Appeal board says Manitoba should pay for out-of-country spinal surgery in 'deeply concerning' case
CBC
An appeals board says Manitoba should pick up the tab for the spinal surgery a patient had in another country amid debilitating pain and intolerable wait times in the province.
The Manitoba Health Appeal Board suggests the patient met the criteria for urgent surgery, but resorted to paying more than $77,000 for it out-of-country last fall due to barriers they faced in the provincial health-care system, as their condition began "rapidly deteriorating."
"Their health required surgery without delay…. The appellant was in a state of urgency and had lost bowel and bladder function and was being severely debilitated by their condition," the board — an arm's-length organization intended to provide recourse for patients unsatisfied with certain health-care related decisions — wrote in its October decision.
"This situation is deeply concerning to the board."
The Manitoba Health Appeal Board met in July to review the complaint and recommended the patient be reimbursed for costs incurred for out-of-province medical services, a diagnostic procedure, accommodations and travel.
In its review, published online Oct. 29, the board asks Manitoba Health Minister Uzoma Asagwara to respond within 60 days.
The patient, who isn't named in the board decision, filed the complaint after Manitoba Health denied a request for reimbursement in May.
According to the board, the patient first began suffering from low back pain in 2020 due to lumbar stenosis, a condition where the narrowing of the spine can pinch blood vessels and nerves.
That's when they asked their family doctor for a referral the Manitoba Spine Clinic. That request wasn't completed until March 2023, the board says.
During the ensuing two years, the patient tried to cope through swimming as a "desperate means to alleviate the pain" while waiting on an assessment in Manitoba, the decision notes.
During their first assessment appointment in March 2023, a physiotherapist advised the patient wasn't a candidate for surgery but gave no explanation as to why, according to the appeal board.
The patient was referred to a pain clinic for spinal injections, but when the pain persisted, a doctor there eventually sent them back for another assessment. Again, the patient was deemed ineligible for surgery.
They had a couple more phone appointments, two steroid injections for pain and an MRI, all in April 2024.
Then they were told a surgeon was open to seeing them, and to call back every two weeks until an appointment opened up. They were eventually able to book a consult for November 2024.
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