About 18 hours went by between the time two young sisters disappeared along with their father and the moment an Amber Alert was issued, according to a Quebec coroner's report.
The report, obtained by Radio-Canada, says the two girls could have been saved had Quebec provincial police acted more quickly.
The two girls, Norah and Romy Carpentier, aged 11 and 6, disappeared along with their father, Martin Carpentier, on July 8, 2020, after the vehicle they were in crashed into several sign posts on Highway 20 in Saint-Apollinaire, Que., a municipality about 45 kilometres southwest of Quebec City.
According to coroner Sophie Réignière, the father left the crash site with his daughters, and killed them in a wooded area a day later with a blunt object. He then took his own life.
Their disappearance triggered one of the longest Amber Alerts in the province's history.
The report noted several issues that hindered the investigation that, if addressed, might have helped prevent the deaths of Norah, Romy and their father.
The coroner highlighted the fact that for several hours after the crash, investigators treated the case as a hit-and-run, and not a missing persons case.
The crash took place at around 9:20 p.m. on July, 8, 2020. The Amber Alert was issued by police at around 1:20 p.m. the following day. The girls, and their father, were still alive at that time.
The report also said that once the Amber Alert was issued by the Sûreté du Québec (SQ), it took more than an hour and a half for the media to receive this information.
The report explains that the delay is partly explained by the provincial police communications team needing time to gather details.
Although officials from the SQ have said that they reviewed the investigation following the police operation, Régnière said the police force should again examine what happened, in light of the recommendations in her report.
The coroner recommends that the SQ conduct an "exhaustive examination" of the investigation in order to improve its processes for cases involving missing children.
Régnière also recommends that the Ministry of Public Security broaden the criteria for issuing an Amber Alert and create a co-ordination unit dedicated to disappearances.
Amélie Lemieux, Norah and Romy's mother, declined to comment on the recommendations, saying she prefers to wait for the report to be released officially next week.
Father intentionally crashed vehicle, coroner says
The coroner says she believes the father intentionally caused the crash that happened July 8, 2020, on Highway 20 in an unsuccessful attempt to kill himself and his daughters.
Régnière said it is likely the crash was deliberate considering the text messages Carpentier sent to his wife earlier, which read like goodbye messages.
The timing for when he received the divorce papers, the moment he sent the text messages and the content of those messages are "troubling," she wrote.
She also wrote that the fact he insisted on being alone with his daughters and that he fled the scene of the collision also pushed her to draw this conclusion.
According to the report, "this failed attempt at dying with his daughters represents a point of no return for Mr. Carpentier."
Carpentier feared divorce, coroner says
According to the report, the father panicked after receiving documents regarding his pending divorce from his daughters' mother, Amélie Lemieux and it was a turning point in the events that ultimately led to him killing himself and the two girls.
According to Régnière, it had been five years since he and the girls' mother, Amélie Lemieux, had separated and he was worried the next step would be a divorce.
The report explains that Carpentier was worried Norah, who was not his biological child, would be taken away from him even though he had adopted her when she was born in 2008.
When the couple broke up in 2015, his concerns about losing his place as a father grew, "especially since Norah's mother took steps to put her in contact with her biological father," the report stated.
Notes from his family doctor indicate Carpentier met with a lawyer in June 2020, which helped reduce his stress, the report said. A doctor prescribed him medication to treat insomnia, and the expert considered the possibility of him being clinically depressed.
A few days before disappearing with his daughters, Carpentier saw met with his lawyer to prepare the divorce petition.
The lawyer emailed him the document on July 8, 2020, for approval — the same day he disappeared with his daughters. Receiving the document is what triggered him, the coroner said.
After spending part of that day with his family and having dinner with them, Carpentier went to eat ice cream with his daughters. He insisted on going alone with them and said he would return by 9 p.m.
They never came back.
Police found the two girls' bodies in a wooded area on July 11, 2020, about two kilometres from the crash site. The coroner wrote that several signs point to the father experiencing a psychotic episode when he killed his daughters.
According to the results of the psychological autopsy conducted at the request of the coroner, he allegedly displayed signs of experiencing a "severe depressive episode with probable psychotic symptoms."
The Amber Alert turned into a manhunt that lasted nearly 10 days before the father's body was found a few kilometres down the road.
At the time, the SQ said the events played out within a period of eight hours, and that investigators could not have done anything more.