Lawyers begin closing arguments in defense of paramedics charged in death of Hamilton teen
Defence says paramedics didn't fabricate reports to avoid liability
Two former Hamilton paramedics on trial in connection with the death of a teenager truly believed he hadn't been shot with a real gun, the defence argued on Wednesday, when they were called to treat him the night he died.
Steven Snively, 55, and Christopher Marchant, 32, are accused of failing to provide the teenager — 19-year-old Yosif Al-Hasnawi — with the necessaries of life after he internally bled to death from a gunshot wound on Dec. 2, 2017.
Jeffrey Manishen, Marchant's lawyer, told Ontario Superior Court in his closing arguments that while people might make negligent decisions, it doesn't always mean they should be branded as criminals.
Those paramedics, the court has heard, thought Al-Hasnawi had been shot with a BB gun.
"Their belief was that's all that he had suffered," he said.
Unconscious biases ruled out gunshot, defence says
But the teen was shot with a bullet from a .22 calibre handgun from an altercation near his mosque in Hamilton's central lower city. It took paramedics 23 minutes to leave Main and Sanford for St. Joseph's Hospital, rather than Hamilton General Hospital, which is a regional trauma centre.
Al-Hasnawi died with two litres of blood in his abdomen.
The Crown argues that the paramedics' treatment of Al-Hasnawi led to his death.
Manishen said people can criticise the paramedics' actions that night, but they weren't enough of a marked departure to end in criminal convictions.
Instead, he said the paramedics were following unconscious biases, which pointed them to the belief that Al-Hasnawi wasn't dying, but was superficially injured by a BB or pellet gun.
That's also why they started exploring if something else was medically wrong with him, Manishen said, perhaps involving drugs or alcohol.
"It wasn't a matter of choice at all," he said of following their biases.
He pointed to the testimony of Dr. Pat Croskerry — director of Dalhousie University's critical thinking program and a witness for the defence — who spoke about unconscious biases, clinical decision making, and the errors that can arise.
"If it's sufficiently problematic that it can influence doctors in emergency medicine room decision making... it's every bit as significant, if not more so for paramedics," Manishen said, noting that paramedics don't have training in avoiding biases like doctors do.
Witnesses, including other first responders, have described Al-Hasnawi's wound to the court as a surprisingly small one. The court also heard that bystanders were tossing out suggestions for his injury, one of those being a BB or pellet gun.
Though the teen's white sneakers from that night were speckled with spots of blood, the defence said the paramedics didn't see them in the dark or in the back of the ambulance.
Even after Al-Hasnawi's condition deteriorated, Manishen said Marchant still didn't think the problem was a penetrating wound. And while doctors testified that their decision to go to St. Joseph's Hospital for a psychiatric issue was a mistake, Manishen said it was reasonable and followed what the paramedics thought was the main issue.
He said it's up to Justice Harrison Arrell, who presides over the judge-alone trial, to consider if their belief that Al-Hasnawi was shot with a BB gun was an honest and reasonably held one.
Medics did not fabricate reports, defence says
He also challenged the Crown's suggestion that the paramedics fabricated reports from that night to avoid culpability.
The ambulance call report and incident reports talked about an uncontrolled crowd, interjecting family members, and agitated patient.
The Crown said video surveillance taken from across the street showed Al-Hasnawi and the situation as relatively calm.
But the paramedics, who testified in their own defence, said the teen started "thrashing" once moved off camera and near the stretcher. This continued while in the back of the ambulance, they said, and a police officer helped them restrain him.
The Crown also disagrees with whether the paramedics palpated Al-Hasnawi's abdomen, as Marchant didn't check off the box saying it was "soft" on the report.
If they were to fabricate a report, Manishen said, then this definitely would have been filled — Marchant simply didn't report a negative finding, he said.
Emotional night for paramedics
The defence said that night was emotional for Marchant and could "certainly affect the rationality of his report writing."
He saw Al-Hasnawi's chest opened up in an attempt to save his life, and the blood that squirted out of the wound during CPR, Manishen said. He also was confronted by the teen's father after his son had died.
When the paramedic went home, Manishen said, he didn't sleep, came back to work, and submitted the report.
The details included didn't do much to "exculpate" the paramedics, Manishen said, and there was no avoiding suspicion, as the Crown knows it was the paramedics who treated the teen before he died.
He also made reference to statements by the Crown on whether Marchant had missed Al-Hasnawi's slowing heart rate in the ambulance as well as signs of shock.
While Dr. Richard Verbeek, medical director for Toronto paramedics at the Sunnybrook Centre for Prehospital Medicine, testified on these issues, Manishen said they weren't included when he wrote a 2018 report on the case.
On why they were missed, "the answer is that it's not that apparent," Manishen said.
Al-Hasnawi has been referred to as a Good Samaritan because the shooting happened after he intervened on two people accosting an older man. The trial resumes via Zoom on Thursday at 10 a.m.
Crown attorneys are Scott Patterson and Linda Shin.
Defence attorneys are Jeffrey Manishen of Hamilton, who represents Marchant, and Michael DelGobbo of St. Catharines, who represents Snively.
Dale King, the man who shot Al-Hasnawi, was acquitted of second-degree murder. That case is being appealed.