An Ontario woman died of an infection after an abortion. Her sister says doctors failed her

about a relationship or school problem, but not her. “You’re the one I’m most fearful of disappointing,” Ms. Laderoute told her.

When Ms. Laderoute realized she was pregnant at 19, she told neither her sister nor her mother. She went to a women’s health clinic in Brampton, Ont. – about an hour’s drive from her home near Newmarket – where she was prescribed Mifegymiso, the abortion pill.

When she was still heavily bleeding and experiencing abdominal pain two weeks afterward, she sought emergency care, as the pill’s brochure instructs patients to do.

On Feb. 14, 2022, she walked into the emergency department at Newmarket’s Southlake Regional Health Centre, a bustling 400-bed hospital located across the street from where she worked as a medical receptionist. Ten days later, she died of an infection, with signs of septic shock – a devastating outcome that appears as if it could have been prevented.

In the week leading up to her death, Ms. Laderoute visited Southlake’s emergency department three times. Her condition continued to worsen, but doctors failed to recognize the seriousness of her symptoms.

During her final visit, medical records show nurses were pleading for her to be transferred to the ICU, but that move wasn’t made soon enough.

Two investigations into her treatment by the College of Physicians and Surgeons of Ontario revealed several red flags were missed, and necessary tests and treatments weren’t provided in a timely manner.

One of the doctors who treated her – Marko Duic – had been cautioned previously by the college for poor documentation and inappropriate care. He’d also been the subject of a 2018 Globe and Mail investigation, which detailed allegations of gender discrimination in his hiring and training practices and improper billing, accusations he has disputed. Although Dr. Duic resigned as the hospital’s chief of emergency within two months of that investigation, he continued to see patients.

Relying on more than 400 pages of Ms. Laderoute’s medical records, which were provided by Ms. Costabile, as well as two decisions of the college, The Globe has reconstructed the medical decisions that preceded Ms. Laderoute’s death – a series of events that raise questions about the professional conduct of two of the physicians responsible for her care, and whether there has been adequate accountability within the health care system.

‘Constant refusal’ for ICU care

On Ms. Laderoute’s first visit to Southlake, the emergency doctor who saw her ordered an ultrasound, which didn’t show any retained fetal or placental remnants, a potential cause of an infection. This was a good sign, but it didn’t rule out an infection entirely; very rarely, serious infections after abortions can occur when bacteria invade the uterus through the open cervix.

The doctor referred Ms. Laderoute to Southlake’s early pregnancy loss clinic for more testing, and discharged her. (The Globe is only naming the two health providers who were later investigated by the college in relation to Ms. Laderoute’s care.)

The next day, the clinic was unable to reach Ms. Laderoute to set up an appointment, with a staff member writing back to the emergency doctor, “Phone number provided not in service.” No efforts to find alternative contact information are documented in Ms. Laderoute’s health records.

A week later, Ms. Laderoute returned to the Southlake ER, this time by ambulance. Notes from the paramedics and emergency nurses include that Ms. Laderoute told them her lower abdominal pain had “significantly been getting worse.”

The notes also show she complained about symptoms suggesting an infection: “discharge, foul-smelling, using 2-3 pads per day. Nausea.” She ranked her pain as 10 out of 10.

The doctor assigned to Ms. Laderoute on her second visit was Dr. Duic. Shortly after he assessed Ms. Laderoute, a nurse described her in the medical record as holding her abdomen, breathing heavily and crying.

Dr. Duic wrote that Ms. Laderoute had a “peritonitic” abdomen upon examining her. Peritonitis, swelling of the lining around the abdominal organs, is life-threatening. Dr. Duic ordered imaging, bloodwork and a urine sample – tests which the college later determined weren’t sufficient to investigate this condition.

With morphine and Gravol in her system, Ms. Laderoute was feeling well enough to walk. Dr. Duic wrote that Ms. Laderoute might have “cyclic vomiting” owing to her cannabis use. He discharged her six hours after she arrived at the hospital, with a prescription for oral antibiotics for a suspected urinary tract infection, as well as Percocet, a heavy-duty painkiller.

About 24 hours after being discharged, Ms. Laderoute arrived at Southlake’s emergency department, once again by ambulance. This was her third visit in the span of a week.

At triage, at around 10:30 p.m. on Feb. 22, 2022, Ms. Laderoute’s heart rate was sky high – 175 beats a minute – and her systolic blood pressure was low, at 99. She told the triage nurse that she had vomited blood.

Despite these alarming symptoms, Ms. Laderoute was not immediately taken to the ICU. Instead, she was placed in the waiting room, where she waited for three hours before being seen by a doctor.

When she was finally assessed by a doctor, it was noted that she was pale, weak, and in severe pain. Tests revealed that she had a high white blood cell count, indicating an infection. However, even with these results, the decision to transfer her to the ICU was delayed.

It wasn’t until the early hours of the morning that Ms. Laderoute was finally transferred to the ICU. By then, it was too late. She went into septic shock and passed away shortly after.

Seeking Accountability

The tragic death of Rheanna Laderoute has raised questions about the quality of care provided in emergency departments, as well as the accountability of healthcare professionals. Two physicians involved in her care have come under scrutiny for their actions leading up to her death.

Dr. Marko Duic, one of the doctors who treated Ms. Laderoute, had previously been cautioned by the College of Physicians and Surgeons of Ontario for poor documentation and inappropriate care. Despite these warnings, he continued to see patients until Ms. Laderoute’s death.

Another physician involved in Ms. Laderoute’s care, whose identity has not been disclosed, also faced criticism for failing to provide adequate tests and treatments in a timely manner.

The family of Rheanna Laderoute is seeking justice for her death. They are calling for a thorough investigation into the circumstances that led to her passing, as well as accountability for the healthcare professionals involved.

In the meantime, they are left to mourn the loss of a beloved daughter, sister, and friend – a young woman with a bright future ahead of her, whose life was cut short due to a series of medical errors and oversights.

As the family grieves, they hope that their story will serve as a cautionary tale for others, highlighting the importance of advocating for oneself in the healthcare system and ensuring that proper care is provided at all times.

Laderoute a watch as a gift. She had the back of the watch engraved with the words, “My sister, my friend, always.”

Now, as Ms. Costabile holds the purse and the necklace, she thinks back to that special day and the hopes and dreams her sister had for the future. She can’t help but feel a deep sense of loss and regret that those dreams will never be realized.

Ms. Costabile took her sister’s case to the College of Physicians and Surgeons of Ontario, seeking answers and accountability for the care that Ms. Laderoute received. She wants to ensure that no other family has to go through what hers did, watching a loved one suffer and ultimately lose their life due to delays and mismanagement in medical care.

As she waits for the investigation to unfold, Ms. Costabile holds onto the memories of her sister, the good times they shared, and the love they had for each other. She knows that nothing can bring her sister back, but she hopes that by speaking out, she can prevent similar tragedies in the future.

The loss of Ms. Laderoute is a painful reminder of the importance of timely and appropriate medical care, especially in cases of severe illness like sepsis. It serves as a warning to healthcare providers to listen to the concerns of patients and their families, and to act swiftly and decisively in critical situations.

As Ms. Costabile continues to seek justice for her sister, she holds onto the memories of their time together, the laughs they shared, and the love that will always remain in her heart. She will never forget her sister, her friend, always.

The heartbreaking story of Ms. Laderoute’s untimely death has shed light on the importance of proper medical care and the consequences of medical negligence. Her sister, Ms. Costabile, has been relentless in seeking justice for her sister and holding the medical professionals involved accountable for their actions.

The findings from the coroner’s report and the subsequent disciplinary actions against the doctors involved highlight the need for improved protocols and practices in the healthcare system. It is crucial for medical professionals to always prioritize patient safety and well-being, and to be diligent in their assessments and decision-making.

Ms. Costabile’s determination to seek justice for her sister serves as a reminder of the enduring bond between siblings and the lengths one would go to in order to honor and protect their loved ones. The card that reads, “I’ll always be proud of you, I’ll always be there for you, I’ll always trust you, and most importantly, I will always love you with all my heart. You were and always will be the greatest surprise of my life,” encapsulates the deep love and admiration she has for her sister.

As Ms. Costabile continues to fight for justice and accountability, her sister’s memory lives on as a symbol of strength, love, and the enduring bond between siblings. May her story serve as a catalyst for positive change in the healthcare system, ensuring that no family has to endure the pain and loss that the Laderoute family has experienced.

Costabile is now fighting for accountability and justice for her sister. She has joined forces with Mr. Kastner and Dr. Cohen to demand answers from Southlake Hospital regarding the care her sister received and the systemic issues that may have contributed to her death.

They are pushing for transparency and changes to ensure that no other family has to go through the same pain and loss that they have experienced. They want to see improvements in communication between healthcare professionals, gender diversity in medical staff, and a commitment to providing the best possible care for all patients, regardless of their gender.

Ms. Costabile’s dedication to seeking justice for her sister is a testament to the love and bond she shared with Ms. Laderoute. Despite the heartbreak and grief she has endured, she remains determined to make a difference and hold those responsible accountable for their actions.

As she continues to navigate the legal and emotional challenges of seeking justice for her sister, Ms. Costabile remains hopeful that her efforts will bring about the changes needed to prevent similar tragedies in the future. She is determined to honor her sister’s memory by fighting for a healthcare system that prioritizes patient safety and accountability above all else. Costabile is on a mission to raise awareness of what happened to her sister in the hopes of preventing others from suffering the same fate. She believes that the healthcare system failed her sister by not digging deeper into the root cause of her pain, failing to act urgently, and ignoring the warnings from nurses.

“We cannot continue to allow a culture where doctors are not held accountable and where women’s concerns are dismissed or ignored,” Costabile says.

She is determined to shed light on the flaws in the system that led to her sister’s tragic outcome. By sharing her story, she hopes to spark change and ensure that no other family has to endure the same heartbreak.

In a recent development, it was clarified that Jay Sengupta, a member of the Ontario Physicians and Surgeons Discipline Tribunal, chaired the panel that reprimanded Marko Duic, not a male physician as previously reported. The reprimand was actually delivered by Madhu Azad, a physician and college board director.

Costabile’s fight for justice and accountability continues as she works to make sure that no other family has to experience the pain and loss that her family has endured. Her determination to raise awareness and bring about change is a testament to her love for her sister and her commitment to ensuring that no one else falls through the cracks of the healthcare system.