Inquest judge calls for detox centre in Thompson

The death of a northern Manitoba woman while in police custody highlights the continuing need for service providers to work together to address systemic racism, a judge says in an inquest report.

“There is recognition that additional resources and political will are required to effect change,” provincial court Judge Doreen Redhead said in an inquest report into the Feb. 1, 2020, death of 44-year-old Thompson resident Celine Samuel.

“All parties, including Indigenous stakeholders and organizations, and the community at large need to work together,” Redhead said.

Samuel was taken into custody under the Intoxicated Persons Detention Act after staff at a McDonald’s restaurant called RCMP shortly before 8 p.m. and reported she was intoxicated and had fallen off a stool two times.

Security video confirmed Samuel struck her head on the floor, but paramedics who medically cleared her at the restaurant testified at the inquest they had not been told she had hit her head.

Samuel was held in an RCMP cell. Shortly after 11 p.m., a guard found she was not breathing. Staff at the scene and arriving paramedics were unable to resuscitate Samuel and she was declared dead 30 minutes later.

One of two officers called to the restaurant testified he was concerned for Samuel’s safety; because there was no one available to release her to, officers decided to detain her under the law.

The inquest was told Samuels had a history of alcohol use disorder and seizures. Three weeks before her death, Samuels was in custody under the intoxication law when she fell in her cell, resulting in serious injuries to her face, after which, as per the testimony of one officer, her health appeared to deteriorate. Samuels suffered more seizures and went to the hospital several more times before her death.

The inquest report concludes with more than three dozen recommendations targeting medical, police and social services. They include:

• Medically clearing people for pre-existing conditions before taking them into custody under the Intoxicated Persons Detention Act and providing ongoing monitoring and re-assessment by a medical professional while in custody;
• Establishing a detoxification centre in Thompson similar to Winnipeg’s Main Street Project, with rehabilitative services and programs to support people with substance abuse issues;
• Initiating discussion between Thompson RCMP and the province to eliminate such detentions in police cells in favour of detoxification centres;
• Improving information sharing with first responders and medical professionals;
• Expanding the health services available to Thompson residents, including establishing a minor injury clinic;
• Mandatory cultural safety and anti-racism training for all medical and clinic staff in Manitoba.

“There is an acknowledgment that racism exists in the health care system,” Redhead said. “A preventable death and an inquest report are the costs. This report suggests many recommendations on how to prevent a similar tragedy from occurring again. It is my sincere hope that each and every recommendation (is) seriously considered and implemented.”

The inquest heard testimony from 16 witnesses over 11 days between March 11, 2024, and Jan. 31, 2025. The inquest was repeatedly delayed to allow courts to clear the backlog of cases resulting from the COVID-19 pandemic.

“The (Samuel) family waited for this inquest for a very long time,” Redhead said.

dean.pritchard@freepress.mb.ca