Crown counsel accused a former Hamilton paramedic of “guessing” what was wrong when a patient in his care “absolutely crashed” in the back of an ambulance in 2017.
During day 24 in the trial of two former paramedics charged with failing to provide the necessaries of life, the Crown’s Scott Patterson suggested the accused Christopher Marchant would not accept shock as the reason his patient’s heart rate dropped suddenly on the way to a Central Hamilton hospital.
“What you’re doing, sir, is you’re just trying to invent, you’re guessing, you’re making up possibilities, you’re dealing with everything other than the obvious cause, which was shock,” Patterson said.
Marchant responded by saying he had “ruled out” penetrating trauma in a reassessment of 19-year-old Yosif Al-Hasnawi in the back of an ambulance, believing that his patient was suffering from a psychiatric issue.
“As I said, Mr. Patterson, I ruled out the penetrating trauma with my reassessment in the back, which would have been if it was penetrating trauma then probably shock, yes, but I ruled that out,” Marchant replied.
Much of the Crown’s line of question on Thursday morning revolved around Marchant’s actions after Al-Hasnawi was loaded and restrained in an ambulance set to depart for St. Joe’s hospital on the night of Dec. 2, 2017.
Earlier, the patient was shot by a .22 calibre gun during a confrontation with Dale King on Sanford Street just south of Aikman Avenue. Several witnesses at the scene the night of the shooting and a firefighter suggested the young man was shot with a pellet gun, which was the working theory paramedics adopted when they first examined Al-Hasnawi.
After Marchant and co-accused Steve Snively talked to family members and other witnesses, the pair believed Al-Hasnawi’s “confused” and” combative” state was a psychiatric issue potentially brought by drugs or alcohol.
Using archived data from a ZOLL monitor defibrillator, Skyhawk ambulance data and an agreed statement of facts with the accused, Patterson also suggested that Marchant was still on the first patch communication with the destination hospital when Al-Hasnawi “crashed.”
Patterson said Marchant got on the first patch with St. Joe’s at 9:32 p.m. for 70 seconds when the archived Zoll data showed Al-Hasnawi’s heart rate had slowed considerably at 9:33 p.m.
He also suggested that Marchant took his eyes off Al-Hasnaw because the configuration in the back of the ambulance to complete a call would mean he would have to leave the patient’s side.
“You were actually on the patch when he crashed. Isn’t that right?” asked Patterson.
“I don’t believe so,” Marchant replied.
Using Skyhawk data, Patterson revealed that co-accused Snively, who was driving, stopped at the intersection of Main Street East and Wentworth for a short period of time believing he may be at a red light.
It isn’t until 9:38 p.m., according to Skyhawk, that the driver of the ambulance activated both lights and the siren.
Records show that the second patch to St. Joe’s was initiated at 9:35 p.m. when the urgency of the call was upgraded to a code four — the highest priority call.
“After the person who you have responsibility for in the back of the ambulance has crashed, right, it’s pretty obvious that Mr. Snively wasn’t aware of what was taking place. Isn’t that fair?” Patterson said.
Marchant replied “That’s possible. Yes.”
Patterson then followed up, asking Marchant if he thought Al-Hasnawi was faking.
“That’s completely incorrect,” Marchant said.
Day 24 was the first day of testimony for the co-accused, Steven Snively.
Responding to questions from his defence counsel, Michael DelGobbo, Snively characterized his partner Marchant as “diligent” and “conscientious.”
“He had a very strong work ethic and I had no difficulty working with them,” Snively said.
Snively explained that his partnership with Marchant, in terms of which paramedic takes on the primary care of a patient, was based on a rotational system, per call.
“If he started attending and I drove, then the next call I would attend and he would drive,” Snively said.
Unlike his partner, Snively had past experience with a gunshot wound after a shooting in downtown Hamilton about nine years ago. Snively said he assessed a wound and transported a victim to Hamilton General Hospital.
Snively also told the court he was a hunter and experienced with firearms.
“It looks moist”
Snively was the first of the two paramedics on the night of Dec. 2 to assess Al-Hasnawi when he and Marchant arrived at the scene.
When he first saw the patient, he was looking up and alert.
“He wasn’t moving his head so much, but his eyes were moving around,” Snively told the court.
After manually checking basic vital signs, Snively says he looked at Al-Hasnawi’s abdomen area for any distension or obvious injury.
After a firefighter shined a light on his stomach, the paramedic observed the wound next to his belly button.
“I look at it, I don’t see any blood. It looks moist. I think I described it a number of times as if someone had picked the scab,” Snively said.
He then said he began palpation of the wound using both hands looking for rigidity and pain.
“He didn’t seem to squirm or move aside,” Snively said. “He just kind of laid there.”
Having been the primary caretaker on a previous call, Snively handed off Al-Hasnawi to Marchant and relayed the patient’s name and vital signs verbally.
Snively then told the court he felt he and his partner could manage the patient themselves and released three firefighters who were at the scene.
Dragging the patient backwards
Snively says that once he left the patient, he went to go talk to witnesses to ascertain what happened and “elicit” as much information as possible on the case.
During the playback of security camera footage from Sanford Avenue, Snively identified himself and recalled that he was the one who made his way to the ambulance stretcher to set it up for transport.
He told the court that, not long after, he was caught off guard when he saw a young man pick up the patient.
“I think I actually see myself kind of looking and going, what’s going on?” Snively said.
“Because it kind of caught me off guard in the sense that it was no direction from myself.”
During the trial, Al-Hasnawi’s younger brother Mahdi admitted he was the one who picked up his brother after a failed attempt by Marchant and a Hamilton police officer.
Snively said he immediately moved to Al-Hasnawi and reached under to scoop up his lower body.
“And I’m now in the process of following this unknown man as he’s dragging our patient backwards,” Snively said.
So did he use the words pellet gun?
The paramedic admitted has recalled some events out of order recently, citing the call in 2017 as a “stressful” event.
He originally thought he talked to Yosif’s brother, Mahdi, before he picked up his brother but now says that actually happened after the attempt.
During the conversation, he learned that Yosif had been punched in the head and asked if he fell and hit his head. Mahdi replied “no.”
Snively said he asked about the gun that allegedly shot Al-Hasnawi, and Mahdi told him it was a pellet gun and said there was no muzzle flash from it.
Counsel DelGobbo then stopped Snively’s account momentarily and asked, “So did he use the words pellet gun?”
Snively replied, “He did.”
The former paramedic also told the court that he “distinctly” heard one of the police officers tell the patient to “stop acting, if I look hard enough, I can find a pellet on the ground.”
Snively said that’s when he faced a “fork in the road” and thought there were some potential behavioural issues going on.
“I believe in my mind that it was no longer a penetrating trauma based on the wound that I saw, his initial presentation and the information that we were gathering about this repeated pellet gun,” Snively said.
Day 25 of the judge-only trial resumes Friday.
Justice Harrison Arrell is expected to hear more testimony from Snively as his counsel DelGobbo continues a direct examination, followed by a cross-examination from the Crown.