Prison psychiatrist denies negligence, describes Skye Martin's demeanour before her death as 'silly'

The psychiatrist who provided treatment to a woman who died in a Clarenville jail says claims that he failed to give her the medical care she required are unfounded.

Skye Martin was 27 when she died in April 2018 after choking on a sandwich wrap she forced down her own throat. At the time, she was in a segregated cell at the Newfoundland and Labrador Correctional Centre for Women in Clarenville.

Last August, her mother, Natasha Martin, filed court documents claiming Dr. David Craig's treatment of her daughter was negligent.

"[Craig's] refusal to provide Skye with her required medication, and the use of segregation to deal with Skye's mental health conditions caused Skye to experience severe mental anguish and emotional injury," reads her statement of claim.

On Thursday, Craig filed a statement of defence, saying the care he gave Skye Martin was appropriate, and he defended the course of treatment he prescribe for her.

Somewhat unkempt and 'silly' in her demeanour, but otherwise unremarkable. - David Craig

"Craig denies that he was negligent in the care and treatment of Ms. Skye Martin," says the court document.

"Craig states that at all times material to this action, the services provided conducted in accordance with well-recognized medical practice and procedure."

Craig, who has been providing psychiatric services for the province's correctional facilities for two decades, assessed Martin numerous times between March 20, 2018, and April 20, 2018.

Craig says that after the first assessment he conducted on or about March 23, he noted reports that Martin was "hoarding" medications.

She had been prescribed lidexamphetamine, sodium divalproex, risperiodone, quetiapine, and sertraline by another physician before she was sent to Clarenville. She had been hospitalized at the Waterford Hospital forensic unit for several weeks before she was incarcerated.

Craig says suicidal precautions were initiated at the Clarenville facility after "she attempted to scratch her wrists with a plastic knife."

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After his first assessment, Craig said Martin was stable and agreed with her previous diagnosis of borderline personality disorder but concluded she was "not otherwise acutely mentally ill."

"Martin repeatedly denied suicidality and reported she did not want to be on suicidal precautions," says the psychiatrist's nine-page statement of defence.

"Further, she reported no mental health complaints. Craig noted she was not depressed, anxious, or otherwise distressed."

He determined the medications Martin had been prescribed were not helping her and began to "taper" her off them, according to the statement.

'Silly' in her demeanour

Craig assessed Martin again on April 3, 2018. Again, he decided she was not depressed, anxious or otherwise distressed and reported that she was not suicidal "or homicidal."

"The mental status examination revealed her to be somewhat unkempt and silly in her demeanour, but otherwise unremarkable," reads Craig's defence.

He concluded Martin's behaviours were in keeping with the diagnosis of "a severe personality disorder."

Demanded assessment at the Waterford Hospital

Craig saw Martin a third time on April 17, days before her death. Craig's defence says he reported two incidents. In one, he said, Martin poured hot water from a kettle on herself and, in the other, he said, she obtained and attempted to swallow a blister pack of medications, "both in an apparent attempt to be taken to hospital," according to his statement.

"When interviewed, Martin … demanded an assessment at the Waterford Hospital. Craig recalled Martin saying something to the effect of 'something bad will happen' if immediate transfer to the Waterford Hospital was not arranged."

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Martin was brought to hospital after a choking incident on April 20, 2018. She was pronounced dead at 3:28 a.m. the next day.

Egregious and inflammatory

Natasha Martin's lawsuit is seeking punitive damages from Craig for her daughter's death.

"The allegations 'of wanton disregard for Skye's rights and reprehensible disregard for Skye's health and safety' are egregious and inflammatory," reads Craig's defence.

"If unproven at trial, Craig states that cost sanctions on a solicitor-client basis ought to be imposed against Martin for making such an allegation."

Other defendants haven't responded

Craig is one of three parties, along with the provincial government and the superintendent of prisons, named as defendants in a lawsuit filed by Natasha Martin. He is the only defendant who has to date filed a statement of defence.

Craig's care has been questioned before. In March 2011, Newfoundland and Labrador's Citizens' Representative Barry Fleming called for Craig to be removed from his duties in the justice system, after issuing a report that found inmates at HMP, some of whom had complained about being taken off prescribed medicine, do not receive the level of psychiatric care that they would receive outside.

A peer review the following year said Craig "meets the standard of care, where that standard is comparable service provision in other provinces."

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