Manitoba regulator cancels licence of nurse after medication error that led to cardiac arrest
A disciplinary panel revoked the licence of an internationally trained RN who gave drugs in the wrong order during an intubation, a mistake a paramedic corrected to save the patient.
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By Torontoer Staff
Manitoba’s nursing regulator has cancelled the licence of Nipaben Patel after a disciplinary panel found she administered medications in the wrong order during a preparatory procedure, provoking a cardiac arrest that only ended after a paramedic intervened, according to the panel’s sentencing report released Thursday.
The decision, published eight months after the College of Registered Nurses of Manitoba raised concerns about some internationally educated nurses, highlights tensions between labour mobility rules and professional safeguards meant to verify recent clinical experience.
What happened in Lynn Lake
On the morning of Nov. 6, 2024, Ms. Patel was working in the emergency room of the Lynn Lake hospital when paramedics brought in a 55-year-old man who was struggling to breathe and had blood around his mouth. The lone physician on site decided the patient should be flown to Winnipeg and needed intubation for the transfer.
According to the panel’s summary, Ms. Patel administered fentanyl and succinylcholine in the wrong sequence, gave the drugs without the doctor present or the intubation equipment ready, did not double-check medications or ask for clarification, and failed to document her actions properly. The patient went into cardiac arrest and only survived because a paramedic intervened to do CPR, the regulator’s lawyer said at the hearing.
The patient went into cardiac arrest and only survived because a paramedic intervened to do CPR.
David Swayze, lawyer for the regulator’s complaints investigation committee
Who Ms. Patel is and how she was licensed
Ms. Patel was educated in India and had not practised as a registered nurse for 13 years when she began working for private nursing agencies in Manitoba in 2023. She had more recent experience working as a licensed practical nurse in long-term care, providing foot care and similar duties.
She passed an RN licensing exam in New York, secured a licence there, then obtained an Ontario licence, which allowed her to gain a near-automatic Manitoba licence under interprovincial labour mobility rules. The disciplinary panel said that if additional scrutiny had been applied when she applied in 2023, the incident and subsequent proceeding might have been avoided.
These tragic events and this proceeding might have been avoided in their entirety.
Disciplinary panel
Hearing, defence and panel decision
At the hearing, Ms. Patel’s lawyer told the panel her client panicked in a chaotic situation and had never worked in an emergency room. Ms. Patel admitted administering the medication, took responsibility, cooperated with investigators, pleaded guilty to most of the allegations and resigned her position. She has not worked since the incident and had no prior discipline history.
The defence asked the panel to suspend Ms. Patel rather than revoke her licence, warning against using her case as a symbol for all internationally educated RNs who obtain Manitoba licences through labour mobility. The panel rejected that argument and cancelled her licence.
Policy context and next steps
The case comes after a broader dispute over a "currency of practise" requirement the College of Registered Nurses of Manitoba sought to keep in effect. That standard would require recent clinical hours, a competence assessment, or remedial education for applicants whose registrations come via labour mobility.
A previous provincial government removed the standard in 2022, citing the Canadian Free Trade Agreement. The college reintroduced the policy in December 2024, but the provincial government struck it down last spring. The college also implemented, in March last year, a rule that RNs must have more than 2,000 hours of experience in a Canadian jurisdiction to work for private agencies.
Deb Elias, the college’s chief executive officer, said the organisation will seek a meeting with the Manitoba government to discuss the currency of practise standard in light of the case. Manitoba Health Minister Uzoma Asagwara’s office did not immediately respond to a request for comment.
Timeline at a glance
- 2022: Province orders the currency of practise standard scrapped, citing the Canadian Free Trade Agreement.
- March 2024: College requires RNs to have more than 2,000 hours in a Canadian jurisdiction to work for private agencies.
- Dec. 2024: College reintroduces a currency of practise policy; government later quashes it.
- Nov. 6, 2024: Medication error in Lynn Lake leads to cardiac arrest; patient survives after paramedic CPR.
- 2023: Ms. Patel applied for and received a Manitoba licence via labour mobility after obtaining licences in New York and Ontario.
- Thursday (decision published): Disciplinary panel revokes Ms. Patel’s licence.
The ruling places the spotlight back on how Manitoba balances labour mobility obligations against safeguards that verify recent clinical experience. The college has signalled it will press the government to revisit the issue, and the case underscores ongoing debate about patient safety, credential recognition and workforce needs in the province.
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