Hospital managers testify in Samwel Uko inquest about potential areas of improvement

Managers from different parts of the Regina General Hospital testified on the fourth day of the inquest into the death of Samwel Uko to highlight potential improvements that could be made around the hospital.

Uko, 20, was pronounced dead when his body was found in Wascana Lake in May of 2020.

According to the forensic pathologist who conducted Uko’s autopsy, the cause of death was drowning.

He went to the Regina General Hospital (RGH) seeking mental health support twice on the day he died. The second time, he was escorted out by security before receiving treatment.

The manager of security at the RGH said more mental health training for guards would be helpful for dealing with patients who, like Uko, are seeking support.

“Any training we can provide to help them recognize those conditions, there’s definitely a benefit to that,” security manager Bill Parrell said.

He said more diversity training is expected in the future and agreed that would also be helpful for his staff.

Parrell said security relies heavily on medical staff to decide how to deal with patients they are assisting. He said his guards are aware of the policy change that makes it mandatory for all patients to see a physician before leaving the hospital.

Throughout Parrell’s testimony, questions were raised about if the security guards were acting within their job description by physically removing Uko from the building.

Parrell said any time force is used by a guard, a form has to be filled out to review appropriateness.

He said he can’t recall if Uko’s removal was flagged and reviewed. He said the manner in which the guards escorted Uko seemed appropriate because there was a level of resistance from the patient.

Following Uko’s death, Parrell said staff now seek clearer guidance when asked to move a patient.

Manager of registration, Lolita Vansteelandt, said her staff could work on becoming more familiar with identification cards from other provinces.

She also said the unidentified patient process has been updated to give registration staff five to 10 minutes to try to get a name from a patient, and after that they will be registered as unidentified.

She said the registration clerk working that day could have went with the unidentified approach for Uko when the clerk could not identify a name.

She did not know police gave the working clerk a name and birth date for Uko.

The director of the Regina emergency departments, Desiree Nahachewsky, said some changes have been made since Uko’s death but added more could be implemented.

She said more physician staffing could help prevent similar situations in the future.

More diversity training would benefit everyone, she added.

MENTAL HEALTH EXPERTS TESTIFY

One retired psychologist testified about the broad struggles some mental health patients face. He did not testify specifically about Uko’s case.

Bruce McKee said one difficulty with treating mental health patients in an emergency room is a lack of options if they aren’t admitted into hospital. He said medication and talk therapy both take time to become effective and immediate care can be hard to find.

He said only about 20 per cent of mental health patients are typically admitted into hospital.

“This is not a new problem,” he said.

He said emergency rooms aren’t always suitable for a mental health crisis.

David Nelson, a senior consultant with the Canadian Mental Health Association, was the final witness to testify in the inquest.

He formerly worked as a psychiatric nurse and social worker.

When it comes to emergency rooms, Nelson said they’re almost exclusively set up for physical injuries and emergencies. For that reason, he said mental health patients typically end up waiting for an extended period of time.

“It is not a timely pathway,” he said.

He said urgent care centres specifically for mental health would be an improvement.

“We need much better assessment and we need much slower pace of assessment,” he said.

Nelson said it takes specialized training to communicate with a patient in a disorientated state.

Counsel for the SHA, Reginald Watson, highlighted that both mental health experts have not been practicing in their professions for many years.

The six-person jury is expected to be charged by the coroner on Friday morning. They are tasked with answering some specific questions relating to the case. They may also compile a list of recommendations to prevent similar deaths in the future.