The first aid to Abdi: Was it enough?
CPR not given to Abdi until after paramedics arrived, inquest hears
The Abdirahman Abdi inquest is being livestreamed during the day here.
It's not clear exactly when Abdirahman Abdi's heart stopped beating on July 24, 2016.
But here's what the ongoing coroner's inquest into his death has pieced together about his final moments:
Abdi was a Somali-Canadian man struggling with his mental health.
After the 38-year-old groped several women in Ottawa's Hintonburg neighbourhood that morning — in what one expert psychiatrist has suggested was a schizophrenic episode affecting Abdi's perception of reality — he resisted being handcuffed and fled police.
Things culminated in a struggle in front of Abdi's apartment building where Const. Daniel Montsion punched Abdi in the head several times as he and former constable David Weir tried to handcuff him.
The punches worked to distract Abdi. He was cuffed and, within minutes, his body went slack.
Montsion and Weir called paramedics at 9:48 a.m., with Montsion checking to see if Abdi was still breathing but neither officer checking without gloves for a pulse or attempting CPR.
Eight minutes after being called, paramedics arrived and found Abdi had no pulse, wasn't breathing, showed no other vital signs and was in cardiac arrest. They directed Montsion to provide CPR.
By this point, Abdi's brain was starved of oxygen and, as an expert pathologist testified, already "irreversibly damaged."
Doctors pronounced Abdi dead at the hospital the next day.
The inquest, which began on Nov. 18 and is now in its fourth week, is focused on finding ways to prevent deaths like Abdi's in the future.
It has circled back to different moments of the Abdi arrest, including Weir's initial contact with Abdi and how that might have played out differently.
But on Monday and Tuesday, the inquest returned to another question: whether Montsion and Weir, by not directly checking for a pulse and not beginning CPR on Abdi before paramedics arrived, provided adequate first aid in the crucial moments after Abdi's violent arrest.
'Every minute counts,' ICU doc says
This is not an unwarranted detour for the inquest.
In fact, the wide-ranging fact-finding process — which is not about assigning any legal blame — has stated one of its core concerns is officers' "management" of Abdi from the time he was apprehended to the arrival of the ambulance.
But the inquest has heard mixed testimony about how important immediate CPR would have been in Abdi's case.
Dr. Kwadwo Kyeremanteng, Abdi's ICU doctor, said that in a situation of cardiac arrest without CPR and no (or limited) oxygen to the brain, "every minute counts."
There are risks to performing CPR, such as broken ribs, but the benefits, including potentially pointing to signs of life, "definitely" outweigh those risks, he added.
"If my child was unconscious and some bystander did CPR and even if [it] ended up being unnecessary, I would be grateful," Kyeremanteng said.
In his own inquest testimony, Chief Forensic Pathologist for Ontario Dr. Michael Pollanen said the moment of Abdi's death can't be pinpointed.
For that reason, it's difficult to make a "categorical" statement about how the absence of CPR on Abdi until the arrival of paramedics might have affected his outcome, he said.
Abdi's heart rate was revived, but "because of the period of lack of blood flow to the brain, he was ultimately brain dead as a result," Pollanen said.
While Pollanen added that "you want to get resuscitation as soon as possible," he also cautioned that resuscitation "is not a guarantee the person is going to survive."
Investigator defends officers
The issue of first aid to Abdi surfaced again on Monday and Tuesday during the testimony of Sgt. Grayson Lafoley, one of the Ottawa police officers who conducted the force's internal investigation into the Abdi arrest.
The internal review, the results of which were not publicly released until Monday, focused in part on whether the actions of Montsion and Weir followed the police service's prisoner care and control policy.
The police found no issues there.
But as Lafoley outlined under questioning by inquest lawyer Alessandra Hollands, the review was concerned not with the depth of the care provided to Abdi but simply on whether any first aid was provided.
Lafoley pointed to several steps the officers took: calling paramedics, upgrading the priority of the call, applying a bandage to Abdi, staying by his body, placing him in the recovery position twice, and performing CPR when asked to by paramedics.
On Monday, Hollands asked Lafoley if not checking for Abdi's pulse factored into his review.
"Mr. Abdi had [bitten] Mr. Montsion," he replied. "So expecting an officer to reach down and put their hand near a person's neck who's been violent is not necessarily a realistic application of first aid."
The officers aren't doctors, nurses or paramedics, he added. "So whether or not they could successfully determine a pulse in that situation, it's an unfair expectation for officers."
The inquest previously heard from an instructor at the Ontario Police College that CPR is not taught there, though Montsion testified that he has received CPR training "many times" elsewhere.
He said he did not check for Abdi's pulse because: "I could tell he had a pulse because he was breathing."
Monstion added he stopped checking for Abdi's breathing about a minute or a minute and a half before paramedics arrived because by then the scene had grown chaotic and noisy — an observation backed up by the responding advanced care paramedic.
The scene got even more tense when Montsion began doing CPR, that paramedic testified.
WATCH / The death of Abdirahman Abdi: Here's what you need to know:
The inquest has heard that a summary report of the internal review's findings still hasn't been sent to the Ottawa Police Services Board, the police's civilian-led oversight body.
Under further questioning by Hollands on Tuesday, Lafoley conceded that, as Hollands phrased it, "the quality or sufficiency of first aid and life saving measures" given to a community member was important information to be passed on to the board. (One of the other focuses of the inquest is the police force's reporting relationship to the board.)
But in an exchange that soon followed, Hollands and Lafoley showed how far apart they remained on the question of first aid to Abdi.
In continuing to press the issue of taking Abdi's pulse, Hollands asked Lafoley if he agreed Abdi did not pose any physical threat to the officers once he was handcuffed and unresponsive.
Lafoley said he could not agree with that.
"You could be blacked out for five seconds, one second and regain consciousness. It's too subjective a proposition to understand. We don't know when he's unconscious. You can go into convulsions, right? You could have involuntary bodily reactions that could be damaging to a person rendering first aid. If there's a seizure, they can bite down.
"There's all kinds of things that can happen in that moment."
The inquest continues on Wednesday.
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