Robert Knipstrom was face down and handcuffed for more than an hour before his cardiac arrest, a coroner's inquest has heard. (CBC)

A coroner's inquest jury in Chilliwack, B.C., heard testimony Wednesday that suggests that delays and improper handling in custody contributed to the 2007 death of a man following a violent confrontation with police.

Robert Knipstrom of Chilliwack died five days after the confrontation at an equipment rental store Nov. 19, 2007, in his hometown, 100 kilometres east of Vancouver.

Police responded to a call about a man acting strangely, apparently on drugs. RCMP ultimately used a metal baton and pepper spray to try to control Knipstrom, 36, then used a Taser stun gun on him six times.

But the focus shifted at the inquest Wednesday from the RCMP's handling of Knipstrom to his treatment at the hands of paramedics and Chilliwack hospital staff.

Paramedics Rick Simon and Andrea Seymour said they came on the scene in the rental store to find Knipstrom covered in blood and incoherent, face-down on the floor with his hands cuffed behind his back.

Face-down on trip to hospital

Knipstrom remained face-down — even when placed in the ambulance — because he refused to turn over, they said.

Roderick MacKenzie, lawyer for the inquest, suggested that physical position might have restricted Knipstrom's breathing, contributing to his eventual cardiac arrest.

'You made a decision not to follow policy?'—Inquest lawyer Roderick MacKenzie

B.C. Ambulance Service policy states that patients should be transported on their back, especially when handcuffed.

"You made a decision not to follow policy?" MacKenzie asked paramedic Simon.

"Yes, I did," said Simon. "We tried numerous times to roll him. He was resisting our attempts."

The paramedics said once they got Knipstrom to Chilliwack hospital, they had to wait almost half an hour for Knipstrom to be seen by a nurse.

'He was turning blue'

"I was getting concerned about the patient. I was looking for the bedside nurse, to say, 'We need some attention here,'" said Simon.

"I came back into the room, and saw he was turning blue. I grabbed a ventilator bag and mask and yelled out I needed help."

An emergency team raced in but, by then, Knipstrom was in cardiac arrest, the inquest was told.

The team restarted his heart, but he was brain-dead and died four days later. Outside the inquest Wednesday, an RCMP spokesman said Knipstrom's combative nature made everyone's job difficult that day.

"I think this certainly corroborates what our officers were encountering and what their challenges were," said Sgt. Peter Thiessen.

The inquest continues Thursday.