YK hospital changes rules for psych patients

In the aftermath of Jason Tologanak-Labrie’s tragic death, officials at Stanton Territorial Hospital in Yellowknife have changed their procedures for patients who require consultation with a psychiatrist. (FILE PHOTO)

CAMBRIDGE BAY— Changes at Yellowknife’s Stanton Territorial Hospital mean patients who require a psychiatric consultation can no longer be held in the emergency ward, where they are free to leave, the coroner’s inquest into the death of Julian Tologanak-Labrie learned this week.

Tologanak-Labrie, 20, leaped from an airplane 7,000 metres in the air hours after he left the hospital on April 15, 2009.

Tologanak-Labrie had stayed voluntarily at the hospital for less than a day, in the emergency ward, before getting on a charter to Cambridge Bay.

Now a patient like Tologanak-Labrie, judged in need of a psychiatric evaluation, must be admitted to the psychiatric ward or go home, said David Pontin, an emergency doctor at the Stanton hospital who examined Tologanak-Labrie when he arrived at the hospital at about 2 a.m. on April 15, 2009.

The RCMP brought Tologanak-Labrie to the hospital after responding to a call about a disturbance in a Yellowknife hotel where they found him holding a kitchen knife.

Const. Violet Pokiak said she told Pontin she was sure Tologanak-Labrie wanted to kill himself.

Testifying during the morning of April 13 to the inquest, Pontin said he found Tologanak-Labrie to be friendly but guarded, with poor eye contact.

Pontin said he asked Tologanak-Labrie if he wanted to be uncuffed, to which he responded “absolutely,” and gave him a physical examination on a gurney.

Pontin said he found no evidence of alcohol or drug use.

Pontin said he had “no vibration” that Tologanak-Labrie’s condition was life-threatening, or that his life was in “acute jeopardy.”

But he “didn’t know what to make of him.”

Pontin said Tologanak-Labrie gave “clipped answers” to his questions and there were many questions which Tologanak-Labrie did not appear inclined to answer.

But Tologanak-Labrie said he didn’t feel suicidal.

It was still a situation that called for further observation, Pontin said.

Pontin asked Tologanak-Labrie if he would stay to talk to a psychiatrist in the morning.

Brought to the hospital by the RCMP on a “Form 5,” which allows the police to transfer an individual to medical caregivers, Tologanak-Labrie was not admitted to Stanton on a “Form 1,” which basically calls for an involuntary hospitalization.

Pontin decided not to call the psychiatrist, Dr. Thomas Ripley — who testified later that his contract means he’s only available during his shift — and-or contact Tologanak-Labrie’s family.

“We had time, so we had no reason to call family and friends in the middle of the night,” Pontin told the inquest.

So Tologanak-Labrie remained in the emergency ward, where he slept soundly through the early hours of the morning.

In his verbal hand-off of his patients to the emergency doctor handling next shift, Pontin couldn’t recall what he had said about Tologanak-Labrie.

The assessment from Ripley, who examined Tologanak-Labrie the next day at about 11 am, said the young man had “adjustment disorder complicated by excessive drinking,” leading to blackouts.

Ripley’s notes said Tologanak-Labrie was alert and oriented, co-operative and “grooming hair,” although his mood was “depressed” and his movements slow.

Noting most people usually say they are drinking less than they do, Ripley said Tologanak-Labrie admitted to drinking before he had been brought in.

Ripley said he found no psychotic symptoms, that his “thought processes were normal,” and released Tologanak-Labrie with a scheduled follow-up in Cambridge Bay for April 22.

Stanton social worker Carole Barriault, who handled travel arrangements for Tologanak-Labrie, told the inquest she found him “very quiet.”

However, Barriault said she had “no concerns about his safety,” as she worked with Tologanak-Labrie’s mother and the owner of Adlair Aviation Ltd. to get him on a charter back to Cambridge Bay.

Barriault said she would have followed up any disturbing signs from Tologanak-Labrie before she sent him off in a taxi from the hospital to the airport.