'She won't die in vain'
Originally posted on TJ.News on March 16, 2023— A photo of Hillary Hooper posing with sunflowers sat on a podium in Saint John’s courthouse for three days.
Her mother, Patricia Borthwick, said she wanted those testifying in the inquest into her daughter’s suicide death to remember her face.
“You have thousands of patients,” she said, “but I have one daughter. When you walk by her, I want you to know she lived, she had a great life, and she mattered. I want you to remember her beautiful face.”
A five-person jury confirmed Hooper, 27, died of suicide while she was hospitalized in the Saint John Regional Hospital’s psychiatric wing, after hearing testimony from a provincial coroner, numerous mental health professionals, as well as law enforcement and a Horizon Health Network executive.
Following the testimonies, a judge and coroner issued over a dozen recommendations in order to prevent deaths under similar circumstances.
Borthwick says her daughter can finally rest now that the family knows the details of Hooper’s final moments, something the family has been seeking for more than two years.
The testimonies tracked Hooper’s way through the hospital moment by moment, from arriving at the emergency room after overdosing on prescription medication on Nov. 13 to being taken off life support on Dec. 9.
Lauren Oulton, a mental health nurse who assessed Hooper in the emergency room after her initial suicide attempt, described the woman as “unshakeable” in her resolve to end her life. Hooper was placed on 4D North, the hospital’s psychiatric unit.
On Dec. 2 during 11 p.m. hourly bed checks, nurses discovered Hooper had barricaded her room with a hospital bed. Once they finally pushed the door open and found her room was empty, they noticed a light on in the adjacent bathroom.
When the nurses opened the door after “four or five” tries, they found Hooper, who had attempted suicide and was unresponsive but still had a pulse.
Karen Wood, charge nurse on that night, described how they performed CPR until the hospital’s “code blue” team arrived and continued resuscitation efforts. Hooper was then moved to the hospital’s intensive care unit, where she was taken off life support a week later, dying moments after.
Borthwick said it was difficult to hear the gory details of her daughter’s final moments, but necessary.
“I needed to find out the truth,” she said, calling the testimonies “graphic, but wonderful.”
Some of the testimonies unearthed new information that hadn’t been told to the family, like that Hooper had managed to cut herself while in the emergency room before being transferred to 4D North, the psychiatric wing.
Other pieces of information contradicted what Borthwick had been told over the span of the past two years, as she begged the health network for more information about her daughter’s final days.
“But I got the real story,” Borthwick says. “Now, as a family, I feel we can move forward.”
The jury also heard Hooper was a dog lover and had a great sense of humour, with a knack for telling dirty jokes.
After hearing testimony from 16 witnesses, the jury recommended the hospital’s psychiatric unit use bedding which tears easily and wouldn’t be able to support the weight of a grown adult, along with bolting hospital beds to the floor so they can’t be moved to barricade a room.
The jury also recommended “any time a patient door is blocked, that attention be given to the room immediately” and also said Horizon Health should consider increasing overnight staffing levels on the psychiatric ward.
The jury also recommended installing security cameras in rooms on the psychiatric ward, though the jury said they realize there are "issues" surrounding patient privacy.
The jury also recommended a “short-stay” unit be added to the hospital as a part of their psychiatric services, which Horizon Health also recommended after its own internal review.
Hooper had been diagnosed with borderline personality disorder, which included attention-seeking behaviour, self-harm and other maladaptive coping strategies, as well as vast fluctuation in emotions and intense moods, among others.
The unit would be intended for people with borderline personality disorder and similar mental health afflictions, in order to “stabilize” people in crisis and help them with coping mechanisms for their daily lives.
Provincial coroner Emily Caissy, who presided over the inquest, also recommended the short-stay unit be implemented.
She also recommended Horizon provide information sessions for local physicians on local resources available for borderline personality disorder, and “adopt or make a continuous assessment of suicide urgency” via standardized forms in emergency departments and other clinical settings.
Caissy also recommended the Department of Justice and Public Safety support the Office of the Chief Coroner in establishing a suicide fatality review committee.
Borthwick said the jury “nailed it” with their recommendations.
“It’s all the things that should make it impossible to do what she did again,” she said.
In an emailed statement, Renée Fournier, Horizon’s Director Addiction and Mental Health Services for the Saint John area, said the health network will be reviewing each recommendation.
Fournier testified Horizon’s internal review also recommended cutting off the tops of doors on the psychiatric ward in order to prevent suicide by hanging.
“In the wake of this particular tragedy, Horizon moved quickly to implement safety enhancements to our inpatient psychiatric unit at Horizon’s Saint John Regional Hospital. These changes, and any others resulting from these recommendations, will help mitigate the risk of similar incidents from taking place in the future,” her email said.
In an emailed statement, Geoffrey Downey, media representative for the Department of Justice and Public Safety, said the department was reviewing the recommendation to establish a suicide fatality review committee, but did not elaborate further.
Aside from the recommended changes, Borthwick also hopes legislation changes will prompt inquests automatically whenever someone dies by suicide while hospitalized.
“She won’t die in vain,” she said.