Health, Harstad municipality | Selma (66) was found dead on the living room floor:

On the morning of 15 February 2023, Ole Martin Bergan called his wife, Selma Jensen, at home to ask if she was ready to drive out to do some errands. She replied that he had to come home to help her. She couldn’t get out of bed, nor had she managed to call him. Ole Martin went home and drove Selma to the municipal GP’s office in Harstad, which is responsible for the daycare if people need immediate help.

– Mum couldn’t stand on her own two feet. My stepfather Ole Martin had to support her to the counter. Here they were informed that there was no available doctor’s appointment for immediate help. They had to come back later, was the message, says Selma’s son, Tommy Sørensen to iHarstad.

On the way home, Selma felt a little better. She sat down on the stress reliever in the living room, and Ole Martin could go for a quick trip to work with cakes that were left over from the Mother’s Day celebration, before they had to drive back to the doctor’s office.

– When he returned an hour later, mum was lying dead on the living room floor. She had a heart attack, says Tommy Sørensen.

This was two hours after the visit to the doctor’s office.

See the municipality’s response at the bottom of this case.

– Failure of treatment

Selma should have been assessed by a doctor, believes the State Administrator in Troms and Finnmark. According to VG, the Statsforvalteren has pointed out violations of the law for deficiencies in investigation routines.

“Our assessment is that the failure of the treatment unfortunately led to the patient’s death.”

This is written by Norwegian Patient Compensation (NPE). NPE covers compensation for the financial loss, and a person’s effort in the home, when one does not have children living at home. According to NPE, this is valued at NOK 8,000 a year, the so-called Bastrup supplement.

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Selma Jensen from Harstad had been examined and treated for reflux. It is a disease where acid and other contents from the stomach come up into the esophagus. Selma had had stomach problems over time, including vomiting and acid reflux.

But the autopsy report shows that Selma had also had a heart attack in the past. Sørensen believes that heart problems in women are under-communicated.

– I feel a curse that my mother did not get help, both this day and earlier. If it had been discovered earlier that she had heart problems, she would in all probability have been fine. But the doctors had stuck to a clue that she had reflux. I have received some kind of explanation from Harstad municipality that symptoms in connection with heart attacks in women are different from those in men, but that this is so new that people may not be paying enough attention to it. I find that strange, all the time this has been researched for decades. Hasn’t Harstad municipality taken this into account, and can make the correct diagnosis since it is a woman who has a heart attack, asks Tommy Sørensen.

The state administrator points out that the patient’s complaints and symptoms could be compatible with a worsening of the complaints with reflux, but that, according to the journal note, an alternative diagnosis was not considered either.

“The ECG was not taken and possible cardiac symptoms were not assessed either,” writes the Statsforvalteren.

Considering lawsuits

Tommy Sørensen and his family are considering a lawsuit against Harstad municipality because she did not get help on 15 February 2023. Sørensen says that until VG contacted Harstad municipality, no fault was admitted on the part of the municipality.

– I see that Harstad municipality is apologizing now. They have done that in the past too, but I wonder what they are apologizing for. I perceive it as hollow, and a logical flaw when they claim at the same time that they have done nothing wrong.

The family’s lawyer, Anders Hauge, states, according to HT, which discussed the case first, that Harstad municipality has rejected the bereaved’s claim for reparation compensation for the harm they have suffered as a result of the death. A survivor’s compensation can amount to a maximum of NOK 165,000 per survivor.

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– The GP center must have a doctor on standby to whom patients must be allowed to go if immediate help is needed. In our case, it was considered that mum was not sick enough. It’s clearly a misjudgment, and one can wonder where the line is when mum died shortly after the visit, says Tommy Sørensen.

He says that lawyer Anders Hauge is in dialogue with Harstad municipality now. Sørensen does not want to speculate on what a possible claim for compensation will be. The most important thing for the family is that the system changes so that others can get help.

– It’s too late with mom. But if we manage to get the municipality to change the routines, we will have made some progress. I understand that the municipality is a bit stressed after VG mentioned the case, so now we’ll see what happens. It cannot be the case that people should die without receiving medical attention when they need it most.

Would most likely survive

– What do you think the municipality should do?

– I do not have medical expertise, so it is not so easy for me to say. But the municipality must change routines. Perhaps it should be a requirement for all doctor’s offices that there must be a nurse at the counter if you have a day doctor’s call. Perhaps trade unions, employers and the state must work together to secure the GP scheme in a better way. Perhaps Harstad municipality should subsidize a doctor’s office with on-call responsibility during the day for several hours for immediate help. Or perhaps the day care unit should be moved to UNN Harstad.

NPE writes in its justification that the family has been entitled to compensation:

“If the patient had been seen and examined by a doctor, and an EKG examination had been taken on 15 February 2023, it would most likely have been discovered that the patient had heart-related symptoms. She would then be referred to the specialist health service as immediate help. In the specialist health service, the patient’s heart rhythm would have been monitored and treatment measures would have been implemented against the patient’s heart problems. The patient would most likely have survived if she had not been sent home from the medical center without medical supervision.”

The case continues below the picture

Initiates talks with UNN

Municipal director Børge Toft in Harstad says that the case is difficult, and he understands that relatives have strong feelings.

– This case has both a human, legal, organizational and medical side. After the tragic outcome, we have reviewed routines and practices, and we are continuously working on quality improvement in our doctors’ offices as well. This includes measures to prevent something like this from happening again, says Toft.

Among other things, there have been initial talks with UNN Harstad, for the extension of the emergency room to be during the day as well.

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– Now at the beginning of April, regardless of the media reports, the head of the department, the medical service, the municipal chief medical officer, the assistant municipal chief medical officer, the head of the emergency room and the head of the unit meet to continue working with immediate help and the use of *triage at the doctor’s office. We have also obtained a knowledge base from other comparable municipalities on how they organize their immediate assistance during the day. So we continuously look at what we can do to change and improve our routines, says the municipal director.

*Triage is a process where patients are sorted into groups based on their need for immediate health care. Triage is done in hospital emergency departments, emergency rooms and at accident sites and in disaster situations.

When asked by VG whether Harstad municipality will change the routine whereby employees without medical training must prioritize who gets emergency appointments, Toft replies:

– We have not concluded on this. If such a practice is to be established as a norm, this will entail major organizational consequences for Harstad municipality, as well as for other municipalities. Against this background, there is a need to assess whether the State Trustee’s legal position can be fully accepted as a norm.

iHarstad has asked the municipality to get a comment from a medical officer at the medical centre, but the municipality believes that it is Børge Toft who should handle inquiries from the media in this case.