Inquest into Heather Winterstein’s sepsis death to hear from Ontario hospital CEO, emergency medicine chief

goodness forenoon. I'm alice paul Forsyth, and I've been natural covering this inquest since it began on process 30. 

The coroner’s jury has taken in a lot of emotional testimony on what may have led up to the death of Heather Winterstein on Dec. 10, 2021. The 24-year-old collapsed in the St. Catharines, Ont., hospital’s emergency department waiting room on the second day she tried to seek care for pain from a fall.

We’ve already heard from a number of the about 22 witnesses set to speak during the 13 days of hearings.

They include Winterstein’s mother, father, brother and stepmother, who spoke about the grief the family has endured since she died of sepsis. The life-threatening medical emergency amounts to a severe reaction to a bacterial infection, causing the immune system to harm healthy tissues and organs.

Winterstein was a member of the Cayuga Nation, with ties to Six Nations of the Grand River. Her family and community organizations have raised concerns about whether addiction discrimination and anti-Indigenous racism may have played a role in how she was treated. 

Yesterday, testimony addressed whether there were any medical “biases” in the Winterstein case, in part due to her being Indigenous. 

Among medical professionals who’ve testified was an emergency room triage nurse who said the COVID-19 pandemic put even more strain on staff in the busy emergency room, so she barely had time with Winterstein. 

A range of doctors and medical specialists have weighed in on the type of assessments and care Winterstein received, including on Dec. 9. The physician who saw her, Dr. Emad Nour, looked for signs of infection, but ruled that out in part because she didn’t have a fever. He diagnosed her as having “social issues,” and noted in his doctor's notes that she had a substance use disorder and generalized anxiety disorder. She was sent home with a Tylenol and given instructions to come back to the hospital if her condition worsened. 

The next day, Winterstein died despite frantic attempts by medical staff to save her. A woman who was seeking care and spoke briefly to Winterstein told the inquest she “just looked terrified.… She clearly wanted help" before she collapsed.

Crawford says the hospital has had 100 per cent buy-in among top administration in a 12-hour cultural safety training program. 

She agrees that "anti-Indigenous bias" in health care does happen.

Shoush says the fact administration is on board for the cultural safety training program is “fantastic."

Crawford is citing other steps the hospital has undertaken to help improve Indigenous services.

She noted all staff and physicians are undergoing bias- and trauma-informing training. 

Shoush says that type of training can lead to better patient-centred care. 

"These are skills for lifesaving," she says, noting it’s similar to what using CPR on someone can achieve.

Kate Crawford, a lawyer for Niagara Health, which operates the hospital, is asking Shoush about a new Indigenous community room in the hospital that the regional health system has created. 

Shoush says it’s a good step, but other steps in terms of engaging individuals using the ER are also needed to improve health-care services for Indigenous people.

The inquest is now underway, with Dr. Suzanne Shoush continuing testimony she began yesterday. 

Shoush is a family physician with expertise in the Indigenous experience in the health-care system.

Not every death is examined by coroner’s offices in Canada. 

The purpose of such investigations also vary according to the province or territory involved. But commonly, inquests are held to investigate deaths that are sudden, out of the norm or unexpected.

In Ontario, there are “mandatory” inquests (for instance, if someone dies while in prison or police custody) and “discretionary” inquests, which are called when they’re deemed in the public interest.

Jurors are tasked with determining the facts in a case and may make recommendations to prevent similar deaths. They don’t assign blame or make findings of guilt or innocence.

Today, the 11th day of the inquiry, we’re expected to hear from:

Good morning. I'm Paul Forsyth, and I've been covering this inquest since it began on March 30. 

The coroner’s jury has taken in a lot of emotional testimony on what may have led up to the death of Heather Winterstein on Dec. 10, 2021. The 24-year-old collapsed in the St. Catharines, Ont., hospital’s emergency department waiting room on the second day she tried to seek care for pain from a fall.

We’ve already heard from a number of the about 22 witnesses set to speak during the 13 days of hearings.

They include Winterstein’s mother, father, brother and stepmother, who spoke about the grief the family has endured since she died of sepsis. The life-threatening medical emergency amounts to a severe reaction to a bacterial infection, causing the immune system to harm healthy tissues and organs.

Winterstein was a member of the Cayuga Nation, with ties to Six Nations of the Grand River. Her family and community organizations have raised concerns about whether addiction discrimination and anti-Indigenous racism may have played a role in how she was treated. 

Yesterday, testimony addressed whether there were any medical “biases” in the Winterstein case, in part due to her being Indigenous. 

Among medical professionals who’ve testified was an emergency room triage nurse who said the COVID-19 pandemic put even more strain on staff in the busy emergency room, so she barely had time with Winterstein. 

A range of doctors and medical specialists have weighed in on the type of assessments and care Winterstein received, including on Dec. 9. The physician who saw her, Dr. Emad Nour, looked for signs of infection, but ruled that out in part because she didn’t have a fever. He diagnosed her as having “social issues,” and noted in his doctor's notes that she had a substance use disorder and generalized anxiety disorder. She was sent home with a Tylenol and given instructions to come back to the hospital if her condition worsened. 

The next day, Winterstein died despite frantic attempts by medical staff to save her. A woman who was seeking care and spoke briefly to Winterstein told the inquest she “just looked terrified.… She clearly wanted help" before she collapsed.

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