A family is demanding answers from health officials after a 78-year-old Winnipeg man who was sent home from the hospital in a cab died on the way to his doorstep.

Here he is, by himself, in the cold, in the middle of the night. No help, no chance of help. - Miles Pollock, nephew of David Silver

On Dec. 30, 78-year-old David Silver was taken to Grace Hospital in an ambulance, suffering stomach pain, nausea and a headache.

According to Silver’s family, the doctors told him he had gallstones and kidney stones and the problem wasn’t serious enough for him to be admitted to the hospital.

At 1 a.m. on Dec. 31, they told Silver they were sending him home.

“He had nobody to call to take him home so they told him, ‘We're sending you home by cab, and we'll give you a cab slip' and that's what they did,” said his nephew, Miles Pollock.

David Silver is shown sometime in the 1960s. He died at age 78 on the front steps of his home after being released from hospital at 1:30 a.m. and sent home in a cab. (Family photo) According to Pollock, the senior was given a cab slip and sent home in his pyjamas and slippers.

On the way to his door, Silver collapsed and died. He wasn’t found until the next day, when his caregiver arrived to find him frozen in the snow. Temperatures overnight on Dec. 31 reached -37 C without the wind chill.

“[His caregiver] found him lying on the porch, frozen,” said Pollock. “He was taken to St. Boniface Hospital where he was pronounced dead. As you’d expect.”

Silver didn’t die from freezing to death, Pollock said. “He had died from a heart attack or some kind of a heart issue.”

Pollock and Silver’s sister want to know how an ailing 78-year-old man could have been released at 1:30 a.m. into bitterly cold temperatures with nothing but slippers and a cab slip.

Health authority investigating the case

The Winnipeg Regional Health Authority has confirmed it is investigating the incident, but officials have yet to determine if the situation meets the criteria for a critical incident review.

“People come at every time of day or night. We certainly have people discharged at every hour of the day or night,” said Lori Lamont, the vice-president and chief nursing officer of the WRHA.

Lamont added some patients will be discharged in pyjamas because that’s all they came to the hospital in.

She said the WRHA wanted to express its condolences to the family, and officials will look into formalizing a policy that has taxi drivers watch to see patients get to their doors safely.

"We need to look at those and understand them and see if there's something we need to be doing differently in the future," said Lamont. "We're looking at all circumstances surrounding his visit to the Grace Hospital emergency department, and we have been working in co-operation with the investigation by the chief medical examiner’s office.”

Current guidelines do not require cab drivers to escort patients to the door, but officials with the WRHA said cab drivers typically do watch for patients to get inside or help them.

"Part of the discussion and investigation is looking at what are the usual procedures of taxis and what, if anything, should we put in place in the future," said Lamont.

Officials added emergency rooms in Winnipeg see high volumes of patients, with the Health Sciences Centre seeing 50,000 ER visits per year alone, and staff can’t hold beds for people who are determined fit to be released.

“Frankly, I think it’s reprehensible. I don’t really understand why a hospital would release somebody at that time in the morning,” said Pollock. “Take some responsibility for making sure he makes it into his house! Especially on a night like that and especially at such an ungodly hour.”

Silver described as caring, mild-mannered man

According to Pollock, Silver had spent the last few years of his life caring for his brother.

“That was what he did. He saw himself as a person who had to look after the household and other people and he just was a good guy,” he said.

But Silver didn’t have many living relatives nearby who could have come to get him in the middle of the night.

Pollock and his family are now trying to come to terms with what happened.

“Here he is, by himself, in the cold, in the middle of the night. No help, no chance of help, and when you think they didn’t find him or he wasn’t found until 12 or 13 hours later – frozen. Oh my god, you just can’t compute that,” he said.

Not first time it has happened

This isn’t the first time a Winnipeg hospital has sent a patient home in a cab only to have the patient die shortly after.

Heather Brenan was sent home in a taxi from the Seven Oaks Hospital emergency room in January 2012. She collapsed on her doorstep and died from blood clots in her lower legs.

Her sister received an apology from the hospital, and officials with the WRHA said a new policy was developed after Brenan's death.

That policy was implemented at the Health Sciences Centre, but officials could not say if it was implemented at Seven Oaks or Grace Hospital.

Brenan's daughter, Dana Brenan, told CBC News on Thursday that hospitals need to take a closer look at how they treat and discharge patients.

"I think there's too much emphasis on turning over patients, of clearing patient numbers, instead of actually taking care of the patients that are ill," she said.

An inquest has been called into Heather Brenan's death, but her daughter said no date has been set yet.