Winnipeg Free Press - PRINT EDITION

Nurse defends Sinclair decision

Believed he could advocate for himself

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Brian Sinclair was sent alone in a taxi to Health Sciences Centre's emergency by a clinic because while he had a suspected bladder infection and his catheter was blocked, his condition was stable and he could advocate for himself.

An occupational therapist, who the year before assessed Sinclair's cognitive ability, said he could have forgotten he was given a doctor's note to give to the emergency department.

Shireen Loat, a nurse at the Health Action Clinic, said she helped another nurse do an examination of the 45-year-old Sinclair after he arrived unannounced on Sept. 17, 2008, complaining that no urine had passed through his catheter into the urine bag since the day before.

"He was answering questions," she said. "I think the only question I asked was 'Brian, when did you last see any pee coming into the bag?' -- and he said yesterday. He was concerned the catheter was not draining..."

"He didn't look in undue distress."

"I felt he needed to go to emergency because he likely had a bladder infection and he certainly had a blocked catheter," Loat said.

The inquest has been told that 34 hours after the taxi dropped Sinclair off at the emergency room, and he was directed to the waiting room by an HSC employee, the double amputee was found dead there in his wheelchair.

The inquest has heard testimony that Sinclair, who died of a bladder infection, could have been dead anywhere from two to seven hours before being discovered dead in the waiting room.

When asked by inquest counsel Melinda Murray why the clinic couldn't change the catheter itself, Loat said she believed pulling out the blocked catheter could have caused physical trauma to Sinclair and then he would have had to be taken to the hospital in a lot of pain and by ambulance.

As well, Loat said the clinic was closed on the weekend so any blood or urine samples they would take for testing wouldn't have the results back until Monday, far too long for the condition she believed Sinclair was in.

Loat said because Sinclair was deemed stable and able to answer their questions, he was sent to HSC emergency in a taxi with only a note from a clinic doctor. She said if the double amputee hadn't needed a wheelchair, a clinic aide would have been able to drive him to hospital.

"If he had a relative there he could have gone in just a regular car with his wheelchair," she said. "A relative could have rolled him (in his wheelchair) there."

She said the clinic usually phoned the hospital at the time, but said in Sinclair's case "I gather the phone call wasn't made. I guess because he was stable and could advocate his problems himself."

Later, Danielle Harling, an occupational therapist at the HSC, said a cognitive test she gave Sinclair more than a year before his death found he was functioning at a "partially independent" level.

Harling said in a memory test, while Sinclair would remember how much a stamp and bus fare were shortly after being told, about half an hour later he couldn't remember the prices.

When asked by lawyer Murray Trachtenberg, who is representing the Sinclair family, whether Sinclair's memory problem meant he wouldn't remember to give a doctor's note to HSC staff an hour after he was given it, Harling said that based on her testing "it would be a concern having him recall that particular information a significant amount of time later."

The inquest continues today.

Republished from the Winnipeg Free Press print edition August 21, 2013 B2


Updated on Wednesday, August 21, 2013 at 9:29 AM CDT: Fixes spelling of Danielle Harling and adds blog box.

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