Crown presses ex-medic on stand

Two former Hamilton paramedics are charged with failing to provide care for fatally shot teen

Words matter when a paramedic assesses a patient.

They matter in the written report a paramedic passes on to doctors and nurses continuing the care of that patient.

All those words also matter when a paramedic goes on trial, accused of failing to properly care for that patient — a 19year-old bleeding to death from a gunshot wound.

Dictionary definitions, additions and omissions of words, and choice of vocabulary were pored over Wednesday as disgraced paramedic Chris Marchant was cross-examined about the night Yosif Al-Hasnawi died on his watch.

Marchant, 32, and his partner, 55-year-old Steve Snively, are charged with failing to provide the necessaries of life. The trial has heard they relied on bystander speculation that the teen — who wanted to be a doctor — was shot with a BB gun and not seriously hurt.

In fact, on Dec. 2, 2017, when Yosif tried to protect a stranger from harassment, he was shot in the abdomen with a .22-calibre hollow-point bullet that left a small hole and perforated two major blood vessels.

It happened near Yosif’s downtown mosque, where he attended that night with his father and brothers.

Dale King, who fired the fatal bullet, was acquitted of seconddegree murder. The verdict is under appeal by the Crown.

Snively and Marchant were fired by the Hamilton Paramedic Service.

Assistant Crown attorney Scott Patterson started the Zoom proceedings with the word “diagnose.”

Twice in earlier testimony Marchant talked of “diagnosing” Yosif. But when pressed, he admitted he isn’t qualified to diagnose. A paramedic is trained to assess and treat.

His assessment, it turned out, was wrong.

“You didn’t recognize this was a penetrating abdominal wound?”

“Yes, that’s correct.” Instead, Marchant assessed a mental-health issue and possible drug problem. The paramedics took Yosif to the psychiatric emergency department at St. Joseph’s Healthcare rather than the regional trauma centre at Hamilton General Hospital.

Patterson and Marchant debated the appropriateness of the word “blame.”

Did he make a major mistake going to St. Joe’s?

“We had chosen the wrong hospital destination, yes.”

Did he blame himself for Yosif’s death?

“I was confused and sad at the events … But I wouldn’t say I blamed myself.”

“Do you feel responsible at least in part for him dying?”

“Yes … I wouldn’t say he died because of that, but we did make a mistake.”

At the end of every shift, Hamilton paramedics are to complete and submit their “ambulance call reports.” Those reports can be shared with hospitals to assist with the patient’s care.

That night, after Yosif’s death, Marchant wrote the report and Snively read it over. But Marchant didn’t submit it. Instead, he returned to it the next day — making no changes, he said — before submitting it.

Despite that extra care taken with the report, it is chock full of problems. Marchant told court he twice palpated (examined by touch) Yosif’s abdomen to assess his injury. His report makes no mention of palpation.

“Because it was a pertinent negative,” Marchant explained.

A pertinent negative is something that can aid assessment by its absence. The report form includes space for pertinent negatives.

“The most pertinent negative of all in this case is ruling out internal bleeding?” suggested Patterson.

“Yes,” answered Marchant. Seven other pertinent negatives were, however, in the report, such as Yosif not complaining about abdominal pain, his lungs sounding clear and no complaint of back pain.

There was nothing in the report noting the paramedics restrained Yosif by strapping him to the stretcher. Restraints are to be documented.

Five times in the report Marchant referred to Yosif as “combative.”

What does he mean by “combative?” Spoiling for a fight, as the dictionary says?

“His limbs were coming in contact with my partner.” Was it a poor choice of words? “That’s fair,” he agreed. Marchant agreed numerous tests he said were done on Yosif were not listed in the report.

Under the heading “chief complaint” the report reads: “soft tissue/penetrating trauma” — even though Marchant’s testimony is that everything pointed toward psychiatric issues.

When Yosif’s family and friends were asked if he had psychiatric issues or used drugs, they said no. Still, Marchant believed that was the problem.

Marchant testified he heard a police officer at the scene tell Yosif: “C’mon, you’ve been shot with a pellet gun. Stand up and act your age.”

Despite those words, Marchant still described the officer as “taking the scene seriously.”

The day after Yosif’s death, Marchant took a phone call from a dispatcher. Unbeknownst to him, he was being recorded.

Marchant described Yosif acting like “a dickhead” in the back of the ambulance.

What is his definition of a dickhead?

“Somebody who is speaking Arabic to his father, but not speaking to me in English.”

Marchant was annoyed that a dying young man spoke his final words to his father in their own language.

Marchant eventually heard Yosif speak English, on their way to the wrong hospital. “I can’t breathe,” he said. Moments later, Yosif was pronounced dead.