Answers sought after Surrey man’s in-care death

Patient’s family says their pleas to three hospitals, including White Rock's Peace Arch Hospital, were ignored

The family of a Surrey man who died in February in a seven-storey fall from St. Paul’s Hospital in Vancouver says the tragedy has links to care he received at two local hospitals in the weeks prior.

Spencer Walden’s brother, Brodie, said his mother, spouse and siblings decided to go public with Spencer’s story after months of feeling “stonewalled” by health officials during their efforts to get answers and have a ruling – that his death was a suicide – reversed.

The death last month on Highway 99 of a woman – who Peace Arch News reported had been released from Peace Arch Hospital against her family’s wishes earlier that same day – was the final straw.

“When I saw (the article), I sent it out right away,” Spencer’s widow, Nicki Walden, told PAN. “How are they not taking accountability?”

Brodie said his brother’s story spans three hospitals.

“It’s a mess,” he said. “Surrey Memorial discharged him early when we asked them not to, Peace Arch gave him day passes when we asked them not to, St. Paul’s didn’t move him when we asked them to.

“Unfortunately, he paid the price.”

Fraser Health officials declined to comment on the specifics of Spencer’s case, but said deaths are reviewed by the health authority in which they take place. St. Paul’s Hospital is under the mandate of Providence Health Care.

“The tragic loss of a loved one is heartbreaking and our thoughts are with them during this very difficult time,” FHA spokesperson Tasleem Juma said Monday by email.

“Because this death occurred in another health authority, they take the lead in reviewing the patient’s death. We cannot speak to the specifics of this case, but can say generally, if they request information from us during their investigation, we would contribute any relevant details about the patient’s care.”

According to Spencer’s family, the care he received at Peace Arch Hospital is particularly relevant.

“For them not to listen when we’re so involved, it’s really disheartening,” said Rhianna Juco, Spencer’s older sister. “We know the signs, we know the care plan, we know what to do. It’s so mind-boggling.

“If they hadn’t released him, I highly doubt that we would be in this position. What happened to him was extremely preventable.”

Father ‘loved life’

Spencer was 32 at the time of his death. Married seven years, he and Nicki had one child together. Daughter Alina – who is now four years old – last saw her dad on the day he died, when they enjoyed a Jell-O dessert together during a lunch visit at St. Paul’s Hospital.

According to his family, Spencer was a kind, generous man who “loved his life” but would go through “troubling times” every few years due to his mental illness.

Diagnosed when he was a teenager with schizoaffective disorder, his family says they worked hard to ensure he always had a strong support system and care team, and that Spencer was high-functioning and lived a productive, happy life.

As an adult, Spencer operated his own window-washing business, was committed to his faith and enjoyed helping others.

Outside of those close to him, most people had no idea he lived with mental illness, they said.

Episodes of psychosis over the years were typically rooted in Spencer’s “really bad habit of winding his own doses down,” and hiding the fact he wasn’t taking his medication, said Brodie. They arose about every three years, and lasted three to four weeks, he said.

“We were there to always help him and make sure he made it through safe,” Brodie said.

In the months before his death, Spencer’s family knew he was struggling more than usual. They saw his behaviour start to change around November of last year – he became distant, disengaged, had difficulty concentrating and showed signs he was internalizing something.

Nicki said she took her husband to see his case manager at Surrey Mental Health, where it was suggested the family take him to Surrey Memorial Hospital for assessment by a psychiatry team.

Hospital discharge

On that day in early January, he waited eight hours to see a doctor; a wait he endured because he knew he needed help, his mother Rosanne said.

Admitted to the psychiatric ward, Spencer was discharged after two weeks – a decision that surprised his family given it was clear to them that he remained incapable of looking after himself.

In the days that followed, his state of active psychosis worsened, and they called on Surrey RCMP to help get him to Peace Arch Hospital – he needed urgent medical attention and “we had had success here before,” Nicki said.

Spencer was admitted Jan. 24.

While out on a therapeutic pass issued the morning of Feb. 13, Spencer called Rosanne to say he would not be returning to the hospital, claiming that he was ill and just needed some time away.

His mother said she talked him into returning, then called hospital staff to advise of the conversation and implore them not to issue him further passes.

“I told them he was a flight risk,” Rosanne said, as the family gathered outside Peace Arch Hospital Monday. “I said, ‘You cannot give him any more passes.’”

The following day, Spencer was issued two passes, one in the morning and one in the afternoon, his family said.

He was late returning from the first; he did not return after being issued a second.

According to White Rock RCMP, officers were dispatched at 6 p.m. Feb. 14 to assist in locating a man “who went out for a smoke break and never came back.”

Sgt. Joel Glen would not identify the subject patient, but did say he was still listed as missing as of 7 a.m. the following morning.

Glen said Wednesday that such assistance is not often asked of police, and only when a “director’s warrant” has been issued by the hospital.

“It doesn’t happen that often. We would only get involved if it’s somebody in the hospital’s custody.”

According to Juma, off-ward privileges are an essential part of a patient’s care plan, are discussed with the patient and family as appropriate, and are to help patients regain their independence ahead of discharge. Approval of such privileges is authorized by the patient’s doctor only after a mental-status assessment has been completed in consultation with a patient’s care team.

Family input “is one of many perspectives that inform the physician’s final clinical decisions,” Juma said.

In an interview conducted earlier this month – prior to Spencer’s family contacting PAN last week – Dr. Nigel Fisher, Fraser Health’s program medical director for psychiatry, said that while relatives’ input on issuing passes to an adult patient is considered, they “don’t necessarily have a veto on saying someone shouldn’t leave.

“The clinical team would listen very carefully to that,” Fisher said. “The vast majority of the time, there’s agreement between family, patients and clinicians as to what should happen. On odd occasions, there isn’t that agreement, and those are the occasions, whatever the outcome, that tend to attract the most attention.”

Final days

According to the family, Spencer arrived at St. Paul’s Hospital by ambulance early Feb. 15. Despite their concern and requests, he was never transferred to the psychiatric ward, a fifth-floor unit with shatter-proof windows.

His death three days later was ruled a suicide – but it’s a determination his family does not accept.

“I have a small daughter and I don’t want her to think that her dad killed himself,” said Nicki. “I don’t want her to feel that he left her by choice.

“His life was a gift. To me, it’s very important that his legacy isn’t distorted. He was such an amazing man.”

The family says they were initially told Spencer had jumped to his death.

However, reports they later obtained from police and hospital indicate Spencer was in an agitated state for 2½ hours before grabbing an oxygen tank, smashing a window, sitting on the window ledge and falling out backwards.

The family said they’ve received no indication that steps were taken to restrain him.

“It’s our opinion he was delusional and he was running from something,” Brodie said.

Nicki said the family would be comfortable if Spencer’s death was ruled as “psychosis-induced.”

“We would like them to take a better look at what happened here. Not sort of put a stamp on it and put in on the pile,” Brodie added.

Under review

B.C. Coroners Office spokesperson Barb McLintock confirmed by email Monday that Spencer’s death is “most definitely” under review.

“It is still an open and active investigation and it is too soon to say whether it will be concluded by a coroner’s report or by a public inquest,” McLintock said.

The family is pushing for an inquest, and today (Sept.16), Rosanne is in Ottawa hand-delivering her son’s story to the offices of Prime Minister Justin Trudeau and the minister of health.

“The rules and regulations surrounding mental health, they have to be looked at,” she said.

She said she hopes her family’s decision to speak out on Spencer’s behalf will inspire others to do the same, and result in change that prevents similar tragedies.

“There’s power in numbers,” she said. “The more (people) talk about this, then maybe one thing will stick in one doctor’s mind.”

Spencer Walden & daughter

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