The family of a man who died in his wheelchair after waiting 34 hours for help in a Winnipeg hospital's emergency room is pulling out of an inquest looking into his death.

Brian Sinclair's family members say they have lost confidence the inquest will result in meaningful changes to prevent future tragedies to vulnerable people.

Brian Sinclair

An inquest resumes Tuesday into the death of Brian Sinclair, who died after waiting about 34 hours in a Winnipeg emergency room without receiving care. (Family photo)

The family and aboriginal groups announced in court on Tuesday they are pulling out of the second phase of the inquest, just as it is set to begin.

That leaves the Winnipeg Regional Health Authority and the Manitoba Nurses’ Union as the only parties participating.

Phase two is set to examine ways to prevent similar deaths from happening in the future. But the Sinclair family, as well as some lawyers and aboriginal groups taking part in the inquest say Judge Timothy Preston is setting parameters that narrow the scope too much.

 "We came here for the truth. It's obvious that we're not going to get the whole truth," Robert Sinclair, Brian's cousin and the family spokesperson, said on Tuesday.

"It's like the government is sugarcoating things … serious problems that exist in Manitoba hospitals for aboriginal people."

On Jan. 10, Preston announced that the inquest would look at overcrowding at Winnipeg emergency departments and delays in treating patients, as well as aboriginal health issues.

But aboriginal groups also want it to look at systemic racism issues in the health system.

Brian Sinclair's 34-hour ER wait

Watch a video chronology of Sinclair's final hours.

"It appears to the Sinclair family that phase two will no longer allow the biases and attitudes that were at the root of Mr. Sinclair’s death to be fully understood, and will instead entrench the marginalization of aboriginal voices," states a letter written to Preston, announcing their intention to withdraw from the inquest.

“Last October, I heard Judge Preston say that ‘this court is alive to the issue of inequality and marginalization.’ He noted ‘the estrangement of aboriginal people from the halls of justice,’" Robert Sinclair said.

"But right now, this family feels very marginalized, and very estranged from the justice system.”  

The inquest, which began in August 2013, has been examining the circumstances surrounding the death of Sinclair, a 45-year-old double-amputee.

Sinclair went to the Health Sciences Centre's emergency room on the afternoon of Sept. 19, 2008. He was sent there by a community clinic because he had not urinated in 24 hours.

It wasn't until 34 hours after he arrived at the hospital that he was found dead in his wheelchair after midnight on Sept. 21. He had not been triaged and he did not receive any care during his time there.

His death was later attributed to a treatable bladder infection caused by a blocked catheter.

'You walk in my shoes, as an aboriginal person for 50 years, you will know that there’s hidden racism and discrimination in this country'  - Robert Sinclair, cousin of Brian Sinclair

In February 2010, Attorney General Andrew Swan rejected a call for a public inquiry into aboriginal health issues, stating that the inquest would be broad enough to deal with the issues raised by the aboriginal interveners in the inquest, according to the news release issued by the Sinclair family on Tuesday.

Because the inquest judge has decided to sideline those broad systemic issues, the Sinclair family will be renewing its call for a public inquiry.

“If we don’t fix the root problems, we are afraid there could be another Brian Sinclair. We cannot accept that," Robert Sinclair said.

"That is why we will continue to fight for fundamental systemic changes. We will therefore be renewing our call to the attorney general for a full public inquiry, and we will be asking every person and organization in Manitoba who is concerned about this human rights injustice to do the same.”

But on Tuesday, Swan echoed his previous sentiments, saying there were no plans to call a full public inquiry into  Sinclair’s death.

“I think it’s important we let the inquest run its course, and I can tell you, there is no plan to call an inquiry,” he said. 

Aboriginal groups withdraw

Aboriginal Legal Services and​ Ka Ni Kanichihk (an aboriginal support services agency) are the groups that have asked to be removed as parties with standing.

Emily Hill, a senior lawyer with the Toronto-based Aboriginal Legal Services, has said the inquest's narrowed scope will ignore the systemic issues facing aboriginal patients in the health-care system, such as discrimination.

'We believe that the legitimate concerns of many people in Winnipeg, in Manitoba, and across the country about Mr. Sinclair’s death will not be addressed' - Emily Hill, Aboriginal Legal Services

"We believe that the legitimate concerns of many people in Winnipeg, in Manitoba, and across the country about Mr. Sinclair’s death will not be addressed,” she said.

"A number of witnesses have testified that staff at the Health Sciences Center made assumptions about Brian Sinclair – that he was intoxicated, that he was homeless, that he had nowhere else to go," stated a press release from ALST.

"Nurse witnesses have also testified that they did not see Mr. Sinclair, even though video footage showed many of them walking right by him and looking directly into the waiting room where he was seated in his wheelchair."

Aboriginal Legal Services did not make this decision lightly, said Christa Big Canoe, legal advocacy director for the organization.

"ALST got involved in this case because we thought it was important to provide an aboriginal perspective and to share expertise about the experiences of aboriginal patients to address best practices for providing care to our community," she said.

"Unfortunately the inquest is now focused on patient flow. Because the issues which brought ALST into this process are no longer central to the inquest, ALST can no longer justify expending its limited resources participating in the inquest."

The Sinclair family still wants to make closing submissions at the end of the inquest regarding evidence heard in phase one.

Robert Sinclair said the family will continue to fight not only for Brian but for others who may have experienced similar treatment.

“It’s about all the other people that are mistreated there that we don’t hear about, and I know there’s lots because you walk in my shoes, as an aboriginal person for 50 years, you will know that there’s hidden racism and discrimination in this country," he said. 

Sinclair family letter to judge

Inquest into the death of Brian Sinclair

Submission of counsel for the Sinclair Family to the Honourable Timothy J. Preston

February 18, 2014

On January 10, 2014, you made a ruling outlining the scope and structure for Phase 2 of the inquest.  In light of that ruling, the Family of Brian Sinclair has asked me to advise you of its intentions with respect to participation in this inquest going forward.  I also wish to speak to the motions brought by Aboriginal Legal Services of Toronto and Ka Ni Kanichihk. 

The Sinclair Family had two objectives in this inquest: (a) to get the facts out; and (b) to have this inquest make recommendations for systemic changes to prevent similar tragedies to marginalized people like Brian Sinclair. 

We made some progress towards the first objective in Phase 1.  For example, we now understand that Brian Sinclair was ignored by emergency staff for 34 hours largely because they made false assumptions about him based on his appearance, and because they recklessly ignored repeated cues to his distress.  We will have more to say in that regard in closing submissions. 

However, with respect to the second objective, the Family has lost confidence that this inquest would make recommendations in Phase 2 that could lead to meaningful systemic changes to prevent future tragedies to vulnerable people like Brian Sinclair.

Originally, according to the rulings of former Chief Judge Raymond Wyant dated August 2009 and February 2010, issues of race, poverty, disability, and other factors of marginalization were supposed to be front-and-centre at this inquest.  The Sinclair Family has participated in this inquest in good faith on that understanding.  Also, in February 2010, Attorney General Andrew Swan commented that the inquest would deal with the broad systemic issues raised by Aboriginal groups with standing, and he refused to call a public inquiry on that basis. 

However, just last month, this inquest rejected the direction of former Chief Judge Wyant and ruled that the scope of Phase 2 would be greatly narrowed.  It appears to the Sinclair Family that Phase 2 will no longer allow the biases and attitudes that were at the root of Mr. Sinclair’s death to be fully understood, and will instead entrench the marginalization of Aboriginal voices. 

Phase 2 will exclude all but a token number of independent expert witnesses.  For example, there will be only one single independent witness called to address Aboriginal health issues.  It is manifestly impossible for one single independent witness to do justice to this critical issue.  In comparison, the inquest will call six WRHA witnesses and three Manitoba Nurses’ Union witnesses to speak about the issues that interest them.  Thus, as the Sinclair Family sees it, Phase 2 seems more likely to become a public relations platform for WRHA than an opportunity to catalyze meaningful systemic change. 

As you indicated on January 10, 2014, issues such as patient flow through, overcrowding, and delays in emergency rooms will now be the prime focus of Phase 2.  However, according to the evidence we have heard, those were not the issues that caused Brian Sinclair to be completely and fatally ignored.  Given our mandate, as well as limited resources, we will be unable to contribute to the inquest with respect to those issues.

For these reasons, the Family of Brian Sinclair is withdrawing from Phase 2 of the inquest.  We will not be attending or participating in the hearings during Phase 2. 

For the same reasons, as well as for the reasons articulated by Aboriginal Legal Services and Ka Ni Kanichihk, our client understands and supports the motions of ALST and Ka Ni Kanichihk to be removed as parties with standing altogether.

However, unlike ALST and Ka Ni Kanichihk, we still wish to make closing submissions with respect to the evidence we heard in Phase 1, and therefore the Family does not ask to be removed as a party with standing altogether.  We ask that inquest counsel notify us as soon as the schedule for final submissions has been determined, and continue to include us on all correspondence concerning the inquest.