“When Rheanna Laderoute realised she was pregnant at age 19, she told neither her sister nor her mother. She went to a women’s health clinic in Brampton, Ontario – about an hour’s drive from her home – 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 February 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 Intensive Care Unit (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’s 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 40 pages of Ms Laderoute’s medical records, which were provided by Ms Costabile (her sister), 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….”
[This is a long, detailed article that describes almost hour by hour the decline in her condition, leading to her death the next day, which deserves to be read in full. We cannot provide the whole text but encourage readers to read the whole article, due to the many intersecting critical problems it raises that involved so many different hospital staff. It shows how she was constantly denied ICU care by a second senior male doctor, in spite of the nurses regularly requesting it.]
“The coroner, who performed a post-mortem examination in the hours after Ms Laderoute’s death, found peritonitis and signs of septic shock. While “the source of the infection could not be identified,” the coroner noted that “a bacterial infection was likely”. (Blood and swab tests came back negative, possibly because samples were only taken after IV antibiotics were administered.)….
“Although the hospital said they would review what happened and make recommendations if necessary to prevent future harm, the chief communications officer declined to provide any information on whether reviews had been completed regarding Ms Laderoute’s care, and what, if any, changes resulted….
“After accessing and poring through her sister’s medical records, Ms Costabile complained to the College of Physicians and Surgeons of Ontario about Dr Duic’s and Dr Chang’s treatment of her sister. The dismissive comments attributed by the nurses to Dr Chang made her livid, and she didn’t think Dr Duic should have discharged her sister, given how sick she was.
“Dr Chang received an in-person caution, the regulator’s term for a warning. The College said “the Respondent missed many clinical signs/symptoms or ‘red flags’ that the Patient was very sick and was experiencing end organ dysfunction, and thus should have been admitted to the ICU sooner, if not at the Respondent’s first assessment, then definitely by the Respondent’s second assessment.” At that point, his case was still under review, however.
“Dr Duic’s punishment was more severe. In February 2025, the Ontario Physicians and Surgeons Discipline Tribunal found that Dr Duic committed professional misconduct and suspended his licence for three months. (The report goes into the details of these.) Dr Duic did not contest these. In April 2025, Dr Duic, who is in his 70s, resigned his medical licence.
“Danny Kastner, a Toronto-based lawyer, who represented eight female physicians who first complained about Dr Duic in 2018, says the College should have issued a more severe punishment to Dr Duic years ago. Mr Kastner points out that the College cautioned or counselled Dr Duic four times between 2009 and 2018, without ever sending him to a disciplinary committee. Mr Kastner also said the college failed to adequately investigate the gender discrimination and improper billing allegations against Dr Duic, which were reported in The Globe and outlined in a complaint that Mr Kastner submitted to the College in 2019. “My clients and I are haunted by the realization that a decisive disciplinary response from the College… might have prevented this tragedy,” he said….
“Systemic failings also contributed to Ms Laderoute’s death, sources interviewed by The Globe said. Health workers and advocates said the delays, communication breakdowns and difficulty accessing an ICU bed are clear signs of an under-resourced health system. An emergency physician from Perth, Ontario, said that understaffing at hospitals means emergency doctors are overwhelmed with sick patients and “you worry every day that you’re going to miss something.”
“Michelle Cohen, a current family physician and former emergency physician from Brighton, Ontario, and one of the eight female physicians represented by Mr Kastner, questions whether the predominantly male makeup of Southlake’s emergency physicians was a factor in the care Ms Laderoute received. For most of the seven years Dr Duic was chief of emergency, there were no female physicians working in the department. Today, Southlake has two female emergency physicians out of 17, making it an outlier compared with other departments its size in the province.
“In comparison, St Joseph’s Health Centre in Toronto rapidly scaled up its presence of female physicians after Dr Duic’s time there ended more than a decade ago. Today, 21 of the hospital’s emergency physicians are women, representing 40 per cent of the total….
“Dr Cohen pointed to research showing female physicians are generally more responsive to women’s health issues than male physicians, and that they can positively influence how their male colleagues practise. As an example, a study published in the British Medical Journal in 2021, involving 98 physicians and more than 2,600 patients, found female emergency doctors are 50 per cent more likely than male doctors to request an obstetrician-gynaecologist consult in early pregnancy loss cases.
“Dr Cohen, who reviewed Ms Laderoute’s medical records with Ms Costabile’s permission, points out that they show none of the emergency doctors who assessed Ms Laderoute (all of whom were male) performed a pelvic exam, nor requested an in-hospital gynaecologist consult – which meant neither of these occurred until she was unconscious in the ICU.
“Southlake has had since 2018 to investigate serious concerns about gender discrimination and I’m not at all reassured by how they’ve dealt with it,” Dr Cohen says. “I think the onus is on the hospital now to show that they’ve actually addressed longstanding concerns, including the possibility of a women’ health knowledge and skills gap in the emergency department.”….
“Ms Costabile hopes that raising awareness of what happened to her sister can prevent others from suffering the way her family has. “This system failed her. It failed to look deeper into what was causing her pain, failed to listen to the nurses who were sounding the alarms,” she says.
“We cannot continue to allow a culture where doctors see themselves as above accountability, and where women are dismissed, disbelieved or ignored.”
SOURCE: The Globe and Mail (BC edition), Globe2Go.Pressreader.com, 27 August 2025.