A triage nurse who was on shift at a Winnipeg hospital's emergency room on the night Brian Sinclair died, after waiting 34 hours without care, has told the inquest into his death she initially thought the man was intoxicated.
Wendy Krongold, who was working as a triage nurse at the Health Sciences Centre's emergency ward on Sept. 20, 2008, was the first to acknowledge she was aware of Sinclair waiting there, but she admitted that she did not help him.
Krongold told the inquest on Thursday that she first thought the 45-year-old aboriginal double-amputee was an IPDA patient, referring to the Intoxicated Persons Detention Act.
Patients deemed to be IPDA patients would be so intoxicated, they would need to be detained by police.
However, only doctors can determine if a patient is intoxicated under the IPDA, and the patient has to be triaged before being seen by a doctor, the inquest was told.
Krongold testified that she thought Sinclair was IPDA because he was in a wheelchair, as staff would often put intoxicated people in wheelchairs.
When asked if she thought he was IPDA because he was aboriginal or male, she said no.
The inquest was told that triage nurses are generally in charge of reassessing IPDA patients until police officers pick them up.
Krongold admitted in her testimony that she walked by Sinclair without checking on him or providing care for him.
The inquest has heard that Sinclair was not intoxicated when he went to the Health Sciences Centre's emergency room in 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.
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The cause of his death was attributed to a treatable bladder infection caused by a blocked catheter.
Manitoba's chief medical examiner has previously testified that Sinclair had probably been dead for hours by the time staff noticed him.
An administrative review of Sinclair's death found that staff at the Health Sciences Centre observed him at least 17 times during his 34-hour wait, but no action was taken to address his medical needs.
'He wasn't on my list'
Krongold testified that she saw Sinclair in the waiting room at 4 a.m. on Sept. 20.
She admitted that Sinclair had been waiting for hours, but she thought he was sleeping, even though she did not see his face.
When asked why she did try to wake him up or look for his ER wristband, Krongold replied, "He wasn't on my list of patients. He wasn't on my chart. I don't know."
Krongold was then asked how she could have known Sinclair was not on her list unless she checked his ER wristband. She acknowledged that she did not check it.
The inquest saw surveillance video footage of Krongold walking past Sinclair at 4:15 a.m. without waking him up. She went over to wake up another sleeping patient and check that person's wristband, the video showed.
Krongold testified that it took her about 30 seconds to decide that the sleeping Sinclair was intoxicated, but she admitted that she did not assess or reassess him, nor did she wake him up or check his wristband.
The next time Krongold said she saw Sinclair, he was dead. She and a resuscitation team tried to revive him, but they were unsuccessful, the inquest heard.
Nurse doesn't recall conversation with guard
Earlier on Thursday, another triage nurse told the inquest she did not recall having a key conversation with a security guard about Sinclair's well-being.
The testimony from Val Penner, who was also working as a triage nurse during Sinclair's wait, contradicted earlier testimony from security guard Ed Latour, who said he had raised concerns with her about a man sitting in the same spot in the emergency waiting room all night.
Penner told the inquest she does not remember having that conversation with Latour.
However, the inquest saw the surveillance video footage from the hospital on Sept. 20 that shows Latour approaching Penner that evening and pointing to the emergency waiting room, and Penner looking in that direction.
According to Latour, Penner told him the patient had been discharged earlier that day before going on with her business.
Penner said while she doesn't remember the 1½-minute conversation with the security guard, she said she must have thought Latour was talking about a different patient in a wheelchair, who had been triaged earlier and was in the same waiting room as Sinclair.
"That would make the most sense," she told the inquest.
She added that hypothetically speaking, if anyone warned her that a patient was in the ER all night, "You should go over and investigate."
Thursday's testimony appeared to be emotionally difficult for both nurses. Penner cried after finishing her testimony and Krongold was sobbing during and after her testimony.
The inquest hearings resume on Oct. 15 with more testimony from nurses.