Witness tells inquest Heather Winterstein looked ‘scared’ before collapsing at St Catharines Hospital

Heather Winterstein’s skin was pale and she was struggling to control her body in a wheelchair the day she died in a St. Catharines, Ontario, hospital, a woman who was waiting to see a doctor that day told a coroner’s inquest.

Emmaline Young is believed to have been the last person who spoke to Winterstein. He died of sepsis on December 10, 2021.

On Friday, Young testified that she was horrified by the sight of Wintersteen’s face moments before she collapsed in the emergency department waiting room.

“She just looked scared. In her eyes, I could see it.

“That’s what gets me: She clearly wanted help.”

Young is among the witnesses who have described what they saw or experienced before Winterstein’s death at the hospital, which was officially renamed Marotta Family Hospital in 2024. A total of more than 20 people are expected to testify over 13 days. The hearing, which began on March 30, is being held virtually.

The Ontario Coroner’s Jury is tasked with determining the facts in a case and may make recommendations to prevent similar deaths, but does not assign blame or conclude guilt or innocence.

‘I could see he ain’t ‘o’K’

Young remembered sitting in a packed hospital waiting room on the afternoon of December 10. She said she saw a man escort Winterstein to the triage nurse station about two meters away from her.

“I can see he’s not OK,” Young said of Winterstein. “She was clearly having trouble controlling her body. She was very unstable.

“She was lying in a strange position on the wheel chair.”

Young also noticed that Winterstein’s body was discolored.

“She had this spotty rash. It was on her face, on her neck, on her stomach. I could see it everywhere on her body.”

Young said Winterstein wanted to say something briefly to the triage nurse, but the nurse quickly attacked Winterstein.

“I heard the nurse say, ‘We’ll be with you in a moment, Heather.’ I felt he was insulting me. This was quite shocking for me.

“I thought Heather was an inconvenience to this triage nurse.”

Winterstein had developed an extreme reaction to a bacterial infection, resulting in sepsis, a life-threatening condition that causes damage to the body’s tissues and organs.

Asked for help within a period of two days

A day before Young addressed the inquiry, the jury heard from a triage nurse who said triage nursing staff were experiencing an influx of patients in waiting rooms on Dec. 10, partly because of the COVID-19 pandemic.

Young said he asked Winterstein if he needed help. Winterstein stammered and struggled to say “no.”

Winterstein’s first attempt to get help at a hospital was on December 9, when she arrived by ambulance complaining of pain after reportedly falling down the stairs the day before. She was given Tylenol and sent home with instructions to return to the emergency department if her condition worsened.

The emergency doctor who assessed her determined “social issues” were behind her hospital visit, the inquest heard earlier

She returned to the emergency department by ambulance the next day and was sent to the waiting room until she could be seen by a doctor. On Thursday, the inquest heard that although hospital rules required Winterstein to be reassessed by a triage nurse every 15 minutes, given the severity of his condition, no reassessment was made in the two and a half hours he waited.

Eventually, Young said, Winterstein stopped running altogether. She collapsed at 2:41 pm ET.

“Her body twists on itself as if her head is too heavy. Her head hits the top of her thighs and she falls from the wheelchair to the ground.”

There was no sense of urgency.– Emmaline Young, inquiry witness

Fighting back tears, Young recalled that Winterstein’s eyes were open but not blinking.

A group of doctors, nurses and two security guards walked through the double doors toward Winterstein, Young said.

“There was no sense of readiness.”

Hospital personnel caring for Winterstein placed him on a stretcher and brought him to the emergency department, Young said.

A day earlier, the inquest was told that doctors worked hard for several hours to try to revive Winterstein, before he was pronounced dead at 8:42 pm.

Winterstein was a member of the Cayuga Nation, which had ties to the Six Nations of the Grand River.

Since his death, family members and community organizations have expressed concerns that addiction discrimination and anti-Indigenous racism may have played a role in his treatment.

Young was asked if she considered Winterstein to be indigenous. He said he did.

Triage nurse Andrea Demery previously told the inquest that she did not know Winterstein was Indigenous.

Doctor has denied lying in the notes

Dr. Imad Noor, the emergency department physician who treated Winterstein on Dec. 9, was testifying Friday.

In cross-examining Noor, attorney Rachel Gardner, representing Winterstein’s family, accused him of lying in his doctor’s notes. He said he had mentioned in a document just days after her death that he had examined Winterstein’s organs in efforts to determine whether he had any infections.

This is “a fabrication,” said Gardner, who accused Noor of denying the transition after learning Winterstein had a substance abuse disorder and anxiety.

Noor refused to lie, saying, “I have to go to bed at the end of the day and sleep.”

Gardner showed the inquiry a video of Winterstein showing her unsteady and walking with difficulty in the waiting room two hours before seeing Noor. She previously testified that she determined in her evaluation that she was satisfied she could walk adequately,

“She’s standing straight, she’s walking in a straight line. My only comment is, it’s going slow,” he said Friday, referring to the video.

Inquiry lawyer cites previous complaints about doctor

Julian Roy, one of the lawyers in the investigation, pointed to several cases over the years of patients or families who filed complaints with the hospital about the care provided by Noor.

The presiding officer of the inquiry, Dr. David Eden, ordered the hospital’s operator, Niagara Health, to provide those records.

Eden told inquest jurors that those complaints were brought forward to help improve how the hospital responds to them, which is part of efforts to improve patient care.

Among the complaints, Noor allegedly asked a girl, who had ulcerative colitis and severe stomach pain, whether she was a “drug mule” based on computed tomography (CT) scan findings.

He defended his actions by saying that during the interrogation the radiologist had asked him to question the girl about what was shown in the scan.

“I said, ‘I’m very sorry to ask this question, but the radiologist saw something in your body … and he’s concerned it might be medications,'” he testified about what he said to the girl. “I had to ask if she was putting drugs in her anus because I was told.”

In some of the complaints about him, Noor apologized to patients or families, but he said, “It doesn’t mean wrongdoing.”

“A large percentage of patients walk out of the emergency room unhappy with the care, wait and service.”