No opioid withdrawal plan in place prior to woman's death at Regina remand centre, staff testifies at inquiry

White Birch Female Remand Unit in Regina was prepared to deal with alcohol withdrawal but did not have a plan for opioid addicts going through withdrawal at the facility prior to the 2015 death of Breanna Kannickat the centre, an inquest into the woman's death heard Tuesday.

The lack of drug treatment was brought up by staff who testifiedduring the second day of the coroner's inquest into the 21-year-old's death. They both said her withdrawal systems were not irregular leading up to the incident that led to her death, and included vomiting and the release of black fluid from her nose and mouth.

Kannick died at the remand centre in August 2015 while withdrawing from the hydromorphone she was addicted to. At the time, she was in custody for failing to appear in court on drug possession charges.

Kristal Bonilla, assistant deputy director of White Birch, testified that Kannick had approached staff at least once asking to go to the hospital.

Bonilla said one of the nurses told her Kannickwas just going through withdrawal and that she wouldn't be sent to a doctor. She was told nausea would be normal and was advised to drink liquids. Bonilla said that was the only time she remembered Kannick asking to see a physician.

The guards reported Kannick had been throwing up and suffering from diarrhea, but they did not log that fact.

"They could've put she was vomiting but it wasn't unusual for someone going through withdrawal," Bonilla said.

At one point, Kannick complained of leg cramps but was told that was also to be expected. Eventually, she was moved to a cell with cameras and a bathroom, which was referredto at the remand as a "wet cell."

When she went to sleep, Kannick's vitals seemed to be improving, staff said.

Opiodwithdrawal not seen as fatal, staff says

The next morning, Bonilla said a staff member went to get Kannick up. She began vomiting and black fluid started coming out of her nose and mouth. An ambulance was called and staff started chest compressions on Kannick.

Bonilla said there was no protocol at the remand centre for drug withdrawal. She said they did not document what inmates were eating, if they were eatingor how often they were checked on by guards.

She said that Kannick's condition wasn't seen as serious because staff didn't believe someone could die from withdrawal.

Kayla Olson, a registered psychiatric nurse, also testified that drug withdrawal was not seen as potentially fatal.

Olsen said White Birch has a policy for treating alcohol withdrawal because there have been deaths from it in the past, but there is no drug withdrawal plan. She testified she has never seen methadone used to treat opioid withdrawal so she didn't know that it was possible.

She said she dealt with Kannick once, for about eight minutes on Aug. 17, to complete her initial health assessment at intake.

Olsen said Kannick seemed like a healthy young girl, who was pleasant and co-operative. Her vitals were good. She said she wasn't emaciated, "just skinny," but didn't weigh her.

Kannick told Olsen it was her first time in custody and admitted to having an addiction to hydromorphone and morphine. Olsen asked Kannick if she was going through withdrawal, but at that time Kannick said she was just tired and sore.

Kannick requested Valium from Olson during her initial assessment, to help with withdrawal symptoms, but Olson told her they do not treat opioid withdrawal. The facility instead offered Gravol, Imodium and Tylenol.

Kannick died three days after the assessment.

The inquest into Kannick's death began Monday. An inquest is held if a person dies while in custody, unless a coroner determines the person's death was due entirely to natural causes and was not preventable. The inquest provides a public hearing to examine the details surrounding the death.

The six-person jury selected for the inquest Monday morning will have evidence sworn before them, and they may also make recommendations to prevent similar deaths.

The inquest is expected to last the rest of the week.