Indigenous health-care challenges remain 13 years after Brian Sinclair's death

·6 min read

It was 13 years ago this month that Brian Sinclair entered a Winnipeg emergency room with a treatable medical issue, but one that could turn deadly without proper care.

More than 34 hours later, Sinclair sat slumped and dead in his wheelchair in that same emergency room, while all around him people came and went, but no one even noticed that he was dead.

At the age of 45, Sinclair had lived a life that had thrown many challenges his way, including cognitive impairment, chronic illness, addictions, and confinement to a wheelchair due to having both his legs amputated.

On Sept. 19, 2008, Sinclair arrived by taxi at the Health Sciences Centre (HSC) in Winnipeg, and just before 3 p.m. he was wheeled into the hospital’s emergency room after being referred there by a local clinic because of abdominal pain, problems with his catheter, and an inability to urinate.

A hospital employee at triage spoke with Sinclair that afternoon, made notes on his condition, and then asked him to wait, and Sinclair wheeled himself into a corner of the waiting room.

According to reports, as hospital employees came and went and fellow patients were sent in and out for care over the next 34 hours Sinclair sat in that same corner while no hospital staff came to offer him the opportunity to be admitted for care, or even check on him.

While Sinclair sat and waited, he vomited on several occasions as his body shut down, and at some point during the 34 hours Sinclair succumbed to sepsis, a condition explained as the body’s “extreme response to an infection.”

Sepsis is said to happen when an untreated infection a person already has triggers a chain reaction throughout the body. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.

With no treatment or assistance for 34 long hours, Sinclair was left to die.

On Sept 21, 2008 shortly after midnight, a security guard at the hospital finally noticed that Sinclair was dead, and alerted hospital staff.

According to reports, rigor mortis had already set in on Sinclair’s body when staff discovered that he was dead, and that is why an exact time of death has never been determined.

An autopsy later found that Sinclair had a treatable bladder infection brought on by a blocked catheter, and had been deceased for between two to seven hours before finally being noticed by medical staff at the hospital.

It was later revealed that some staff members working over that 34 hour period had assumed that Sinclair was intoxicated or possibly sitting in the ER because he was homeless and looking for a place to sleep.

The death of Sinclair made local and national headlines, and brought to light the issue of Indigenous people and their treatment and care within the health-care systems both here in Manitoba, and across the country.

An inquest into Sinclair’s death led to a report completed in 2014, and that report concluded Sinclair's death was “preventable.”

The report put forward 63 recommendations to overhaul parts of Winnipeg's health-care services, including how patients in ERs are triaged and registered.

But the final report from the inquest did not rule that Sinclair's death was a homicide, and no staff members who worked during the time he was in the ER have ever been disciplined.

After the report was made public a group of doctors and academics from across Canada conducted their own examination of Sinclair’s death, and in 2017 the group released their own report titled Out of Sight, which looked at the role that racism played in Sinclair’s death.

“This blindness to Mr. Sinclair’s experiences allowed him to die in plain sight,” the Brian Sinclair Working Group wrote in their report.

“Sinclair came to the HSC ED seeking urgent, but not critical care. Had he received the care he needed, he would not have died. His presence in the waiting room was visible to HSC staff, but he was not seen as a patient needing care. Instead he only appeared as someone to be ignored.

“Even as his medical situation worsened and he began vomiting and slumping further in his chair, no one saw him as a patient in distress. Even when members of the public intervened on his behalf, HSC staff members were quick to explain that he was not sick, but rather sleeping or intoxicated.”

And while some health care workers assumed Sinclair was intoxicated, his autopsy later revealed that he had no drugs or alcohol in his system at the time of his death.

The group’s report recommended a number of actions to be taken by the health-care system in this province and across the country to improve health care for Indigenous people.

The report also stated that health-care professionals in all sectors of the system must “address the ongoing systemic discrimination and racism that continues to contribute to poor health outcomes and in extreme circumstances, even death, as in the case of Brian Sinclair.”

The Winnipeg Sun reached out to the Winnipeg Regional Health Authority (WRHA) to ask what measures have been put in place since Sinclair’s death to prevent inferior care for Indigenous people, and prevent another death like that of Sinclair’s.

WRHA president Mike Nader declined to be interviewed, but in a statement a WRHA spokesperson said “WRHA has a number of initiatives in place meant to acknowledge and address the barriers that Indigenous peoples face when seeking health care, that non-Indigenous people may not experience.”

WRHA also said that over the last 10 years they have worked to train their employees so they can more effectively and respectfully treat Indigenous people involved in the health-care system.

“Over the past decade, WRHA has greatly increased the delivery of cultural safety training for health-care providers in all areas of the health-care system and region, as well as with partner organizations and educational institutions. These education and training sessions are all ongoing.”

Dr. Mary Jane McCallum, a history professor at the University of Winnipeg and an expert in Indigenous history was one of the academics who worked with the Brian Sinclair Working Group.

She said that even today she hears from Indigenous people that say that when they enter health care facilities in this country, they assume they will be forced to deal with racism and negative stereotypes.

“Many Indigenous people still anticipate racism when going to a hospital or health care facility, and so we can't say that the problem has been fully resolved,” McCallum said.

She added she believes issues with Indigenous health care are systemic, and rooted in colonialism, but also rooted in “indifference.”

“In order to understand and make sense of Sinclair's death, we need to understand the historical context of colonialism in the city of Winnipeg and in Canadian health care, and how it impacts lives like Sinclair’s,” McCallum said.

“It produces an indifference to Indigenous suffering.”

— Dave Baxter is a Local Journalism Initiative reporter who works out of the Winnipeg Sun. The Local Journalism Initiative is funded by the Government of Canada.

Dave Baxter, Local Journalism Initiative Reporter, Winnipeg Sun

Our goal is to create a safe and engaging place for users to connect over interests and passions. In order to improve our community experience, we are temporarily suspending article commenting