Michael Fowlie’s heart stopped beating just 800 metres from a device that could have saved his life.
Fowlie, an award-winning accountant, was just 28 when he went into cardiac arrest on a sunny Saturday afternoon three years ago while cycling along Purcells Cove Road in Halifax.
Seven minutes later, a bystander began chest compressions. Fowlie’s window of survival was closing as the first ambulance pulled up.
A crowd of people were at the scene, but no one knew a portable defibrillator, which could have reset Fowlie’s heartbeat and saved his life, was lying on a sailboat at a yacht club less than a kilometre away.
“My main concern was why didn’t they send someone to get that defibrillator, or to get the nearest defibrillator?” says Fowlie’s father, David Fowlie.
“I don’t want a cardiac arrest to happen and there be a machine nearby that no one is sent to retrieve. I don’t want that to happen to anyone. And yet, right now, I think it does happen to people.”
Portable defibrillators can be found in schools, rinks, businesses and community centres across the Atlantic region, but there is no public information about how many there are or where they are located.
A CBC News Investigation has learned many defibrillators in Atlantic Canada are not registered with provincial authorities, and even 911 dispatchers often don’t know where the life-saving devices are located, making it impossible for them to direct bystanders to the nearest one.
If Michael Fowlie had collapsed in the western provinces or parts of Ontario, the 911 dispatcher could have told bystanders if an automated external defibrillator (AED) was nearby and instructed someone to fetch it quickly.
A dispatcher in Kingston, Ont., would send out an alert to people in the area with an app and a stranger could have shown up within minutes, defibrillator in hand.
None of that would happen in Atlantic Canada.
Cardiac arrest is a big killer in Canada, with an estimated 40,000 deaths annually, according to the Heart and Stroke Foundation. It can strike people of all ages when an abnormal heart rhythm interferes with the heart’s electrical system.
Defibrillators apply a shock that jolts the heart back into a normal rhythm before a person’s organs and brain begin to die.
There is a provincial defibrillator registry in New Brunswick. But a 911 operator would only be alerted to a device if the address of the call exactly matches the address where the defibrillator is registered. Dispatchers wouldn’t be aware of any defibrillators nearby.
Until now, that has also been the case in Nova Scotia. The province recently installed new software that would allow emergency dispatchers to locate any devices in the area surrounding a call, as long as they are on the provincial registry.
Dispatchers, however, are not yet using the software.
Tracy Barron, a spokesperson for the Health Department, said it has been running in the background since March, but the province only received approval to start using it in the past week because of privacy issues.
Newfoundland and Labrador only set up a provincewide 911 system in 2015 and there are no plans for an AED registry. Prince Edward Island plans to unveil one this fall.
Patchwork of systems
Across the country, there is a patchwork of systems. Dispatchers in British Columbia can tell a caller the address of any device within 200 metres of a cardiac emergency. Dispatchers in Ontario may direct people to the nearest defibrillator, depending on the municipality.
Manitoba is the only jurisdiction where legislation makes it mandatory to place defibrillators in locations such as schools, airports, golf courses and community centres, and to ensure they are listed on a provincial registry. Businesses and organizations that have their own devices may register them to the provincial network, although it’s not required. In total, 3,830 are registered.
Rhae Ann Bromley, director of communications with the Heart and Stroke Foundation in Manitoba, said whether dispatchers can direct people to a nearby defibrillator “is highly dependent” on the software and technology used for the system, and how much money is spent on it.
Several provinces have maps online that highlight the locations of available defibrillators. The numbers of devices vary. There is a network of 3,600 in Ontario and about 2,800 in Alberta.
Trying to ‘arm twist’ the government
The Nova Scotia government invites people to register their defibrillators and receive reminders about changing batteries and pads, but the provincial website offers no indication that registering a device could help in an emergency.
David Fowlie said few people know about the registry and it’s time the government took a bigger role in connecting technology that can save lives in an emergency.
“I’m trying to encourage and arm twist the government to change their policy, to provide that information,” he said. “Nova Scotians need to know that information so that this tragedy doesn’t happen to someone else.”
Fowlie believes a successful awareness campaign could change attitudes the same way seatbelts were normalized and drunk driving was stigmatized. He would like to see defibrillators at coffee shops and ATMs, in addition to schools, rinks, airports and gyms.
He said a public map of public defibrillator locations is a first step, but he would also like to see more efforts to educate young people on how to use them.
“Within 15 years, you would have a generation that would know some sort of information to use during emergency situations in the availability and usage of AEDs,” he said.
New N.S. system coming
Initially, Nova Scotia’s Health Department declined an interview request on the status of an AED registry.
Fowlie had been told by Nova Scotia health officials that new software to help 911 dispatchers know the location of defibrillators would be in place months ago.
There are a total of 240 devices on the provincial registry. Barron said the department will be contacting people who own devices this week and, with their consent, input their information into the new system.
Once the information is added, those with defibrillators will be alerted when there is an emergency in their area.
It’s not clear why Michael Fowlie went into cardiac arrest. But his father has spent the past three years piecing together his son’s final moments.
It’s through that research that David Fowlie learned there was a defibrillator not far from where his son collapsed. There is no guarantee it would have been on a public registry, but he believes another device nearby might have.
There are other details, too. Through a series of letters and meetings with health officials, he learned that one of the two ambulances sent to treat his son took a roundabout route that he believes doubled the response time.
In Nova Scotia, emergency dispatchers are supposed to ask people if there is a defibrillator nearby, but in Michael Fowlie’s case, that didn’t happen.
His father still struggles to understand why the emergency dispatcher didn’t direct someone to start chest compressions after the caller said his son’s breathing sounded like snoring — a telltale sign of cardiac arrest.
“I do believe that Emergency Health Services, and medical communications, being the dispatcher, did fail Michael. They didn’t give him any chance to survive the cardiac arrest,” said Fowlie.
“Through the number of errors, yes they were negligent in providing help when he needed it the most. At his greatest time of need in life, this was not available for him.”
In a statement, Barron said the Health Department has improved the technology that routes ambulances as well the way dispatchers coach callers with CPR.
‘Still don’t have all those answers’
David Fowlie said he hopes the Health Department reviews any future cardiac arrest cases to ensure similar errors don’t happen.
“Unfortunately, the more answers I received, the more information I wanted. And I wanted to know what happened. And I still don’t have all those answers,” he said.
“Michael would want me to continue on until there is some change that is positive for the people within Nova Scotia.”