Heather Winterstein’s skin was discoloured and she was struggling to control her body in a wheelchair the day she died at the St. Catharines, Ont., hospital, a woman who was waiting to see a doctor that day told a coroner’s inquest.
Emmaleen Young is believed to be the last person who spoke to Winterstein. She died of sepsis on Dec. 10, 2021.
On Friday, Young testified she’s haunted by the look on Winterstein’s face shortly before she collapsed in the emergency department’s waiting room.
“She just looked terrified. In her eyes, I could see it.
“That’s what gets me: She clearly wanted help.”
Young is among witnesses who’ve described what they’ve seen or experienced leading up to Winterstein’s death at the hospital, which in 2024 was officially renamed Marotta Family Hospital. A total of over 20 people are expected to testify over 13 days. The hearings, which began March 30, are being held virtually.
An Ontario coroner’s jury is tasked with determining the facts in a case and may make recommendations to prevent similar deaths, but doesn’t assign blame or make findings of guilt or innocence.
‘I could see she is not OK’
Young recalled sitting in the hospital’s packed waiting room in the early afternoon of Dec. 10. She said she saw a man wheel Winterstein to a triage nurse station about two metres away from her.
“I could see she’s not OK,” Young said about Winterstein. “She was clearly having issues controlling her body. She was very shaky.
“She was slumped in a weird position on the [wheel]chair.”
Young also noticed Winterstein’s body appeared discoloured.
“She had this blotchy rash. It was on her face, on her neck, on her tummy. I could see it everywhere on her body.”
Young said Winterstein appeared to say something brief to the triage nurse, but the nurse snapped sharply at Winterstein.
“I heard the nurse say, ‘We’ll be with you in a moment, Heather.’ I felt it was belittling. It was quite shocking to me.
“I felt 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 damages the body’s own tissues and organs.
Sought help over 2-day period
A day before Young addressed the inquest, the jury heard from a triage nurse, who said triage nursing staff were facing a crush of patients in the waiting room on Dec. 10, in part due to the COVID-19 pandemic.
Young said she asked Winterstein if she needed help. Winterstein stuttered and struggled to say “no.”
Winterstein’s first attempt to get hospital help was on Dec. 9, when she arrived by ambulance, complaining of pain after reportedly falling down a flight of stairs the day before. She was given a Tylenol and sent home with instructions to return to the emergency department if her condition worsened.
The emergency physician who assessed her determined “social issues” were behind her hospital visit, the inquest previously heard
She returned to the emergency department the next day by ambulance and was sent to the waiting room until she could be seen by a doctor. On Thursday, the inquest heard although hospital rules say Winterstein was supposed to be reassessed by a triage nurse every 15 minutes, given the seriousness of her condition, no reassessments were done in the 2½ hours she waited.
Eventually, Young said, Winterstein stopped moving altogether. At 2:41 p.m. ET, she collapsed.
“Her body folds on itself like her head’s too heavy. Her head hits the top of thighs and she falls out of the wheelchair, onto the ground.”
There was no sense of urgency.– Emmaleen Young, inquest witness
Fighting tears, Young recalled Winterstein’s eyes were open but they were not blinking.
A group of doctors, nurses and two security guards appeared through a set of double doors and walked over to Winterstein, said Young.
“There was no sense of urgency.”
The hospital workers attending to Winterstein put her on a stretcher and brought her into the emergency department, said Young.
A day earlier, the inquest was told doctors worked frantically on Winterstein for several hours to try to resuscitate her before she was pronounced dead at 8:42 p.m.
Winterstein was a member of the Cayuga Nation, with ties to Six Nations of the Grand River.
Since her death, family members and community organizations have expressed concern that addiction discrimination and anti-Indigenous racism may have played a role in how she was treated.
Young was asked if she perceived Winterstein to be Indigenous. She said she did.
Triage nurse Andrea Demery previously told the inquest that she wasn’t aware Winterstein was Indigenous.
Doctor denies lying in notes
Dr. Emad Nour, an emergency department physician who treated Winterstein on Dec. 9, was back testifying on Friday.
In her cross-examination of Nour, Rachael Gardner, a lawyer representing Winterstein’s family, accused him of lying in his doctor’s notes. She said he only mentioned in a document days after the death that he’d examined Winterstein’s limbs as part of efforts to determine if she had an infection.
It’s “a fabrication,” said Gardner, who accused Nour of ruling out an infection after learning Winterstein had a substance abuse disorder and anxiety.
Nour denied lying, saying, “I need to go to bed at the end of the day and sleep.”
Gardner showed the inquest a video of Winterstein appearing to walk unsteadily and with difficulty in the waiting room, two hours before she saw Nour. He previously testified he determined in his assessment that he was satisfied she could walk adequately,
Referring to the video, he said Friday: “She stands erect, she walks in a straight line. My only comment is, it’s slow walking.”
Inquest lawyer cites previous complaints about doctor
One of the inquest’s lawyers, Julian Roy, pointed to several cases over the years of patients or families who lodged complaints with the hospital about care provided by Nour.
Dr. David Eden, the inquest’s presiding officer, ordered Niagara Health, which runs the hospital, to provide those records.
Eden told inquest jurors those complaints were brought forward to help them get a sense of how the hospital responds to them, part of efforts to improve patient care.
Among the complaints, Nour allegedly asked a girl who had ulcerative colitis and severe abdominal pain if she was a “drug mule,” based on computed tomography (CT) scan findings.
He defended his actions, telling the inquest the radiologist asked him to question the girl about what showed up in the scan.
“I said, ‘I’m so sorry for asking this question, but the radiologist saw something in your body … and she’s worried it could be drugs,'” he testified about what he said to the girl. “I had to ask if she was shoving drugs up her anus because I was told to.”
In some of the complaints about him, Nour issued apologies to patients or families, but that “doesn’t mean wrongdoing,” he said.
“A high percentage of the patients walk out of the emergency room unhappy about the care, and the wait and the service.”
