SHOULD AN ADVERSE EVENT OCCUR IN ANY ONTARIO HOSPITAL, THE CITIZENS OF ONTARIO WILL BE ENSURED IT WILL BE COVERED UP BY ALL OF THOSE SEEN BELOW:

THE HOSPITAL --under jurisdiction of Liberal Minister of Health

THE CHIEF CORONER'S OFFICE--appointed by Liberal majority government and --under jurisdiction of Liberal Minister of Corrections and is a member of the CPSO and CMPA!

THE DEATH INVESTIGATIVE OVERSIGHT COUNCIL--appointed by Liberal majority government and --under jurisdiction of Liberal Minister of Corrections --has Chief Coroner or Deputy sitting on this council!

THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO

THE HEALTH PROFESSIONS APPEAL AND REVIEW BOARD--appointed by Liberal majority government --under jurisdiction of Liberal Minister of Health

THE ONTARIO OMBUDSMAN--appointed by Liberal majority government

THE ONTARIO PATIENT OMBUDSMAN--appointed by Liberal majority government

THE ONTARIO PROVINCIAL POLICE--under jurisdiction of Liberal Minister of Corrections

THE INDEPENDENT POLICE REVIEW DIRECTOR--appointed by Liberal majority government and --under jurisdiction of Liberal Minister of Corrections

THE LIBERAL MINISTER OF HEALTH and is a member of the CPSO and CMPA!

THE LIBERAL MINISTER OF CORRECTIONS

THE LIBERAL PROVINCIAL PREMIER

WHEN IT COMES RIGHT DOWN TO IT, THE PRESENT LIBERAL GOVERNMENT SHOULD HAVE COME CLEAN TO PROTECT THE CITIZENS OF ONTARIO.

ALL OF THE ABOVE ARE IN "BREACH OF TRUST" AS THEY COVER EACH OTHERS' ASSES

A FATHER’S FAILURE

Without a doubt; a Conspiracy exists,
Self-protecting Officials; such hypocrites!

If you were a MPP’s daughter; it would cause a fit,
Because you’re mine; they don’t give a shit!

For years we have yearned for justice,
The lack of moral integrity merely disgusts us!

Government institutions that won’t expose,
The Medical negligence concealed by those!

Medical Immunity granted; regardless of guilt,
Preserving Ontario Health Care’s patchwork quilt!

So many individuals paid through our taxes,
Failing us all; what a bunch of asses:

Premier of Ontario --Premier Wynne, Premier McGuinty,

Ontario Minsters of Health --Dr. E. Hoskins, D. Matthews, Rick Bartolucci

Ontario Ministers of Corrections --Yasir Naqvi, Madeleine Meilleur

Ontario Members of Provincial Parliament --majority of them from 2006 to the present

CPSO -- Angela Bates Manager Committee Support Area Investigations and Resolutions, Sandra Keough Investigator

HPARB --Chair Janice Vauthier, Past Chair Linda Lamoureux, Lori Coleman Registrar, Third Appeal Chair Tom Kelly, Members Stephen Jovanoviorc and Brenda Petryna

Ontario Ombudsman --Paul Dube Ombudsman, A Marin-Ombudsman, Investigator Lorraine Boucher- Investigator, Fran Cappe-Investigator,

Humber River Hospital --CEO B. Collins, past CEO Rueben Devlin,

Ontario Chief Coroner’s Office --Dr. D. Huyer, Dr. A. McCallum, Dr. A. Lauwers

DIOC --Joseph C.M. James (Chair), Emily Musing (Vice-Chair), John Pearson (Vice-Chair), William (Bill) McLean, David Williams, Dorothy Cynthia (Cindy) Prince, Denise St-Jean, Fiona Smaill, Lidia Narozniak, Lori Marshall, Lucille Perreault, William (Bill) J Shearing, Michael Pollanen, Fiona Foster Manager of DIOC

Ontario Patient Ombudsman --Christine Elliott, Investigator Marie Claire Muamba

Ontario Provincial Police --Commissioner J.V.N. (Vince) Hawkes, Inspector Bradley McCallum

OIPRD -- Director Gerry McNeilly

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Terra Dawn Kilby
"An Angel In Our Lives"
April 22/78 to July 21/06

Linked 2612 Connections/Followers
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2,884

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DO YOU SMELL SOMETHING ROTTING WITHIN ONTARIO?
https://1drv.ms/w/s!ApBprmlxiUUnhHumD25kXQnNQ4f_

http://www.torontosun.com/…/why-did-woman-die-after-routine…

http://www.torontosun.com/2013/10/18/secret-medical-cautions

https://www.linkedin.com/…/ontario-patient-ombudsmans-offic…

https://www.linkedin.com/pulse/another-failure-arnold-kilby…

https://www.linkedin.com/…/death-investigation-oversight-co…

https://www.linkedin.com/…/terra-dawn-conspiracy-arnold-kil…

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https://www.linkedin.com/…/truth-kept-hidden-abusing-legisl…

READ ALL OF MY POSTS AS I ATTEMPTED TO BRING TRANSPARENCY AND ACCOUNTABILITY TO ONTARIO.

SCROLL DOWN FOR POSTS
--Look on right side under "Blog Archive" (oldest to newest)

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College of Physicians and Surgeons - Stories of Failure

What is especially interesting in this recent Star (last week Feb/2016)article is the following:

“We are not a public organization. . . Our accountability is to our members,” said the College’s executive director, Dr. Francine Lemire" CPSO

ONTARIO OMBUDSMAN'S OFFICE FAILS TO PROTECT CITIZENS FROM HPARB'S LACK OF PROCEDURAL FAIRNESS AND ADHERING TO THE PRINCIPALS OF NATURAL JUSTICE.

We already know the CPSO is corrupt and HPARB from the article where it stated "it looks like HPARB just threw up their hands and said we give up"

http://www.torontosun.com/2013/10/11/why-did-woman-die-after-routine-surgery

http://www.torontosun.com/2013/10/18/secret-medical-cautions

But for the Ombudsman's Office to swallow such garbage leaves the citizens of Ontario with no where to go.

Coalition For Physician and Surgeon Oversight is a group who has been harmed or had a loved one taken through negligence by a doctor/surgeon.

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https://www.youtube.com/watch?v=_LFqWujTEVA&feature=youtu.be

Terra Dawn Kilby --- A Father's Memories
An Angel In Our Lives, Terra Dawn Kilby November 2014

A tribute to the life of my daughter who died due to the negligence of a surgeon at Humber River Regional Hospital, Toronto, Ontario, Canada. Covered up by Humber River Regional Hospital, the CPSO, HPARB, Chief Coroner's Office of Ontario, the DIOC, Ontario's Ombudsman and the entire Provincial Liberal Party!


TERRA DAWN KILBY April 22, 1978 - July 21, 2006. College’s Decision “The routine use of antibiotics prior to bowel surgery is an important aspect of care that was NEGLECTED by Dr. Klein in this case.”…
00:35:48

https://www.youtube.com/watch?v=lMof3T--zUY&feature=youtu.be
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THE PATIENT FACTOR

http://thepatientfactor.com/canadian-health-care-stories/the-unholy-alliance-between-organized-medicine-and-government-a-fathers-quest-for-truth-and-justice-in-public-health-care/

HPARB's Decisions Kilby vs Laz Klein.
First Decision:
http://www.canlii.org/en/on/onhparb/doc/2010/2010canlii44390/2010canlii44390.html
Second Decision:

http://www.canlii.org/en/on/onhparb/doc/2012/2012canlii39837/2012canlii39837.html
Third Decision:
http://www.canlii.org/en/on/onhparb/doc/2013/2013canlii46625/2013canlii46625.html

The Letter I Sent to the Chief Coroner's Office Outlining My Numerous Concerns
Coroner's Comments.doc

Death Investigative Oversight Council's Decision

2 years after my initial request and after both Chief Coroner and Deputy Chief Coroner left the OCC.
DIOC Decision Aug 2013.doc
*********************************************************
The Chief Coroner's Office, the College of Physicians and Surgeons of Ontario, the Health Professions Appeal and Review Board, the Death Investigative Oversight Council, the Liberal government and Ms Deb Matthews and Premier Wynne apparently agree that it is perfectly within the accepted Standard of Care to:
--have open abdominal surgery without the mandatory antibiotic prophylaxis

--having not had the above, accepted that there was no need for antibiotics when the abdominal incision was oozing purulent liquid and was so infected that all staples were removed

--when test results showed "many gram negative bacilli", still it was quite acceptable to provide no antibiotics

ONTARIO CITIZENS----
And the College/HPARB totally ignored Dr. Andrew McCallum's letter to the College when he was Eastern Ontario Coroner. In it he states that infection was a contributing factor in Terra's death.
One must also wonder how on earth the Chief Coroner's death investigation failed to note the lack of antibiotics plus other issues contained within the hospital records and yet I have numerous pieces of correspondence from both Dr. Lauwers and Dr. McCallum stating they saw no issues with respect to the Standard of Care???
HOW DO YOU SPELL COVER-UP???



************************************
THE OMBUDSMAN'S OFFICE has allowed the College and HPARB to establish the above as precedence for future complaints/appeals made to both of them.
VERY DANGEROUS TO ALLOW THIS TO HAPPEN WITH REGARD TO PATIENT SAFETY AND CARE WITHIN OUR HOSPITALS.


********************************************************





http://thepatientfactor.com/canadian-health-care-stories/the-unholy-alliance-between-organized-medicine-and-government-a-fathers-quest-for-truth-and-justice-in-public-health-care/

https://plus.google.com/100940639342885447409/posts/YwvYaMn7eTw

http://www.yelp.ca/user_details?userid=BslEQAF9s6rUav3VSPqcWQ

**************************************************
Gan Reporter to appeared July 21, 2015
Terra Dawn Kilby
“An Angel In Our Lives”
April 22, 1978 – July 21, 2006


Tears still appear when we think of you.
Visits to your grave site we often do.
Loving memories convey serenity too!

Our precious daughter, Terra Dawn;
It’s been nine years since you’ve been gone.
Within our hearts you still belong!

July Twenty-first is a time of sorrow.
Additional years, I wish we could borrow.
Maybe then, we’d not feel hollow!

Today, messages guided to heaven above.
Channeled to you on the wings of a dove.
Expressing our heartfelt, everlasting love!


LOVE MOM, DAD AND BRANDY

Wednesday, 13 July 2011

No Accountability or Transparency in Ontario--Dr. Bert Lauwers/Dr. Andrew McCallum/Dr. Laz Klein--- Part Two

A PRIMER ON THE LAW OF DEFAMATION IN ONTARIO
"Defamation is comprised of two subcategories between libel (libel refers to written defamatory statements)and slander(broadcasting of spoken defamatory words)

Proving a Claim in Libel and/or Slander
"the statement must be false!"

Defences to Actions in Libel and Slander
TRUTH--
"The first defence is the defence of truth. The defence can be made that the statement was truthful and therefore there was nothing false about the statement, meaning therefore, that the statement was not defamatory."


FAIR COMMENT--

"The second defence to an allegation of libelous statement is that the statements made were made as a fair comment. The defence of fair comment would be considered by the Court in situations where, by looking at the statement made, the facts and the situation, a conclusion can be made that the statements made were in actuality a fair commentary on the situation at hand and that the comments were fair and were not malicious."

QUALIFIED PRIVILEGE--
"The defence of qualified privilege arises normally in situations where the individual publishing these statements will escape any liability if it can be proven that the public good could be furthered in open debate. 

******************************************************************************  
Please see June Blog Entry First

And Dr. Lauwers (Chief Coroner's Office)  and his expert feels it was within the standards and quite acceptable to perform elective open abdominal surgery for a colon resection to be done without anti-biotic prophylaxis.
He needs to be replaced!!!!  
Surgeons names withheld until I appeal to HPARB,  these are just some responses.


Antibiotics are recommended for colon surgery just prior to the start of the operation but should be stopped within 24 hours unless there are clinical indications to continue beyond the 24 hour period. These are the guidelines in the US and the goal of perioperative antibiotics is to prevent wound infections from surgery.
Sincerely,   
*****************************************************************

I would have given her anti-biotic prophylaxis. I would like to know the diagnosis before the operation to be able to say if I would have had your daughter have bowel cleansing. 
*****************************************************************
The antibiotic prophylaxis is used to prevent infection during and after surgery. . Please feel free to ask more questions.  
****************************************************************
Both are standard practice for whoever undergoing elective colorectal surgery unless your daughter received an emergency surgery without time for formal bowel preparation. Once again the colonic surgery is a clean contaminated operation, routine antibiotics prophylaxis should have been given
Thanks
*****************************************************************
I will only say that in the US it is considered standard of care to administer IV prophylactic antibiotics within one hour of skin incision for a clean-contaminated surgical case. *****************************************************************
Antibiotics are routinely given prior to colorectal operations, whether open or laparoscopic *****************************************************************
All patients having surgery are required to have antibiotic preoperative and if there is a documented infection it is mandatory to treat it with antibiotics
 ****************************************************************
Yes of course a patient should receive antibiotics prior to colon resection 
****************************************************************
Yes, she should have received "preoperative" antibiotics within One Hour if beginning operation.  
*****************************************************************
Bowel preparation and administration of antibiotics for prophylaxis prior to surgery have been a standard of care in surgery for at least 25 years. In my opinion you have every reason to deserve frank answers about what happened to your daughter.
*****************************************************************
 It is the standard in the United States to give prophylactic antibiotics within one hour of surgery.
*****************************************************************
The standard of care in the US is for patients undergoing any surgery is antibiotics within 1 hr of surgery, and for 24 hrs after surgery. 
*****************************************************************
There is no doubt she should have been given pre-operative and post operative  antibiotics. 
*****************************************************************
I do think it is fair to say that a preoperative antibiotic dose for a colon resection is the standard of care in this country.
*****************************************************************
The standard of practice for prevention of wound infection in colon surgery is to use prophylactic antibiotics.                                      *****************************************************************                                                                                     
Yes antibiotic prophylaxis prior to colon surgery is standard
*****************************************************************
We still adhere to the fact that patients should have a dose of antibiotics at the time of surgery for most colorectal procedures especially those involving a resection.   Ireland
*****************************************************************
I know that it is the accepted procedure to use prophylactic antibiotic coverage for colon surgery in the hospital where I work here in Denver, CO.
*****************************************************************
The standard of practice for prevention of wound infection in colon surgery is to use prophylactic antibiotics
*****************************************************************
In the United States, it is standard of care to administer appropriate antibiotics within one hour of surgical incision for any case deemed at risk for infection. We get in trouble for any case not
administered and documented as such.
****************************************************************
The answer to your question on antibiotic prophylaxis is a clear yes.
The Surgical Care Improvement Project (SCIP) has established clear guidelines on antibiotic prophylaxis prior to all surgery (timing, type). Here in the US our hospital is literally graded on compliance with the SCIP protocols.  As a department chair I am responsible for compliance on my team and have to have appropriate procedures in place to assure compliance. *****************************************************************
The big problem is apparently not cleaning the colon with laxatives or enema prior to surgery.
*****************************************************************
All patients used to receive pre-operative antibiotics prior to any colonic surgery. *****************************************************************
It is standard of care in the United States that all patients undergoing bowel surgery should receive pre-operative prophylactic antibiotics at least 20 min before the incision is made. *****************************************************************
It is standard that all pts receive perioperataive antibiotics with a goal of administering them within 30 minutes prior to skin incision. It is a well validated quality outcome parameter.  *****************************************************************   
The short answer to your question is that, yes, antibiotics should be given prior to colon surgery (and most other surgeries for that matter).  The discharge of somebody with abdominal distention who had undergone a wound packing for infection also seems well below acceptable standards here in the US.  Usually if abdominal distention arises post op the etiology of that distention needs to be sought prior to discharge. 
****************************************************************
In the United States, the practice is to perform at least a mechanical bowel prep before an elective colon resection and in all circumstances perioperative antibiotics are given, usually prior to the incision. 
****************************************************************
It sounds like your daughter did not receive the appropriate standard of care.  Patients undergoing colon resection (if not an emergency), should receive colonic cleansing pre-op.  Additionally, all patients undergoing surgery should receive pre-operative antibiotics. It does not seem that her nutritional supplementation was adequate. Finally, it seems that she was discharged while still infected.      *****************************************************************                   
 I can only say by the description here that there must have been some kind of contamination either during or after surgery most likely coming from the bowel itself based on the gram negatives you describe.       
*****************************************************************
Too many unanswered questions? 
    How about the enlarged abdomen at time of release?                                        
â         How about the foul, purulent oozing incision at time of release?  
â         How about the fact she had no colon cleansing prior to operation? 
â        How about the fact that she did not have the anti-biotic prophylaxis given at the time   of induction? 
â        How about the fact she received no anti-biotics what so ever at any time? 
â        How about the fact the she remained on a liquid diet for 8 days consisting of jello, juice, tea and   both without any nutritional supplement? 
â        How can a wound heal without proper nutrition?
â        How about the fact her resting pulse rate was over 90
â        How about the fact that she was only receiving 687 calories per day for 8 days? 
â        How about the many gram negative bacilli seen? And not treated.
â        How about the low Absolute Lymphocyte (type of white cells)?  
â        How about the many PMN’s (polymorphonuclear Neutrophils) –?        hallmark of acute inflammatory process
â How about the low hemacrit counts, low red blood cell counts and low haemaglobin counts?
       Broken heart ?   Broken heart         
http://tracking.technodesignip.com/?action=count&projectid=642&contentid=6540&referrer=-&urlaction=r...
Arnold W. Kilby awkilby@hotmail.com

"Terra Dawn Kilby, An Angel In Our Lives"
April 22, 1978--July 21, 2006

As we lie within our beds, streaming tears are always shed.
This occurs each evening and night, waiting for dawn's first light.
Thoughts of you are all around, with many restless nights abound.
Awaking each morning I still dread, wishing and hoping I was dead.
Your sister and you were very tight, continuing on is quite a fight.
Loneliness, emptiness brings us down, no peace as yet--- have we found.

Teardrops fall upon the pillow case, with memories of you, a beautiful face.
A mother's love forever there, a heart weighted down with such despair.
Terra, we see you most every day, in our minds and hearts, to forever stay.
Four family hearts in full embrace, will eventually meet in a higher place.
People pass by us -- so unaware--, it's like we are playing solitaire.
Our tearful lives in such disarray, but loving you won't fade away.

Love Always,
DAD XOXOXO


 Thinking of Terra at Christmas 

Our fifth Christmas without you,
Is difficult to bare.
We think of you so often,
Though you are not right here.
Darling daughter, Terra
You know that we do care.
Tears still flow quite often,
Your death was just not fair.
Leaving our once happy home,
A false face do we wear.
Our hearts remain so broken,
Yet, your love remains quite near.
Our Christmas' are joyless,
With you not here, --- but there.
Our lives remain so stagnant,
Too fragile, and easy to tear.

Perhaps, some day we'll celebrate,
Our family life so rare.
Each Christmas tear we shed for you,
Are kisses and hugs to share.
Love you forever, Terra
"An Angel In Our Lives"

The Chief Coroners Office of Ontario failed to: 

1. Conduct a death investigation in a manner that is effective and accountable. 


2. Conduct a high quality death investigation to ensure that no death will be overlooked, concealed or ignored. (By basing all of their decision on a medical expert consultant whose report omitted numerous crucial factors) 

3. To help improve public safety and prevent deaths in similar circumstances (apparently there were 6 more deaths by the bariatric department of this hospital during 2009 and up to Feb. 2020 under similar circumstances—it is almost impossible for me to obtain the details but the Chief Coroner’s Office and the hospital would have them-----these deaths may have been prevented if my daughter’s death was thoroughly investigated) by denying my request for my daughter’s death to go before the Patient Safety Death Committee and denying my daughter’s death be looked into by the Eastern Ontario Coroner through a review. (I know that legislation prohibited me from questioning the denial of a public inquest which I feel definitely limits a citizen’s right to appeal a wrong decision)  


4.  Making sure their concerns and needs of grieving families are met as this office has refused repeatedly to answer specific questions and concerns I have had and relayed to them.  They have also refused to communicate with me via telephone, faxes, e-mails.

They failed by:
5.   Overlooking, concealing and ignoring crucial factors related to my daughter’s care or lack of care which in turn did factor into her death

Is it not incumbent for the Office whose finances are paid by the public purse to pursue and ensure patient safety is protected especially when the hospital refuses to answer the question from the grieving family?   As well, I’m sure the attorneys and committee members are aware of the dismal record of investigations by the Ontario College of Physicians and Surgeons.  The Chief Coroner’s Office has the authority through holding pubic inquests, utilizing the Patient Safety Death Committee and having Regional Coroner investigations to obtain these answers.