I lost my father-in-law a couple of years ago, partly concerning this very issue. He had an MI in Nanaimo, was hospitalized there, and then subsequently transferred down to Victoria for the cath lab. Initial intervention was done, but further heart cath treatment was required. He was sent home but unfortunately had another cardiac arrest a couple of days later and died in the NRGH trauma room. Two things come to mind – had he been able to have the procedure in Nanaimo, possibly he might have been kept in the hospital longer and been able to have the second procedure. Secondly, I’m sure the stress of being sent down to Victoria, alone without family support, also may have contributed to the outcome. I’m confident that my father-in-law received excellent care in both hospitals, but the overall care was lacking because he should have had access to the cath lab intervention he needed sooner and without the stress of a patient transfer.