CIUSSS de la Capitale-Nationale spent more than an hour in his son’s file the day after the article in Le Soleil in November 2020.
Management “arrested” this employee “to respond to media work,” Marjorie Dumas said in the letter. “I therefore see no discrepancies regarding the inspection of your son’s file,” he said in his reply.
In principle, however, the confidentiality of this information is protected by several laws, including the Charter of Rights and Freedoms.
Patrick Martin-Ménard, a lawyer specializing in medical liability, insists that, in addition to the nursing staff, archivists and administrative staff, who are authorized within the scope of their duties, all employees must have the patient’s permission to consult their file.
In the case of a deceased patient, it is very difficult for the family to gain access to the file, and many fail, he says. So what can a deputy director of the CUSSS do with this information to manage the public relations of the hospital?
Patrick Martin-Ménard, lawyer specializing in medical liability
The OIIQ refuses to investigate
Geneviève Déziel also asked the General Counsel of the Order of Nurses of Quebec (OIIQ) to investigate the actions of another IUSMQ employee. The Professional Inspectorate refused to bring the professional’s case before the Disciplinary Board.
“The latter acknowledged that she had no professional reason to consult her son’s file and that it was a miscalculation on her part, however, the deputy general manager admits in a letter to Geneviève Déziel obtained by La Presse. She apologized and showed sincere remorse and thoughtfulness in front of us. »
We have decided not to release the nurse’s name as she has not been convicted.
The CIUSSS did not answer our questions on the matter, citing the confidentiality of its staff’s files. Spokeswoman Mélanie Otis only mentions that the organization must “review and take the necessary corrective actions” when a situation “might indicate that deficiencies have been identified”.
After suicidal crises, Isaac Lajeunesse also visited the Center hospitalier universitaire de Québec (CHUQ). Geneviève Déziel also received the logging of her file at this facility and, according to her, several nurses who consulted her never treated Isaac and should never have ventured there. The establishment did not answer our questions on the subject.
Five other complaints by Geneviève Déziel against the orders for breach of confidentiality are still under investigation.
Twice as many consultations after his death
Three years after her sister’s suicide, Josée Bilodeau found that after her disappearance, hospital staff had multiplied consultations of her medical record. “I fell out of my chair,” she said. After his death, there was a double take. »
PHOTO PASCAL RATTHÉ, SPECIAL COLLABORATION
Josée Bilodeau was “stunned” to discover all the traffic recorded in her sister’s medical chart after her death.
Like Isaac Lajeunesse, Suzie Aubé attended the University of Quebec’s Institute of Mental Health (IUSMQ). Suzie Aubé, like him, committed suicide immediately after her release. Her family had not been informed of her release and were therefore unable to draw up a security plan to protect her.
Josée Bilodeau participated in a public coroner’s inquiry into suicide. This is how, in the summer of 2022, she was able to get hold of the “log” of her sister’s medical records: the list of people who accessed that information.
“I saw it had 23 pages,” she says. I put this document aside because I was so stunned. »
Examination of the coroner
As part of public hearings on suicide, the coroner investigated a number of deaths in circumstances that call into question the quality of care given to the disappeared. For Josée Bilodeau, investigating her sister’s case is certainly not unrelated to the huge “popularity” of her file, she says.
PHOTO PROVIDED BY JOSÉE BILODEAU
Suzie Aube
A few days before the first hearings in December 2019, a social worker, Marie-Ève D’Amours, entered Suzie Aubé’s file and shows the transcript of her file obtained by La Presse.
Marie-Ève D’Amours was not part of her first forays into the Suzie Aubé case. In fact, the social worker was there eight times in the year after her death.
Josée Bilodeau cannot explain it. “Nobody should look at a medical record if they’re not involved in it,” she says. Then there is the responsibility of someone who is being treated. »
She requested an investigation of Marie-Ève D’Amours from the Syndic of the Order of Social Workers and Marriage and Family Therapists of Quebec. The organization confirmed to him at the end of February that they would investigate his case.
Already convicted
Marie-Ève D’Amours has just been fined $2,500 and will face attorneys’ fees after pleading guilty to accessing another person’s file without cause. A publication ban prohibits La Presse from identifying the victim of his indiscretions. She clicked 56 times in the file of the affected patient.
According to the decision, the legal assistant claimed that the offense committed in this file was “of substantial gravity” because “she had viewed strictly confidential information”.
But the disciplinary council of social workers saw it differently. Marie-Ève D’Amours’ violation of the code of ethics was “an isolated gesture in the context of a previously flawless career,” according to the career supervisor.
“Even if the offense is objectively serious, the Council considers that imposing the minimum penalty is sufficient to protect the public and maintain their confidence,” reads the February 28 decision.
Other IUSMQ experts also consulted Suzie Aubé’s file after her death for unclear reasons. Josée Bilodeau is preparing new lawsuits against her.
The CIUSSS de la Capitale-Nationale, which oversees the institute, refused to comment on the case of Suzie Aubé and her social worker.
another sadness
After mourning her sister, Josée Bilodeau lost her brother, who also died last November. In the face of all this drama, why devote energy to demanding accountability for access to Suzie Aubé’s medical records?
“To me, it’s a tribute to him,” she said. She didn’t die with dignity. The idea is to give it back. »
Josée Bilodeau also wants to help better protect Quebecers’ most sensitive confidential information. “I find it scary to know that whether we’re alive or dead, we can still look at our medical records when we shouldn’t be there. »
PHOTO OLIVIER PONTBRIAND, ARCHIVE LA PRESSE
La Presse has identified cases of breaches of medical confidentiality across Quebec.
Numerous violations of medical confidentiality
In all parts of Quebec, disciplinary decisions are the dark chronicle of thousands of indiscretions perpetrated by some unscrupulous health workers.
Morbid curiosity in the file of a young suicide
“There are about fifteen people who consulted my daughter’s medical records while her body was still warm,” denounced the mother of a 13-year-old teenager who committed suicide in a Laurentians village in 2017.
A non-disclosure order prohibits us from disclosing her name. She has filed private lawsuits against employees for wantonly requesting her daughter’s medical information.
One of them, Julie Déziel, has just been found guilty and is awaiting sanction. Another nurse, Emmanuelle Verdier-Huot, was fined $2,500 for leaving her session open on the clinical system, which would have allowed an unidentified third party to view the file.
The mother also filed three complaints against doctors who had viewed her child’s data without giving a reason.
CISSS Director of Communications, Human Resources and Legal Affairs in the region, Antoine Trahan, says he is “shocked by the professional misconduct which has added to the family’s pain”.
According to him, the young girl’s situation “had an important echo” in Laurentian hospitals. “Controls have been tightened in all of our care teams. »
A single nurse, 1109 files consulted
In Gaspésie, in 2020, auxiliary nurse Caroline Therrien was ordered to undergo five months of radiation for accessing the files of 1,109 patients 2,339 times without authorization.
Among the targets of his indiscretions are: his own family, his colleagues and their relatives, public figures in the region…
According to the decision, Caroline Therrien began consulting these files “to identify resources, tips and tricks that might help someone close to her.”
At the trial against her, Caroline Therrien said she was unaware that inspection of files without reason was prohibited.
Union defends overly nosy nurse
Also in the Gaspé, a nurses’ union tried to prevent her dismissal despite their serious indiscretions.
The region’s CISSS accuses Sandra Rioux of having consulted the medical records of 174 people whom she did not follow in 2018 and 2019, according to a ruling by the Arbitration Court consulted by La Presse.
These breaches of confidentiality had serious consequences. The nurse revealed to those close to an affected patient an intimate matter mentioned in her file.
The Eastern Quebec Nurses, Paramedics and Respiratory Therapists Union, which is affiliated with Quebec’s central unions, nevertheless filed a complaint to challenge Sandra Rioux’s dismissal. The referee refused.
According to La Presse’s reviews, Sandra Rioux has not been prosecuted before her Disciplinary Board and remains on the register of the Order of Nurses of Quebec.
Joint access with “homeopathic consultants”
In Quebec, a pharmacist was fined a year of radiation in 2019 for allowing his staff “consultants in homeopathy or naturopathy” to use his access to the Quebec Health Record (DSQ).
This centralized medical information system is intended exclusively for healthcare professionals who go there for clinical reasons as part of a service to a patient.
“In one of the cases, the unauthorized person accessed the DSQ more than 50 times without authorization,” explains the Disciplinary Board of the Order of Pharmacists of Quebec in its decision against Yvan Bourgault.
This is by far not the only accusation that the professional supervisory authority accuses him of. Overall, Yvan Bourgault was sentenced to 30 months of radiation and a $12,000 fine for a series of offenses including selling drugs without a prescription.
A doctor in a colleague’s file
A surgeon at the University of Montreal Hospital Center (CHUM) was ordered to undergo three months of radiation in 2020. He gave his son access to a patient’s medical record at the facility, which he did not follow.
This patient, named “Ms. A” in his Disciplinary Board’s decision, was a colleague with whom she had “several professional conflicts”.
The unwarranted consultations took place at his home while he had remote access to CHUM’s medical record system.
“It is my minor children who would probably have briefly used my computer and opened this medical record,” explained Dr. Alain Jean Barrier according to the decision of the Disciplinary Board of the Medical Association.
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