Hamilton paramedics guilty of failing to provide necessaries of life in death of Yosif Al-Hasnawi

Two Hamilton paramedics charged with failing to provide the necessaries of life following the 2017 death of Yosif Al-Hasnawi have been found guilty.

A Superior Court justice made the decision in the judge-only trial after hearing 32 days of testimony from witnesses, experts and Al-Hasnawi’s family and friends.

At question was the conduct of two paramedics, Steve Snively and Christopher Marchant, who treated the 19-year-old on the night of Dec. 2, 2017, after he was shot during an altercation on Sanford Avenue near Main Street East.

Al-Hasnawi was injured after he, his brothers and some friends confronted Dale King and another male who were allegedly accosting an older man not far from a central Hamilton mosque.

The basis of the Crown’s case surrounded testimony from witnesses who characterized the actions of the accused as unprofessional and who suggested that failures in their treatment endangered the victim’s life.

The defence argued the paramedics had an “honest belief” that Al-Hasnawi was suffering from only a pellet gun wound and psychiatric issues, thus not seeing a need to rush the patient to a trauma centre.

During the reading of his decision on Tuesday, Justice Harrison Arrell called Al-Hasnawi’s death “tragic” and said the paramedics showed a “marked departure” from care standards in three key areas.

Arrell said the pair failed to conclude that Al-Hasnawi suffered a penetrating wound to the abdomen, making it a “load-and-go situation of the highest emergency” requiring immediate transport to a trauma hospital.

2:03 Two Hamilton paramedics criminally charged

The justice said the accused were told from the start by dispatchers that the wound the victim reportedly received was a “penetrating wound involving a gunshot” and told clearly in another query that the wound was “penetrating.”

“He knew at that point that penetrating was not superficial and that would be what he was dealing with,” Arrell said.

“Both accused acknowledged in their evidence that a penetrating wound to the abdomen was considered the most serious type of injury.”

The judge went on to suggest the paramedics failed to “keep an open mind” and act according to minimum standards expected of any properly trained paramedic.

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Additionally, instead of following extensive training as professionals, they listened to “rumours and innuendo” around them at the scene that Al-Hasnawi had a superficial wound.

“I conclude these failures by the accused were not simple inadvertence, thoughtlessness or simple error in judgment, but instead was a conscious decision to ignore the obvious evidence before them,” said Arrell.

During the trial, the Crown suggested that Marchant participated “in a dangerous lift” after surveillance video showed the paramedic and a Hamilton police officer lift Al-Hasnawi by his arms from the concrete sidewalk.

Referring to a passage in a copy of Ontario’s patient care standards – which says a primary survey of a patient should include C-spine precautions – the Crown’s Scott Patterson suggested that the proper way to move a patient with unknown injuries is to do a “log roll” onto a spinal board.

Snively was also questioned during the trial about his participation in another lift in which Al-Hasnawi’s 13-year-old brother, Mahdi, was able to make an attempt with no previous instruction.

Arrell concluded that the lifts and failure to utilize a backboard were a “departure” from the paramedics’ training and the protocols.

“They were not lifts any other primary care paramedic would have attempted under the circumstances found that night,” the justice said.

The judge said by not stopping the lift by the victim’s brother, the paramedics failed to protect their patient from harm under Section 215(3) of the criminal code.

On the night of the shooting, a number of witnesses alleged Snively and Marchant took too long to treat and take Al-Hasnawi to hospital.

The defendants insisted some of the delay was due to the patient’s “uncooperative and extremely combative” nature during treatment.

Arrell suggested otherwise, saying video shown in court appeared to show a patient lying on the sidewalk in a relatively “placid state.”

Standards of care in Ontario clearly dictate that paramedics should limit their time at a given scene to under 10 minutes unless there are complications from extraction.

The justice said that was “not the case” and that the duo took between 20 and 30 minutes from the time of arrival until the time of departure from the scene.

“It is unclear to this court why the accused concluded a 17-minute wait in the ambulance to do further assessments was necessary, justified or could be of any benefit,” Arrell said.

The court ultimately decided the two paramedics had “no idea what was wrong” with Al-Hasnawi and held onto a belief he had some “vague psychiatric issue” for which they appeared to have little supporting evidence.

“I conclude these various failures by the accused were not simple inadvertence, thoughtlessness or simple errors in judgment, but instead were a conscious decision to ignore their training and standards they were familiar with and were put in place,” Arrell said.

In conclusion, the justice said it was clear that the two paramedics “acted in concert” with each other on the night of Dec. 2, 2017 and subsequently their actions fall under Section 21(1) of the Canadian criminal code.

The two were found “jointly guilty” under Section 215(3) of the criminal code for failing to provide the necessaries of life.

Sentencing of the paramedics is expected over two days, Oct. 25 and 26.

Following the verdict, the head of Ontario’s paramedics union called the incident in 2017 “sad and tragic” for the Al-Hasnawi family and a “negative event” for the Hamilton Parmedics.

Mario Posteraro, President of OPSEU Local 256, said what happened was “not the norm” for the service itself.

“Our job is very difficult we’re tasked with making multiple critical decisions rapidly, simultaneously under very difficult circumstances, ” said Posteraro.

“Often there are irate bystanders or family members, there’s often conflicting and confusing information in (medical) history, and it makes decision-making difficult.”

Posteraro wouldn’t comment directly on the trial since it’s not over with a sentencing stage still to come, but said he still believes the public has the trust of the service.

Going forward, he believes EMS administrators need to look at the science of the work as it pertains to the judgments paramedics make in  assessment, treatment and transport decisions.

“This is especially true now as the diagnostics and interventions paramedics administer become more complex and the scope of practice continues to evolve and expand,” Posteraro said.

“So it’s easy to say standards were not followed, but I think we have to try to give some value from an educational perspective to ensure that this doesn’t happen again.”