Yosif Al-Hasnawi’s injury ‘highly lethal’ says pathologist in Hamilton paramedics trial

A former forensic pathologist at the Hamilton General Hospital who conducted the autopsy on Yosif Al-Hasnawi told a court on Thursday there was “no guarantee” the 19-year-old shooting victim would have survived if he was transported to a lead trauma hospital.

Dr. Elena Bulakhtina, who has performed over 2,000 post-mortem examinations in her career, appeared as a Crown witness in a virtual courtroom at the trial of two former Hamilton paramedics, Christopher Marchant and Steven Snively.

Bulakhtina, responding to questions in a cross-examination, clarified an opinon from her 2018 postmortem report in which she characterized the survivability of combined large artery and vein injuries as “highly lethal.”

“What I said in the sentence was, that lots of people thought, if the decision (was to) go to the trauma hospital, he would have lived,” Bulakhtina told the court.

“He could have lived. But I cannot say that he would have lived. So that’s what people assumed. He would have survived if he arrived at the trauma hospital. This is not the case.”

Earlier, the Crown’s Scott Patterson walked Bulakhtina through her autopsy from April 2018 that showed Al-Hasnawi had two litres of blood in his abdomen caused by penetrating injury to the right common iliac artery and vein, the largest in the body.

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In her literature, Bulakhtina suggested a survivability rate of between 38 and 50 per cent for such an injury based on data from lead trauma hospitals. She also stated it’s less, zero to 18 per cent, if that patient needed to go through an emergency thoracotomy or opening of the chest.

On the night of the shooting, the paramedics took the victim to St. Joseph’s hospital instead of Hamilton General believing Al-Hasnawi had been shot by a BB gun instead of a .22 calibre handgun, identified later by police.

In the opinion of trauma centre expert Dr. Najma Ahmed, who testified on Dec. 4, Al-Hasnawi’s “best odds” of survival would have been treatment at a better-equipped lead trauma centre, like Hamilton General.

However, in her report, Bulakhtina said the patient was suffering from a “rapid loss of blood” that would have been “difficult to contain” and that the “nature of his injuries was the strongest determinant of a poor outcome.”

Just before the end of Bulakhtina’s testimony, Justice Harrison Arrell asked if Al-Hasnawi’s chance of survival was “50 per cent at best” based on her literature and assessment of the patient.

She replied “yes.”

Day 18 of the trial will take place on Monday morning at the John Sopinka Courthouse in Hamilton.

The trial is expected to be put on hold for the Christmas break next week.

Over the next month, the judge-only trial will hear more testimony from witnesses, emergency responders, family, and bystanders connected to Al-Hasnawi’s shooting.