Transferring sick detainees was ‘greater a political difficulty than a medical one’, physician tells inquiry into immigration detainee demise

Abdurahman Ibrahim Hassan was nevertheless struggling from delirium when the hospital all started planning to transfer him lower back to a most safety detention facility.

Abdurahman Ibrahim Hassan died on the night time of 10 June 2015 in a hospital in Peterborough.

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As medical workers tried to cope with an immigration detainee’s delirium – a frequent incidence amongst sufferers external intensive care – the choices of transferring him lower back to jail or to yet another hospital for care have been already being explored, an inquest has heard.

The transfer, the physician in cost of Abdurahman Ibrahim Hassan’s healing at Peterborough Regional Health Center wrote inside the affected person’s notes, can be “more of a political issue than a medical one.”

“I often had problems with different organizations that had different rules, that had built up silos about things. And I think, over the years, I’ve just gotten into the habit of calling it medical politics,” Dr. Warren Wilkins advised the inquest Tuesday into Hassan’s demise in June 2015.

“I was already involved with the (prison) guards telling me they probably wouldn’t be able to move him back to the prison. I really didn’t know much about what the prison could do. I know the policy at Peterborough Hospital was to move him back this guy if I felt it was safe to go back to Lindsay Hospital or the jail.”

Hassan, who had been held at the Central East Correctional Center since 2013 awaiting deportation to Somalia, was taken to Ross Memorial Hospital in Lindsay, Ont., for seizures and transferred to Peterborough Hospital on June 3, 2015 for more aggressive care.

The 39-year-old man died after a struggle in his hospital room under the watch of two officers, OPP Const. Andy Eberhardt and Peterborough Police Art. Alicia McGriskin. Both constables were cleared of wrongdoing by the Ontario Special Investigations Unit, which investigates civilian deaths and injuries involving police officers.

The 15-day inquiry is intended to examine the circumstances surrounding Hassan’s death to avoid such incidents in the future. The coroner’s advice has suggested that the cause may have been cardiac arrhythmia related to schizophrenia and antipsychotic medication, physical struggle and restraints, or asphyxia.

The inquest heard that Hassan, who had schizophrenia and bipolar disorder and PTSD, was heavily sedated in the intensive care unit before being released to the operating room on June 7, 2015 for further assessments and observation.

The man appeared to be confused and disoriented and had difficulty maintaining focus, thinking clearly and answering questions put to him. Sometimes he was agitated and aggressive.

Wilkins, who took over Hassan’s care in the surgical unit, said these symptoms met the definition of delirium, something that affects more than half of patients coming out of intensive care. The now-retired doctor said the issue of transferring Hassan to the hospital’s psychiatric unit was never raised.

“I used to be very educated about what psychiatry would and wouldn’t tackle their unit. I used to be concerned in conferences as my position as chief of drugs between psychiatry and drugs about who would finally end up in a psychiatric versus a medical mattress,” Wilkins testified.

“I believed it was simply my feeling that Mr. Hassan wouldn’t finally end up in a psychiatric unit, greater due to the fact he was on insulin, was diabetic and had some different troubles.”

In normal practice, Wilkins said, when a patient’s medical condition stabilizes and intensive care is no longer required, the person will then be transferred back to the sending institution or family. And he recommended that in his June 9 notes after an assessment of Hassan.

Wilkins acknowledged that delirium “wakes and wanes,” but a patient with the condition may be medically stable enough for a transfer.

“The most vital factor was what the jail may provide this man. ‘Can they grant the care that he would want?'” There is a big difference between moving someone back to an emergency hospital versus a prison and home, he explained.

“You need to be a lot greater equipped to have the ability to go to the rest room in your very own and manage most {things}, have the ability to eat, et cetera and do to perform pretty nicely.”

Ultimately, a decision was made on June 10 to transfer Hassan to Ross Memorial Hospital after the prison guard escorting the prisoner and the medical staff at Lindsay Prison raised concerns about the logistics of the transfer and their ability to provide the care the man needed.

“Unfortunately, that (switch) by no means occurred,” Wilkins said, “due to what occurred to Mr. Hassan inside the early morning hours of the eleventh.”

The listening to will resume on Wednesday.

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