It’s a legal first in Canada – two paramedics found guilty of their involvement in the death of a Hamilton teenager. Now other forces are asking questions about how this precedent could change the way they work.
An Ontario Supreme Court judge found Tuesday that former Hamilton paramedics Steven Snively and Christopher Marchant failed to properly take care of the wounded and deceased teenager Yosif Al-Hasnawi.
John Schuman – a paramedic and attorney specializing in family law, education law, and children’s rights in Toronto – says paramedics followed the trial and conviction with great interest.
“From the paramedics’ point of view, if we make a mistake now, will we be charged? And if we have a bad day and our judgment is wrong, will we be charged? ”He said.
Richter describes death as a “tragic case”
It was December 2, 2017 when Al-Hasnawi was shot dead in Hamilton. Snively, 55, and Marchant, 32, were the paramedics who answered the call.
They testified that they believed Al-Hasnawi, 19, was shot with a BB pistol. But they were wrong – it was a .22 caliber pistol, and the teen died of internal bleeding about an hour later.
“To say this is a tragic case would be a gross understatement,” Judge Harrison Arrell said in his ruling.
The judge ruled that there was a “significant deviation” from how a properly trained paramedic would have reacted.
Paramedics failed to identify that the wound was penetrative and participated in dangerous lifting operations to remove Al-Hasnawi from the sidewalk, Judge Arrell said.
They also delayed exiting the crime scene in Main and Sanford, which were down the street from Al-Hasnawi’s mosque in Hamilton’s Lower Town.
“I conclude that these various mistakes made by the defendants are not simply carelessness, thoughtlessness, or simple misjudgments, but a conscious choice to ignore their training and standards,” Arrell said.
Yosif Al-Hasnawi recited the Koran during a religious ceremony shortly before he got into an argument in front of the Al-Mustafa Islamic Center and was shot. (Islamic Center Al-Mustafa)
Effects across the health sector
Schuman says charges usually target people responsible for detainees, those who are totally dependent on others, or children. He stressed that the consequences are not just reserved for the paramedics, although they are at the heart of the process.
“Because of the way the statutory audit applies, it should apply to all health professionals,” he said.
He wonders if families will insist that health care professionals be charged if they deviate from protocol or choose more “risk” treatment to save someone’s life.
Dr. Najma Ahmed, an expert on trauma and critical care, testified that Al-Hasnawi had about a 50 percent chance of survival that night.
Mario Posteraro, the President of OPSEU Local 256, who represents Hamilton’s paramedics, participated in the entire study, which began in November 2020.
When the indictment came up in 2018, he said, “It is both a paramedic and a paramedic [and] a small shock wave to the broader healthcare sector, which could be the potential precedent. “
“I think the concern and coldness that emerged in bringing the charges has now deepened and we don’t really have all the answers,” he said.
The concern, Posteraro said, is that the treatment of paramedics on site, transportation decisions and care provided are examined through a different lens – one that puts workers “in the direct line of fire”.
John Schuman, a medic and attorney, says he believes health professionals are wondering what legal implications the ruling will have in the field in the future. (Zooming)
A change for the better, says a family friend
Firas Al Najim, a friend of the Al-Hasnawi family and a human rights activist, said Tuesday that he believes this will change the field for the better.
“Hopefully there won’t be a case in the future. The paramedics will know not to deal with such a patient,” he said.
“If he tells you he can’t breathe when he’s injured, just take him to the trauma center. Do your job. You’re not there to see if he’s acting.”
Some witnesses said they heard the paramedics laugh. Others recalled hearing a comment that Al-Hasnawi was about to win an Oscar for his behavior. This is denied by the two paramedics who testified in their own defense.
A significant part of the study focused on whether paramedics were following the protocols set out in the Basic Life Support Patient Care Standards used by the Ontario Department of Health.
Failure to follow protocols, said Judge Arrell, depriving Yosif of his only chance of survival.
The delay was unjustified, said the judge
The paramedics were on site for 23 minutes that night, 17 minutes of which were in the rear of the ambulance.
Dr. Richard Verbeek, Toronto Medical Director for Paramedics at the Sunnybrook Center for Prehospital Medicine, testified for several days during the trial.
He said that 23 minutes in North America for blunt and piercing wounds as a combined category would be “within what we might expect in a trauma scene under average circumstances.”
But Verbeek, who published the standards, stated that a penetrating wound qualifies Al-Hasnawi as a “load-and-go” situation for the leading accident hospital.
Judge Arrell said the wait was “unjustified” and it was foreseeable that the paramedics would risk Al-Hasnawi’s life.
Schuman said paramedics are taught to “guess the worst”. But the tests they do can also change the hospital goal, treatment regimens, and the hospital’s response to an incoming patient.
“You don’t want to rush that,” he said. “You don’t want people to do the wrong thing because they are under pressure to move.”
For a while, he said, people might feel pressure to treat anyone, regardless of presentation, as “at the door of death.”
“It’s going to use a lot of resources,” he said.
Future of care
Posteraro also said it is possible that care could be compromised after the verdict.
“It can be an extreme on either side of the equation. Perhaps care can suffer from healthcare providers, paramedics viewing a call, or treating a patient through a different lens – more defensively than in the best interests of the patient, ”he said.
The outcome, Schuman said, could raise questions for workers whether to stay on the front line as paramedics or move into a more detached role like a supervisor.
Dale King, the man who shot Al-Hasnawi, was acquitted of second degree murder last year. An appeal is filed against this decision.