Coroner’s inquest begins evidence relating to death of Roland McKay

THUNDER BAY — The coroner’s inquest into the deaths of Don Mamakwa and Roland McKay entered the ninth day of testimony Tuesday. Having thus far focused on evidence surrounding the circumstances of Mamakwa’s death, she now turns to the testimonies surrounding McKay’s death.

Mamakwa, 44, of Kasabonika First Nation, died on August 3, 2014 while in custody at Thunder Bay Police Headquarters. McKay, 50, of Kitchenuhmaykoosib Intinuwug First Nation, died July 19, 2017.

Kate Forget, the coroner’s attorney, began by reading into the transcript an agreed statement of facts regarding the night McKay died.

According to the agreed briefing, an 911 call was made shortly after 7:30 p.m. on July 19, 2017 regarding a man behind a store at Thunder Center who was described as unconscious. The man has been identified as Roland McKay.

Paramedics from Superior North EMS and officers from the Thunder Bay Police Service were at the scene. An examination of McKay was conducted by paramedics and although his vital signs were elevated, he said he did not want to go to the hospital.

McKay said he wanted to go to a friend’s house, and according to Special Investigations Unit interviews, two people said they were approached by police and asked if they knew anyone named Marlin McKay, who also knew some of Roland McKay.

Both people told SIU investigators that the officers said nothing about asking McKay to stay with them.

McKay was taken to Thunder Bay Police Service headquarters and placed in a holding cell. During one of the checks by an officer, it was found that he was not moving. Another check was conducted and it was found that he was not breathing.

Officers began CPR and an ambulance was called. He was taken to the hospital, where he was later pronounced dead. Earlier testimonies indicated that he died as a result of hypertensive heart disease.

The inquest jury viewed CCTV footage from inside the police station, which showed McKay being taken to the booking room and cell. In the video, he is seen walking next to a police officer and when brought into the cell he was sitting up, began to sway, then lay down and shortly thereafter stopped moving.

Myles Vescio and Summer Philion-Aichinger, the two primary care paramedics at Superior North EMS who first responded to the 911 call, also testified Tuesday.

Philion-Aichinger said when they first arrived at the scene, McKay waved them away, but they exited the ambulance and investigated the situation.

An investigation was conducted which found McKay’s vital signs, such as heart rate and blood pressure, to be above normal parameters.

“I noticed that it was elevated, but just assuming he appeared to be a taller man, he seemed to have some drug or alcohol use problems, so he seemed to be in poor general condition, so his vital signs increased seemed to be, but it might not be far from what would be usual,” said Philion-Aichinger.

Vescio added that a visual assessment, also known as a “gaze test,” was performed and he had no symptoms of his elevated vital signs.

“It passed the so-called look test,” he said. “He had no ailments, he seemed to have no ailments.”

After police arrived, Philion-Aichinger said McKay made it clear he didn’t want to go to the hospital and instead wanted to go to a friend.

“I think I asked him twice,” she said. “I asked him if he had to go to the hospital for anything today and if he wanted to go to the hospital. It just seemed like he wasn’t very happy that we were there.”

Persons cannot be transported to hospital against their will unless they are at risk of self-harm or are unable to adequately assess the care required.

Back then, paramedics weren’t required to get a patient’s signature or witness statements about denied transport, but that’s now changed.

Philion-Aichinger said at the time she didn’t think he needed to go to the ER, but added if he had asked to go he would have been taken.

“We have a lot of calls that are very similar, if we show up, the patient doesn’t want to leave or is too drunk to refuse, so goes to the hospital to sober up, or to an ally, agencies like the police or SOS get people that need to be taken away and take them to the Shelter House or to a place where they can be monitored to some extent,” she said.

“We got out anyway and checked him over to make sure he was okay. If he had expressed some concerns about how he was feeling alongside those numbers on our monitor, I would have chosen to elaborate on the fact that if he wasn’t feeling well he should go to the hospital.”

The Balmoral Detox Center was contacted but no beds were available that night.

Both Philion-Aichinger and Vescio agreed that more decontamination rooms are needed in the city to assist in these situations and to ease the pressure on the emergency services, which often experience delays averaging two to six hours in discharge at the hospital and Code black situations are faced when no ambulances are available in the city.

“Mr. McKay would be in my eyes being watched or in the presence of someone else, he wouldn’t be alone,” Philion-Aichinger said. “To have a larger facility where more people could go and be monitored for hours and hours and over having the resources to get help would really ease that pressure that arises in an emergency.”

“We urgently need a large center where people can safely detox,” Vescio added. “They run the risk of suffering a secondary emergency while being late at the hospital. We don’t have a suitable alcohol substitute for people going through a detox.”

In his 11 years as a paramedic, Vescio said he’s only successfully transported a person to the detox center twice, the only times beds were available.

Before the jury established evidence of McKay’s death, they heard testimony from former Thunder Bay Police Service Staff Sgt. William Boote, who was serving as the watch commander on the night of August 3, 2014, when Mamakwa died in a cell at the police service headquarters.

According to Boote, he leads a “tight ship” as a guard commander and does not micromanage the prison guards. He said he had full confidence in Const. Sherry Heyder was working as a prison guard that night, but he admitted he was not happy with what happened the night Mamakwa died.

“I’m sure Const. Heyder and I would have reacted differently if we had known certain things,” he said, referring to knowing Mamakwa was diabetic.

When asked specifically what he was not happy about on the night of August 3, 2014, Boote pointed out that Mamakwa spent several hours in a cell before he was discovered.

“Even if we had found him dead on the ground at midnight it would still have been a forensic examination. Even if he was taken to the hospital and died a few days later, it would still be a forensic examination and a death in custody,” he said.

“I am not happy because it is inappropriate that this gentleman has been dead on the ground for three hours and we have not discovered him. I don’t think it suits his dignity.”

The recommendations Boote suggested during his testimony that could help prevent similar deaths in the future centered on the need for a new police station.

Boote said a new facility would offer an updated cellblock with better video and audio surveillance to protect detainees from self-harm and officers to better monitor what’s going on in the cells.

“This station is old and run down. They need a new station,” he said. “The electricity entering the building is not enough. There are brown outs. It was built and there was a lot of cost savings. This city is reluctant to spend money on the police.”

Testimony in the inquest will continue on Wednesday.