An inquest into the 2018 death of a Barrie man while in police custody continued Tuesday with testimony from paramedics as well as a doctor who later reviewed the case.
Olando Brown, 32, died June 22, 2018 while in the custody of the Barrie Police Service. An inquest into his death is mandatory under the Coroners Act. The coroner’s inquest is being conducted by video conference, with Dr. Richard McLean as the presiding officer and John Rinaldi as inquest counsel.
In 2019, the Special Investigations Unit (SIU) determined Brown died from an airway obstruction after he pulled two drug-filled, "golf ball-sized" plastic bags from his rectal area and attempted to swallow them during a search at Barrie police headquarters, which at that time was located on Sperling Drive.
Now in its second day, the inquest is expected to continue all week and hear from seven witnesses. It will examine the circumstances surrounding Brown's death. An inquest does not assign guilt, but the jury can make recommendations aimed at preventing further deaths.
Monday's testimony included the Barrie police sergeant who was involved in the initial arrest as well as accompanying Brown at the police station during booking and the strip search when he died.
Half of Tuesday’s session was spent cross-examining Shawn Ridsdale, an advance care paramedic who was on scene and attended to Brown when he was in medical distress. Questioning focused mostly on possible communication issues between paramedic units, as well as between paramedics and Barrie police officers that summer day.
Ridsdale testified he did not have a portable radio on him at the time. He had exited the ambulance to care for Brown inside the police station, despite a policy requiring paramedics to carry a radio.
Questioning tried to determine if there was also a breakdown with how and when paramedics communicate patient status when they transfer responsibilities to each other on scene during a call.
Ridsdale testified he did not know there were obstructions in Brown's airway when he took over care from the initial paramedic crew at the scene.
“I was too focused on the call,” he said. “I don’t think it was told to me.”
Ridsdale characterized the scene as a “highly pressurized circumstance.”
He described paramedic directives, saying there would be two different sets of action taken to immediately care for a patient in regards to a cardiac event or a blocked airway.
When questioned by counsel, he agreed “communication is important to what you do next."
Patrick Hervieux, deputy chief of operations with Simcoe County Paramedic Services, was also questioned about paramedic staffing and training.
As for the perceived breakdown in communications, Hervieux said county paramedics are mandated to carry portable radios when they are out of their vehicles, but admitted “some forget.”
Hervieux also agreed with counsel's assessment that the outcome with Brown’s death “could have affected how all this was treated,” in regard to the absence of a portable radio.
During questioning, Hervieux said there does not appear to be any regular and formal audio audits conducted, only “when they have problems.”
The inquest also explored the use of paramedic suctioning equipment, including its quality and education around it, when used by paramedics during circumstances involving a blocked airway.
Witness testimonies painted a picture of confusion between police officers and paramedics at the scene, along with paramedic dispatch where police were concerned.
The final witness of the day was Dr. Michael Feldman, who conducted a case review and issued a report with findings and recommendations about the Brown case in 2018 in the months following the man's death.
When questioned by counsel on the lack of a personal radio by one of the paramedics, Feldman said he was not aware of this “until last week.”
He also faced questions about human physiology and what happens during resuscitation efforts by paramedics, along with the timeline of a death due to lack of oxygen.
“(Paramedics) chose the right directive with the information at hand,” Feldman said.
Counsel representing Simcoe County then asked him if the paramedics should have transported Brown to a nearby hospital immediately.
Feldman believes Ridsdale ran the call appropriately.
“I think that Mr. Brown’s best chance at survival was being resuscitated at the scene. Once you make a decision to transport … with the hospital at least five minutes away … would not have increased Mr. Brown’s chance of survival,” Feldman added.
“By the time Mr. Ridsdale arrived on scene, it was my perception that nothing would have changed the outcome for Mr. Brown, and that’s because he had an obstructed airway and lack of oxygen for such a long time," he said.
Using time stamps on surveillance videos capturing the scene inside the police station, the amount of time officers and paramedics spent tending to Brown could be determined.
“Once they’ve realized they have a significant airway problem, over nine minutes have elapsed, that’s of the 10 minutes we have until brain death,” explained Feldman.
He testified that Ridsdale arrived on scene around 12 minutes after a police officer indicated the need for chest compressions.
“Brain death is now essentially complete,” Feldman said in regard to the timeframe he saw.
As previously reported, Brown had an outstanding arrest warrant for assault, and had been placed in custody less than two hours before his death that day.
During a struggle with police, officers used a stun gun on Brown on four occasions for an elapsed time of 21 seconds at the Five Points intersection in downtown Barrie during his arrest, which was caught on video.
In 2019, the SIU said Brown's cause of death was an airway obstruction due to the drug-filled plastic bags.
Health Canada later determined the bags contained heroin, fentanyl, caffeine and the painkiller dimethylsulphone, although they did not contribute to Brown's death because the substances did not enter his bloodstream, according to the report.
The SIU's report determined no criminal charges would be laid against the city police officers who were involved in Brown's arrest.
Following Brown's arrest, he was examined by paramedics at the police station and found to be in good health. They removed the stun-gun probes from his shoulder and left the building.
Brown was then taken to another room with two officers for a strip search. To protect his privacy, the SIU says the video equipment was disabled, which is in compliance with Barrie police policy for such searches, while the audio continued to record.
The SIU said Brown "suddenly" removed objects from his rectal area and placed them in his mouth. The officers tried to remove them, but were unsuccessful.
Not long after, Brown went into medical distress. Officers performed CPR and the paramedics, who were still in the parking lot, were called back inside.
Brown was found without vital signs and attempts were made to save his life. He was rushed to hospital where two balloons were removed from his throat.
After some time spent trying to resuscitate him, Brown was pronounced dead.
Prior to the start of the inquest session on Tuesday morning, Brown’s ex-partner at the time of his death, Dawna Dubois, contacted BarrieToday to discuss her thoughts on the inquest’s first session on Monday.
Dubois, along with Brown's two sisters living in Jamaica and one sister in the United States, tuned in to the livestream of the inquest. Through a group chat, they have been messaging each other back and forth.
“We’re all kind of struggling to deal with it," Dubois said. "We all kind of broke down. It was hard to hear certain things.
“Yesterday was very difficult to listen to those last moments,” she added. “It did kind of answer the questions we’ve had, but it was very difficult to actually hear those last moments.”
She gave her daughter a short synopsis of the inquest’s first day.
“I didn’t want her to sit and have to hear all that," Dubois added.
The inquest continues Wednesday at 9:30 a.m.