Saturday, March 26, 2011
THE DEATH OF JAN SZAMKO
NOT 'GOOD TO FLY'
THE TRAGIC DEATH OF A ROMA REFUGEE
Published On Fri Mar 25 2011
BY NICHOLAS KEUNG
A 2-page order, signed off by a Canada Border Service Agency supervisor, cited "faking medical condition" and "uncooperative" as reasons for transferring Jan Szamko from an immigration holding centre to the Toronto West Detention Centre. Szamko was found dead in his detention cell two days later.
Everyone saw Jan Szamko as “uncooperative.” No one, it appears, believed — or detected — the Roma refugee’s dire medical needs.
From the guards to doctors and nurses at the immigration holding centre and Toronto West Detention Centre, everyone who testified at an inquest into Szamko’s death this week thought the man’s bizarre behaviour, including defecating on himself and ignoring instructions, was just an attempt to avoid his imminent deportation.
Did he choose, as some suggested, simply to disregard everyone he came into contact with in his final days in Canada, far from his native Czech Republic? Or was he too sick to respond?
On Dec. 8, 2009, Szamko became the first person to die in the GTA while being held for immigration reasons.
No one had believed his complaints about chest pains or heeded his refusal to eat or drink over the last two days of his life. His constant moans and groans in a segregated cell yielded no attention.
What is clear, according to forensic pathologist Kristopher Cunningham, is that Szamko died of heart failure, probably stemming from a viral infection which led to a lethal level of fluid buildup that compressed the heart, lowered his blood pressure and subsequently shut down his bodily functions.
That’s the conclusion drawn by the inquest jury Friday, who recommended a better system of sharing information on medical issues and emergency contacts when transferring inmates between the immigration holding centre and the Toronto West jail.
Referring to an “acute inflammatory condition,” Cunningham said the lack of blood flow killed some of Szamko’s brain cells, probably explaining his bizarre behaviour.
“It can be a tough diagnosis, because the signs and symptoms are vague and non-specific,” Cunningham explained in an interview.
On the day he died, Szamko was found face down, naked on the concrete floor of his jail cell, with feces and urine on his body and smeared on the wall and floor.
This week’s inquest heard from 20 witnesses in an effort to determine how Szamko, a stocky 5-foot-8, 240-pound man ended up dying in government detention.
“It cannot be said that (Szamko’s) medical concern was ignored, because he was seen by many nurses and doctors,” coroner’s counsel Lorraine Cavion told the inquest. “But his death certainly raises medical issues.”
Szamko, a factory worker, joined his wife, Nadezda Peterova, and 9-year-old daughter, Sabina, in Canada in 2008. He filed a refugee claim based on alleged persecution by neo-Nazis in their homeland.
When Szamko heard in 2009 that his mother was dying back in the Czech Republic, he withdrew his asylum claim and made plans to leave voluntarily. But he allegedly changed his mind after learning of her death.
He was twice booked to be deported but missed the appointment due to undisclosed medical emergencies. He was arrested Nov. 28, 2009, on a warrant and detained at the Rexdale immigration holding centre.
Dr. Brian Zidel, a physician at the holding centre, said the health team had difficulty obtaining medical information from Szamko, who was said to have “adequate English” and not require interpreters.
Officials were unable to track down Szamko’s family physician or identify the medication he was prescribed to control his adrenal gland disorder, a chronic hormonal problem requiring medication.
On Dec. 5, Szamko complained about chest pains and was sent to the William Osler Health Centre, where test results suggested nothing was out of the ordinary. An emergency room doctor declared the patient “good to fly” for his scheduled deportation next day.
The autopsy doesn’t clarify how long it took Szamko’s heart to deteriorate, but his health seemed to take a dive from that point.
Overnight, he was found to have defecated all over his body, bed and room. He was taken in a wheelchair to a segregated holding area.
A 45-minute video taken in the holding area shows a frail Szamko slouching in a wheelchair, head tilted to one side, being spoken to by border services officer Steven Bean.
“He has been checked out and he’s fine. . . He was not responding to verbal instructions or conducting himself in normal fashion,” Bean testified, explaining why he deemed Szamko to be uncooperative and faking his medical condition.
Szamko was taken to the Toronto West Detention Centre on Dec. 6
Mark Holley, the detention centre’s operation manager, also said he found Szamko uncooperative.
“He refused to walk. He was not catatonic, but he was not responsive to directives. He was conscious. His eyes were opened. He would turn his head when someone was talking to him,” said Holley. “He chose not to communicate.”
On Dec. 7, 2009, Dr. William Mueller, a physician at Toronto West, visited Szamko but was unable to conduct a physical exam because the patient was “uncooperative.”
“Whether he understood (me) or not, he was not responding. He was completely mute,” Mueller recalled. He ordered a psychiatrist to see Szamko the next day.
Like other inmates in the segregated unit, Szamko was checked every 20 minutes by jail guards, who kept a log on his position changes and behaviour.
“He was covered head to toe in fecal matter. . . I washed his upper torso front and back as best I could but the feces on his legs was caked on and very dry,” guard Kristian Zandwyk-de Hass wrote in a statement.
Yet, he said, Szamko was strong enough to stand on his own while he helped clean the inmate up.
Dr. Graham Glancy, the detention centre’s psychiatrist, said it is not uncommon for inmates in segregation to defecate as a means of protest.
“Corrections officers are pretty good at differentiating between people who are ill and people who are simply difficult,” Glancy testified.
For most of the two days at the jail, guards reported Szamko lying naked on the concrete floor behind the cell door and refusing to eat or drink.
At around 7 p.m. Dec. 8, guard Joyliz Nassanga-Sessanga spotted Szamko face down soon after she started her shift.
“I kept banging the door, but he wasn’t moving,” said the guard, who activated a medical alert.
EMS district supervisor Steve Venerous and two ambulance crews soon arrived. At 7:50 p.m., after attempts to revive him failed, Szamko was pronounced dead.
Posted by Morgan at 2:16 PM