Patient tells Ontario inquest Heather Winterstein was on floor 'crying in pain' in hospital ER on day she died

goodness morn. 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.

We're now on a 15-minute break, awaiting any questions the jury may have for Hutton.

Roy, the inquest lawyer, asks Hutton if she thought about raising the alarm to hospital staff about what she saw Winterstein experiencing.

Hutton said she did think about approaching staff.

But "I was scared to get involved," she says.

Hutton believes she emerged from getting her wound treated after about half an hour.

She didn't see Winterstein on her way out. Roy shows Hutton a screenshot from a security video of the waiting room at 2:21 p.m., and it shows Hutton walking.

"I want to say how profoundly sorry I am" to Winterstein's family for not doing more, Hutton says.

"I feel horrible that she suffered so much. I hope I'm helping people like Heather in the future." 

Hutton says when Winterstein was in the wheelchair, and "nothing seemed comfortable. She definitely seemed to be squirming, hurting." 

Hutton figures she saw Winterstein on the floor for about 20 minutes before the man told her to get back in the wheelchair. 

She says Winterstein returned to the floor for another half hour or 40 minutes before Hutton was called in to be treated. 

"At first, it was really loud. It got quieter and quieter. Towards the end, it was almost a whimper," she recalls of Winterstein's cries of pain.

Hutton says Winterstein kept repeating, "'my back.' There was no way [for her] to get comfortable.” 

There was "really, a lot of pain." 

Hutton recalls Winterstein being petite and wearing a thin shirt.

"She was barefoot. I noticed her toenails because they had been painted. She seemed like she was in so much pain. I was worried about her. She kind of reminded me of my daughter.

"I was worried about, was she homeless?"

Hutton recalls that Winterstein’s clothing didn't seem appropriate for how cold it was outside.

She says that maybe an hour after she got to the ER, either a security guard or an orderly, a tall man, approached Winterstein.

Winterstein was lying on the floor in a fetal position, and the man "told her that she had to get up on the chair," Hutton says. 

"She said, 'I can't,' and he said, 'You have to.'" She did, but as soon as the man left, she laid back down on the floor, says Hutton.

Hutton is back testifying, saying she checked into the hospital’s ER and was told to sit down, so she sat on a seat at the back wall of the waiting room. 

The inquest lawyer shows a timestamped screenshot of the waiting room with Hutton in a chair. The time 11:36 a.m. Is on it.

Hutton doesn't recall the waiting room being too jammed because she found a whole row of empty chairs. She recalls when she saw Winterstein.

"She was crying out loud, moaning, in pain. I Iooked over [and] she was on the floor. That's how I noticed her."

Sheryl Hutton, a patient who sought care in the St. Catharines hospital’s ER, is now testifying.

The inquest lawyer, Julian Roy, says her evidence is "very important." 

Hutton saw Winterstein in the ER waiting room on the day she died.

Hutton says she was in the ER seeking care after she cut her finger cutting a pit out of an avocado and needed stitches, so she drove herself there between 1 p.m. And 1:30 p.m. 

The inquest heard earlier that Winterstein was triaged just after noon that day and sent to the hospital emergency waiting room.

The inquest is on a short break to sort out technical equipment as jurors were having a hard time hearing the testimony.

We're now on a brief break as we get ready for the next witness.

Shoush says we have "centuries of understanding of how the human body works," but agrees when questioned by Eden that some treatments don't work. 

Shoush acknowledges the grief Winterstein's family is dealing with and hopes important recommendations will come out of the inquest.

Her testimony is now over. 

There was a short break so inquest jurors could ponder questions to ask Shoush. 

Juror questions are always the last part of questioning of witnesses.

The jurors had no questions, but one of them says they wanted to thank Shoush. 

The presiding officer, Dr. David Eden, asks Shoush about systemic racism. 

“We still have a system that still harms Indigenous people," she says. 

Shoush agrees with a question by Eden that identifying individual bigots doesn't stop systemic racism.

Shoush says systemic racism against Indigenous people and other groups is "inescapable.”

Systemic racism and biases "were contributing factors in how care was delivered" for Winterstein, she says.

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