Horizon Health leadership fielded staff concerns about a makeshift hospital unit in an ambulance bay as far back as a year before it came into the public eye.
Those concerns span from infection prevention to temperature issues and loud noise, and are captured in documents obtained through a right-to-information request.
The Medical Transition Unit, or MTU, at the Dr. Everett Chalmers Regional Hospital in Fredericton made headlines in January after several people went public with their experiences on the unit — which was without running water, bathrooms or beds.
Horizon said the unit opened in December 2024, in response to hospital overcrowding, as a temporary space for patients waiting for admission to hospital.
Over a year, Horizon Health staff warned of substandard infection-prevention control and air quality, among other problems, after an ambulance bay was converted to hold patients, documents show.
But staff correspondence shows that the space became used more as a regular unit, with patients held there regularly for over a week.
After the public outcry in January, the network promised to move patients out of the ambulance bay and followed through in early April.
But long before that, documents show that staff within the hospital were sounding the alarm.
‘Elevated’ infection risks
On Jan. 7, Dr. Kimberley Barker, the regional medical officer of health, emailed Horizon with concerns about infections on the unit.
“I worry that patients in these units may become contaminated and, when finally discharged, may become a source of community based antibiotic resistant organisms such as cluster Dificil,” Barker wrote.
She asked Horizon for an opinion from the health authority’s infection prevention and control team.
But Horizon’s leadership team had already received that opinion.
In a briefing note dated November 2025, Horizon’s regional infectious diseases medical director, Dr. Rossana Rosa, and regional infection prevention and control lead, Merita MacMillan, had raised a list of concerns about the unit and asked for urgent action.
They flag “key deficiencies” in the MTU, including inadequate ventilation and temperature controls, absence of sterile supply rooms, limited or no access to hand hygiene sinks, and suboptimal waste management.
“The prolonged use of the MTU as a quasi-inpatient unit — without appropriate infrastructure — poses elevated risks for healthcare-associated infections, [and] compromised environmental hygiene,” the brief said.
Clinical executive director David Arbeau also said in an email that Rosa had been raising these issues “for some time” but doesn’t specify for how long.
But the brief makes it clear that Horizon’s infection prevention and control team wasn’t supportive of the MTU as it was being used.
“Many concerns raised by local [infection prevention and control] teams remain unresolved,” Rosa and MacMillan wrote.
“At no time during the planning, construction, or renovation … were [infection prevention and control] professionals consulted,” Rosa and MacMillan said.
Horizon did not provide Rosa or MacMillan for an interview about their report.
Barker was also not made available for interview, despite a request to the Department of Health.
Temperature concerns
In May 2025, staff began asking questions about how the unit would continue in the summer.
In an email on May 12, hospitalist department head Dr. Jeremy Myles said he had seen “no identifiable progress to prepare” for the hotter months.
“I’m not confident that bedside fans will cut it,” Myles said.
“It’s one thing to pile blankets on cold elderly patients in the winter, but quite another to try to cool them down when it’s >35 degrees in there. This could lead to some potential patient safety issues.”
On May 21, clinical executive director Tricia Murray said it was already “extremely warm” in the space.
“Last week during the hot spell it created some challenges for both patients and staff which will only get worse in the coming months.”
On May 22, an announcement went out that a new cooling system was purchased, but it’s not clear from the emails when exactly it became operational.
However, the network’s infection prevention and control team brief said that still wouldn’t be enough to meet standards.
Substandard equipment
Toward the end of summer 2025, Dr. Kate Hadley wrote with “major concerns” about oxygen equipment on the MTU.
“I recognize there are screening criteria for patients to be ‘appropriate’ to go there, however it often houses newer admissions who have higher likelihood of having a change in clinical status,” Hadley wrote.
“Patients in a hallway would not have plumbed in bedside oxygen or suction — but they would also not be staying in a hallway for 7-10 days.”
Hadley added that if the space is being used as a medical unit, there should be a goal to provide all the standard equipment.
That’s because the state of a patient can change fast, Hadley and Dr. Mark Tutschka pointed out.
“Main point from me is the obvious one…‘not sick’ inpatients can get sick unexpectedly and quickly,” Tutschka said by email.
“When this occurs a pathway for access to higher acuity capability and/or staffing is needed.”
Horizon published a standard operating procedure for transferring patients out of the MTU, but that didn’t take effect until Jan. 7, 2026.
The document lists reasons a patient should be considered high priority to leave the MTU — for example, those with oxygen therapy needs or with a transmissible illness.
Staff report ‘headaches, ringing in the ears’
In January 2025, nurse manager Sophie Cholette wrote to an executive director with concerns about her staff working on the MTU.
“Staff have been voicing concerns about the fan. They report going home with headaches, ringing in the ears and sensitive to noise,” Cholette said.
“Staff do not feel they can work in MTU a few days in a row. Some staff will only be assigned here, and I don’t want to cause them harm.”
Cholette worried about the long-term impact the noise might have on staff.
But added the fan heats the ambulance bay and they would lose heat if staff turned it off.
Facilities manager Richard Schriver said he would send someone to look at the fan — but said it was likely functioning as intended.
“These fans are made for an ‘ambulance bay’ and by nature are noisy,” Schriver said.
The documents provided to CBC News show the area was tested, and noise fell within the acceptable level set by provincial workplace safety laws.
Horizon spokesperson Kris McDavid said those concerns would have been resolved when the new heating and cooling system for the garage was purchased.
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