Jury Examines Circumstances Surrounding Heather Winterstein’s Death

Following a lengthy inquest, a jury is now discussing how Heather Winterstein died from sepsis after the Indigenous woman sought medical attention at an Ontario hospital over two days, collapsing in the emergency department on Dec. 10, 2021, while waiting to see a doctor.

Dr. David Eden, who led the virtual inquest starting March 30, addressed the jurors on Tuesday morning after hearing from around two dozen witnesses.

A coroner’s jury has the responsibility of answering questions about medical causes of death and determining whether it was due to natural causes, accident, homicide, suicide or remains undetermined. They may also suggest recommendations to prevent similar deaths in the future but cannot assign legal blame or responsibility.

In their closing arguments, attorneys for Winterstein’s family and the Niagara Region Native Centre pushed for a finding of homicide.

Both Niagara Health, which operates the St. Catharines hospital where Winterstein passed away, and Niagara’s paramedic service oppose this claim of homicide.

“This jury has heard no evidence whatsoever to support the notion of any intentional act by any person or any system which caused this death,” stated Niagara Health lawyer Kate Crawford.

Heather, left, is shown with her dad Mark Winterstein. The inquest heard he called 911 to get her help. (Submitted by Jill Lunn)

Daina Search represents Niagara Emergency Medical Services (EMS), which transported Winterstein to the hospital via ambulance on Dec. 9 and 10.

“The evidence before you simply and categorically cannot support a finding of homicide,” Search asserted.

Instead, she urged that jurors “should find that the manner of death was natural.”

Was ‘bias’ involved? A key question

Questions posed to several witnesses included whether Winterstein’s background influenced her treatment within the healthcare system.

Dr. Suzanne Shoush, an expert on biases in healthcare systems, testified that anti-Indigenous racism and bias are ingrained within it; biases tied to housing instability, substance abuse and mental health issues also affect patient care.

“Heather was a patient with several features that put her at risk of bias and stereotypes: she was an Indigenous woman; she had a substance use disorder; she was perceived as homeless; she has a mental health history,” Rachael Gardner, an attorney for the family mentioned earlier during the inquest.

However, Search pointed out that when responding to a 911 call from Winterstein’s father on Dec. 10, the lead paramedic believed she was white rather than Indigenous and dismissed claims that bias related to her substance abuse history played a role.

“The evidence shows the opposite.”

The St. Catharines hospital was renamed Marotta Family Hospital in 2024. It’s shown this month. (Diona Macalinga/CBC)

Search highlighted that upon discovering Winterstein had previously used fentanyl and might be experiencing withdrawal symptoms, they escalated her condition rating and took her directly to hospital instead of an urgent-care center as initially planned.

A triage nurse also testified during the inquest that due to overwhelming busyness amid COVID-19 pandemic conditions she did not reassess Winterstein while waiting in emergency but claimed she didn’t know Winterstein was Indigenous.

Winterstein discharged by bus during first visit

The inquiry revealed that during Winterstein’s initial visit to the hospital; a doctor evaluated her symptoms as being related solely to “social issues.” His notes referenced her history with substance use along with anxiety disorder. She left with a bus ticket along with Tylenol and instructions indicating she should return if things worsened.

Vivian Sim is representing at this inquest said systemic biases within healthcare allowed Winterstein – who was Indigenous dealing with substance use issues alongside anxiety disorders – fall through gaps.
“That systemic issue was one of discrimination,” Sim argued.

The only individuals who noticed Winterstein struggling with pain while waiting seemed unconcerned about her rapidly deteriorating condition were non-hospital staff members present nearby.
“She tried hard trying save herself using all strength until last moments,” Sim remarked.

Eden informed jurors if they conclude no one intended nor anticipated Winterstein’s passing then they shouldn’t classify it as homicide.
The Ontario Office of Chief Coroner indicated it could take one or two days for jurors arrive at findings along recommendations.

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