An inquest jury has put forth 13 suggestions to enhance healthcare at Sudbury Jail in northern Ontario following the passing away of a 44-year-old Wiikwemkoong First Nation man, Justin Alexander Trudeau, who was in custody four years ago. Trudeau passed away on Feb. 13, 2021, after being at the jail for five days to serve a 30-day sentence. A post-mortem examination revealed that he succumbed to a severe antibiotic-resistant infection that had spread from his lungs to his bloodstream.
The jury’s recommendations, consisting of eight proposed by the coroner’s office and the jail’s doctor, along with five additions from the jury members, were the result of a week-long testimony highlighting issues like understaffing among medical personnel and guards.
These recommendations, though not legally binding, are aimed at prompting changes in policies and procedures. Within six months of the inquest, the Ministry of the Solicitor General and Sudbury Jail will be required by the Office of the Chief Coroner to respond to the recommendations, confirming their implementation or providing reasons for not implementing them.
Some of the recommendations include optimizing staffing levels during overnight shifts for emergency hospital escorts, upgrading segregation cell door windows for better visibility, providing additional training for nursing staff on sepsis recognition, and enhancing cultural training for Indigenous inmates.
Further suggestions were made to improve communication between correctional officers, enhance documentation standards, and ensure closer monitoring of inmates showing signs of infection. The importance of 24-hour nursing coverage, hiring a pharmacist or pharmacy technician, and prioritizing doctor check-ups for new inmates were also emphasized.
Trudeau had exhibited symptoms such as a mild fever, rib pain, and a request for methadone during his time at the jail. The night before his passing, he contacted his mother, expressing breathing difficulties. The infection that led to his demise had progressed into sepsis, causing organ failure.
Experts testified that closer monitoring could have identified warning signs of sepsis, such as a low temperature reading taken the day before his death.