We now know that the conclusions of an internal review sanctioned by the WRHA were blatantly false. The review concluded that "the facts and circumstances surrounding Mr. Sinclair's death did not derive from any action or inaction by any single individual."
And it's apparent that the WRHA was prepared to continue the deception right up to, and even after, Manitoba's Chief Medical Examiner forced their hand Wednesday by revealing the truth of what happened.
We still don't know why, although we're prepared to venture a guess.
They knew there was security video of Sinclair arriving at the Health Sciences Centre on Friday, September 21, 2008, 34 hours before he was found dead in the emergency room, never having been treated by a doctor.
Winnipeg Free Press reporter Gabrielle Giroday spoke with Dr. Brock Wright, the WRHA's vice president and chief medical officer, and wrote in a story published Sept. 23:
"Security tapes of the facility are being reviewed as part of the investigation, Wright said."
Already by then officials of the WRHA knew what was on the tapes. CTV had the details which appear in their story also dated Sept. 23:
"Sinclair is seen on the hospital's security camera footage when he arrived at the department's main entrance Friday afternoon.
He is not in the footage the entire time, but health officials say they believe the man was in the waiting room for the full 34 hours. It's also believed the man interacted with aides and cleaning staff, but not medical staff."
And the CTV story contained the first step of the WRHA deception--- blame the victim. Brock Wright spoke for the WRHA:
"The challenge for us right now is to explain how it is somebody could be in the department for 34 hours and not have been brought forward to the triage desk area and be entered into the system," Wright said.
Wright said the system relies on people approaching the triage desk so that they can be placed in a queue based on the urgency of their medical needs. He said Sinclair was known to hospital staff, and said staff was surprised Sinclair wouldn't have checked in at the triage desk."
Wright tempered his comments after that, preferring to repeat only that Sinclair never saw a triage nurse and was never officially in the system. Sinclair, said Wright, simply fell through the cracks.
That is, that's what he said until M.E. Thambirajah Balachandra stepped forward.
There was no apparent reason for Balachandra's news conference Wednesday. The fact he was calling an inquest was known almost from Day One. No date has been set for an inquest, and Balachandra had nothing to add, nothing that is except to reveal the hospital video contradicts everything the WRHA wanted the public to believe about Sinclair's death.
We need to be clear as to what Balachandra said.
The Winnipeg Free Press has reported he "released a statement saying that a review of Health Sciences Centre's security tapes found an unidentified man wheeled Sinclair into the ER and up to the triage desk around 3 p.m. Sept. 19, 2008."
And "Statement from Balachandra: "It appears an employee of the HSC at the triage desk spoke to Mr. Sinclair at that time"."
But Canadian Press, which has proven more accurate that the FP with details in the past, reported:
"WINNIPEG - A homeless man found dead after a 34-hour wait in a hospital emergency room spoke to an employee at the triage desk within an hour of his arrival and may have thought he was registered, Manitoba's chief medical examiner said Wednesday.
Thambirajah Balachandra said security tapes show that Brian Sinclair, a 45-year-old double amputee, was wheeled to the desk by an unidentified man after arriving in a taxi last September.
"He was seen wheeling into the triage area," said Balachandra late Wednesday after formally calling an inquest into Sinclair's death. "The CCTV shows that he spoke to some hospital employee who was in a hospital uniform . . . and then he wheeled back."
Officials from the Winnipeg Health Sciences Centre said Sinclair spoke to an aide and was never properly registered by a nurse. But Balachandra said Sinclair may have thought that he would be called by a triage nurse after speaking to a uniformed hospital employee."
Whichever version is correct---the taxi driver wheeled Sinclair to the triage desk or Fontaine wheeled himself "into the triage area" up to an hour after arriving--- the bottom line is the same.
Sinclair spoke with someone in a hospital uniform, someone standing by the triage desk, someone, it's since been revealed, who carried a clipboard and wrote notes as he spoke with ailing man.
Who was this man?
According to the Winnipeg Free Press, Thursday...
"On Wednesday, Wright said Sinclair had contact with at least three staff members in 34 hours, including one triage aide.
Triage aides typically do minor cleaning in the ER, but should also alert the triage nurse of someone waiting for care."
On Sept. 23, more than four months ago, CTV reported that health officials "believed the man interacted with aides and cleaning staff, but not medical staff."
They saw the same video that Dr. Balachandra saw. Unless they're professing some editing trickery, they saw more than four months ago that Sinclair spoke with a triage aide near or at the triage desk.
Yet they allowed Brock Wright to say in repeated interviews that Sinclair never approached the triage desk. They knew this was a lie.
The Winnipeg Free Press reported that even after Balachandra's news conference...
"Dr. Brock Wright, WRHA chief medical officer and senior vice-president of clinical services, maintained that Sinclair interacted with an HSC employee near the triage desk, but never formally presented himself to the triage desk or spoke to a triage nurse."
"Wright said he hasn't watched the security tapes, but was informed of their content by senior HSC staff who did watch them."
Elsewhere they quoted him saying: "I didn't feel the need to review the videotape myself... My information is that he did not formally present himself to the triage desk. If that's later found to be incorrect, then we'll learn that from the inquest. What is not in dispute, I don't believe, was Mr. Sinclair was not triaged."
Still clinging to the thin reed---the absence of a triage nurse---Brock's resolve lasted only one more day. On Thursday he announced he had finally watched the security tape and he was now acknowledging that Sinclair did, indeed, formally present himself to the triage desk.
"The WRHA released a statement this afternoon saying in light of Balachandra's comments, Wright watched the security tapes for the first time today. Wright now says the video shows that Sinclair wheeled himself into the line at the triage desk where the triage nurse on duty was seeing one person ahead of him." (Winnipeg Free Press, Feb. 5, 2009)
Why hadn't he looked at the video immediately?
He didn't want to be accused of "interfering", according to an internal update sent to WRHA staff Thursday.
Yes, that's right, the spokesman for the Winnipeg Regional Health Authority thought the best way to explain to the public what happened when a man died in a hospital emergency room was to know as little as possible about what happened.
But someone knew. Unnamed "senior HSC staff" to begin with. People connected with the various reviews, certainly. People who kept their mouths shut as Brock Wright misled the public time and time again.
There's a name for people like that.
And Brock Wright likes team players.
In November, after Dr. Larry Reynolds, the head of family medicine at the University of Manitoba medical school, was fired from his job, Dr. Brock Wright went to the extent of revealing confidential employee information to the press to malign Reynolds.
Wright sniffed that multiple performance reviews concluded Dr. Reynolds wasn't a "team player."
"He did have a tendency sometimes to take his concerns directly to the minister, directly to the government, without letting us know in advance that he was doing so. That's not really appropriate for someone in an administrative role -- they're expected to bring their concerns right to us."
We can now see why Dr. Reynolds would have been motivated to take his concerns directly to the health minister and bypass Brock Wright.
Dr. Reynolds would not be part of any WRHA cover-up.
(For more on why Wright opposed Reynolds, see The Black Rod http://blackrod.blogspot.com/2008/12/axe-drops-on-dr-larry-reynolds-real.html)
Wright pushed Reynolds out, and now it's clear that it's Wright who must go.
He deceived Manitoban's for four months.
He had a duty to tell the truth.
All he had to do was watch the security video.
He refused for four months.
His credibility evaporated the second the camera lights were turned on Dr. Balachandra. There's no way back. Show him the Exit door and give him a strong push.
Once again we're faced with the usual questions for Dr. Brian Postl, CEO of the WRHA.
What did he know and when did he know it? Was he too busy opening brown envelopes to get the truth of why a man died in a Winnipeg emergency room? Did anyone try to bring their concerns about the false story being put out, only to be turned away?
On the heels of the unresolved Crackerjack scandal (a prize in every envelope) and his refusal to say how he spent $2 million in the WRHA slush fund, Postl should spend time reviewing his retirement plan.
And what about the rest of the team? We need to know who else in the WRHA saw the hospital video and stayed mum as a false story was peddled to the public. We need to know why the internal reviews overlooked the triage aide at the triage desk taking personal information from Brian Sinclair.
And we need to know, how soon they can be fired?
And what about the one public servant who was supposed to make sure such a schmozzle never happened? We're talking about one of the NDP's strong women, Health Minister Theresa Oswald, who has spent the past day hiding from the press until she figured out what to say about the latest WRHA scandal.
Late Thursday she crept out and spoke.
She would not watch the hospital video, she said. She had more important things to do.
She understood why the WRHA was selective in showing the video to some officials, and not to others. It was only to avoid "predictable" accusations of impropriety (as CJOB put it), because, goodness knows, everyone knows its improper to get the facts.
Oswald is counting on the fact that the press is lazy, the Legislature isn't back in session for months, and there's a good chance she'll be replaced by Bill Blaikie by then and won't have to ever answer questions about Brian Sinclair again.
But she's demonstrating what a failure she is as Health Minister, worse, if it's possible, than Dave "Six Months" Chomiak. Instead of getting as much information as she can about the scandalous death in the ER, she's off cutting ribbons, which seems to be her forte.
Even worse still, instead of holding health officials accountable for misleading the public, she makes excuses for them.
Last September, when the death of Brian Sinclair was first reported, the Opposition asked Oswald when she was first notified. Here's what she said. Note how she said it.
Hon. Theresa Oswald (Minister of Health):
Indeed, that question first came from the Member for Inkster (Mr. Lamoureux) the first day we were in the House when the incident was reported. I reported clearly then that my first awareness that I was made where I was able to know something about the patient that I can now reflect on as being accurate was approximately midday on Monday, Mr. Speaker.
She calls that bafflegab "clearly"?
But the Opposition made its point. The Health Minister didn't learn about Sinclair's death until a day and a half after his body was discovered and well after even reporters (Kelly Dehn, in this case) knew about it.
That's how little officials in her own department think of her.
What do they know that we don't?
Finally, we have to return to the question we raised at the beginning.
Why the deception?
They knew there was going to be an inquest. They knew that the hospital video would be an exhibit. They knew the truth would come out eventually?
The stakes had to be high to play the game so long, and even to bluff on the last hand.
We suspect that the inquest will discover that Sinclair was overlooked at the Health Sciences Centre ER because of one of the WRHA's policy changes.
They needed time to correct the problem without admitting they created the problem. Look for evidence of overworked nurses, a change in nurse schedules and duties, or something along that line.