Commonwealth_ Wendy Guimont, a well-loved piano teacher from Cranbrook, B.C., passed away in July 2023, not from the metastatic pancreatic cancer she had been battling but due to kidney failure brought on by a severe reaction to the antibiotic vancomycin. Her death has sparked calls for better drug monitoring in hospitals, particularly for older patients and those who require long-term treatment with this powerful antibiotic. Wendy’s passion for music extended far beyond her piano lessons. She inspired and trained music instructors for children across Canada. Outside of her career, she embraced life fully, enjoying outdoor activities like hiking, biking, and golfing with her husband. They often went on RV trips, including to Arizona. However, while in the U.S., Wendy’s health took a turn. The back pain she had initially dismissed worsened, leading to her Valentine’s Day 2021, diagnosis of metastatic pancreatic cancer.
Remarkably, despite the gravity of her diagnosis, Wendy showed incredible resilience. Her family noted that she gained both weight and strength while undergoing chemotherapy, an unusual but hopeful outcome. Unfortunately, her health journey took a tragic turn in 2023, not from the cancer itself but due to complications from the treatment of an infection with vancomycin, a commonly used antibiotic.
For serious infections like staph, doctors frequently prescribe vancomycin, especially when other antibiotics may not work. However, it carries significant risks, particularly for older patients, like Wendy, who was 65. One of the well-documented risks of vancomycin is its potential to cause nephrotoxicity, or kidney damage, especially when administered over extended periods. As many as 10% of patients receiving standard doses develop some form of kidney injury due to the drug, with the highest rates found in those critically ill and admitted to intensive care units (ICUs).
Wendy experienced this complication firsthand. After developing an infection that progressed into sepsis, a life-threatening condition where the immune system overreacts to fight an infection, she was stabilized and transferred out of the ICU. However, she remained on vancomycin to treat the infection.
Penny Guimont, Wendy’s daughter, explained that her mother was recovering and stable enough to be moved back to her hometown hospital, East Kootenay Regional Hospital in Cranbrook, on February 25, 2023. However, it was here that issues arose with the administration and monitoring of vancomycin. The hospital staff conducted a test to measure the “trough level”—the lowest concentration of the drug in the bloodstream—to determine if dosing adjustments are necessary to prevent toxicity. Unfortunately, they took this sample too soon after administering a dose, resulting in a “peak level” reading instead. This meant that accurate conclusions about Wendy’s vancomycin levels couldn’t be drawn.
The error was recognized, and hospital staff took corrective measures, but by the time Wendy’s kidney function had worsened on March 1, the damage was done. She had already begun to show signs of kidney failure. The vancomycin was appropriately discontinued, but the decline in her kidney function continued, eventually leading to her death on July 8, 2023.
Wendy’s family, particularly her daughter Penny, is heartbroken, feeling that her mother could have fought much longer if the kidney failure had not compounded her already serious cancer diagnosis. They are now advocating for improved monitoring of vancomycin and other high-risk drugs in hospitals. Experts agree that while vancomycin is a valuable tool in fighting infections, it requires careful management, particularly in older patients or those with other health complications. Staffing shortages and other challenges in hospitals can result in delays or mistakes in drug monitoring, which can lead to severe consequences, as was the case with Wendy.
