THUNDER BAY – A paramedic who responded to reports of Don Mamakwa unconscious in August 2014 apologized to his family during an inquest examining his death Thursday, saying she wished she had done more that day to provide him care.
“I want to say to Don’s family that I am very sorry and that I can’t imagine what you’ve been through and what you are going through right now,” said Heather Gilbert, a primary care paramedic with Superior North EMS.
“I wish I could go back to that day and do things differently and take control of that call when he said he wanted to go to the hospital. I would have assessed him and taken the best care of him I could.”
Gilbert was called to testify on day three of the coroner’s inquest into the deaths of Mamakwa and Roland McKay.
Mamakwa, 44, of Kasabonika First Nation died while in the custody of the Thunder Bay Police Service on Aug. 3, 2014 from complications relating to diabetes and chronic alcoholism.
McKay, 50, of Big Trout Lake, died while in custody on July 20, 2017 from a hypertensive heart condition.
Both men had originally been picked up for public intoxication and were transported to TBPS's Balmoral Street headquarters.
During her testimony, Gilbert said she and her paramedic partner, Rob Corbeil, received a call for a 'man down' in the area of Donald and Brodie streets in the late afternoon of Aug. 2, 2014.
When the EMS team arrived, police were already on scene and Gilbert said Mamakwa was standing on his own with an officer.
According to Gilbert, the officer "waved her off," a common practice among first responders when one agency feels it has control of the scene and the other is no longer required.
Before leaving the scene, Gilbert reported hearing Mamakwa say he wanted to go to the hospital.
“The police officer turned to Don and asked him why he wanted to go to the hospital,” Gilbert said. “Don said: ‘umm’ and then the officer said: ‘Do you just want to go to the hospital for a sandwich’ and Don said: ‘yes.’ Then the police officer said that is no reason to go to the hospital, you are going to jail.”
No physical assessment of Mamakwa was conducted by Gilbert, but she said he did seem to be having some difficulty breathing.
Corbeil did not testify, but a videotaped interview with him was played for the jury on Thursday.
In the interview, Corbeil said Mamakwa did not seem to be in any distress and in his opinion, there did not appear to be any shortness of breath.
“He didn’t seem that impaired. He possibly could have been. He wasn’t slurring his words, he wasn’t falling down, he was able to walk on his own,” Corbeil said. “I told them he doesn’t look short of breath to me.”
Corbeil did not conduct any physical assessment of Mamakwa either, such as listening to his heart or lungs or checking his pulse.
Peter Keen, counsel for the coroner, asked Gilbert if not conducting any physical examination of a patient goes against the basic life support standards that are to be followed by paramedics. She agreed that it did.
“I suspect we will hear evidence that officers thought an assessment was done and that he was medically cleared,” Keen said. “Was there any assessment of Mr. Mamakwa that day?”
“No,” Gilbert said.
Asha James, counsel representing the family of Mamakwa and McKay, asked Gilbert about police "waving off" paramedics on the scene.
“Would it be fair to say that with this call off, whether or not someone requires medical treatment is being deferred to the police?” James asked.
“Yes,” Gilbert said.
“Would you agree that is inappropriate?” James asked.
“It appeared to be a call for the police, not EMS,” Gilbert responded.
Keen also asked Gilbert if paramedics were reluctant to take intoxicated people to the hospital at the time in 2014 because it would tie up ambulance crews for extended periods of time.
“I guess yes and no,” Gilbert said. “Over the years, since 2014, I’ve tried to let my co-workers know things that can happen and pass the word. I think in general most medics now, if people need to go to the hospital because they are intoxicated, we take them. It would be nice if there were more options.”
On Wednesday, Dr. Suzanne Shoush, a family physician and medical expert, testified to how racial bias and stereotyping in institutions create barriers for Indigenous people accessing health care.
“If you are an Indigenous person who needs to seek health care, you are aware from the beginning that you might experience discrimination or racism and the health care provided may make assumptions about you like you are a drug seeker or a frequent flyer,” she said.
Shoush said while individuals may not be at fault, systemic racism exists in institutions like the police and health care providers.
“When you're operating in a system that is inherently unfair, you are individually trying to mitigate the challenges,” she said. “This is a system-wide problem and not an individual problem.”
Shoush added there needs to be more cultural sensitivity training, education, and reflection for frontline workers to better assist people facing addictions, mental health issues, and racialized individuals.
More appropriate services are also needed, including alcohol management programs and detox centres, she said, while being placed under arrest shouldn't be the first or only option.
“Arrest for public intoxication is still on the table,” Shoush said. “When no one else is there to help that person, the last resort is to call the police and take them to the ‘drunk tank.’”
Asked what recommendations she'd like to see emerge from the inquest, Gilbert agreed with Shoush that more options are needed.
“I think Thunder Bay needs more addiction and mental health services,” she said. “Supportive houses with services inside that help with addiction and mental health.”
TBPS Const. Ryan Krupa, one of the officers who first interacted with Mamakwa, also began testimony Thursday.
He reported receiving a call of a possible unconscious male near Brodie and Donald. When he arrived, he observed a man on the ground he knew to be Mamakwa from previous interactions.
It took several attempts to wake him up, and Krupa said he could detect an odour of alcohol and that Mamakwa’s eyes appeared glossy and red.
Mamakwa then asked to go to the hospital, according to Krupa, saying he was hungry and wanted a sandwich. He also mentioned that his knee and hip were sore.
Asked about his training on recognizing altered states of consciousness and how other conditions can mimic signs of intoxication, Krupa said he had minimal training in that regard.
However, he said he believed paramedics on scene had cleared Mamakwa to be transported to police headquarters.
“In the field for us as police officers, that’s our best course of action to get any kind of medical checks, [is] the paramedics,” he said. "When I inquired whether he was okay to come with us, it was directed to me in my opinion that he was, I thought that was fine, medically.”
Krupa said there was no change in Mamakwa's behavior from the time he was woken up to when he was placed in a cell.
Keen asked Krupa if, as a police officer, he makes a judgment that a call for service is a medical issue or policing issue. Krupa said that was a fair assessment, and Keen asked if he felt he was qualified to make that judgment.
“I felt [Mamakwa] was intoxicated enough that he needed assistance, whether it be from us or paramedics,” Krupa said. “If it wasn’t for his breach of his probation, avenues for detox would have been explored. I don’t think he was in any shape to say: get out of here, carry on.”
Krupa will continue testimony on Friday.