WINNIPEG - A man who died during a lengthy wait in a hospital emergency room vomited on the floor during his final hours, but a security guard on duty said he assumed Brian Sinclair was intoxicated and "sleeping it off."

Alain Remillard told an inquest that a man in the waiting room at Winnipeg's Health Sciences Centre informed him that Sinclair had either thrown up or soiled himself.

At that point, Sinclair was 24 hours into a 34-hour wait for care.

Remillard said he walked toward Sinclair, saw a clear liquid at the base of his wheelchair and called housekeeping to clean it up. Remillard said he assumed Sinclair had "peed himself" rather than vomited because the liquid was clear.

"I never spoke to him," the guard testified Thursday. "I was assuming at the time that he was sleeping. Since he posed no security threat, I didn't feel it was necessary to wake him up."

In cross-examination by the Sinclair family lawyer, Remillard said he noticed the man was dishevelled, aboriginal and a double amputee.

"At the time, I did assume he was somewhat intoxicated and sleeping it off," he said when pressed.

It's not unusual for people to vomit in the emergency department, so Remillard said he "didn't think it was a medical issue.

"I didn't think it was worth notifying nursing staff. It was more a housekeeping issue."

Medical experts have testified that Sinclair vomiting was a sign his body was going into shock. The inquest has heard that Sinclair vomited several other times before he died of a treatable bladder infection caused by a blocked catheter in September 2008.

Sinclair had been referred to the emergency room by a local clinic because he hadn't urinated in 24 hours. The 45-year-old is seen on security footage being wheeled into the emergency department and speaking to a triage aide. The aide writes something on a piece of paper before Sinclair wheels himself into the waiting room. He doesn't appear to leave the emergency department again. That piece of paper has never been found.

Security guard David Trump, who was also working the night Sinclair was found dead, said Remillard pointed out Sinclair in the aisle of the waiting room when Trump came on duty.

Trump said he was told to "watch his step" because Sinclair had "made a mess on the floor." Sinclair was also described as "an obstruction" in the aisle, but there was "nowhere else to put him," Trump said.

Sinclair was a regular at the hospital, but Trump said he wouldn't have made special note of him.

"I could have walked past him 100 times," he said. "Until they pose a threat ... they are basically not on our radar."

Leslie Spillett, executive director of the Winnipeg aboriginal organization Ka Ni Kanichihk, said it seems people made assumptions about Sinclair based on his race. She suggested people probably wouldn't have assumed he was intoxicated had he been white.

"Racism does not apply in the same way to white people as it does to people of colour — and particularly the stereotype of alcohol and indigenous people. It certainly does not apply in the same way," she said outside court.

"I think the reason why we're here is to look at the extent to which race, class, homelessness and disability played in this particular case."

While the hospital has made a lot of changes to the way people are admitted, it will take longer to change people's attitudes, Spillett said.

Several security guards have testified they raised concerns with triage staff about Sinclair but he was never examined by medical staff.

Security guard Peter Van Den Oever said he was on duty when Sinclair vomited a second time. He said he gave Sinclair a small bowl and then told the same triage aide who had spoken to Sinclair the day before that Sinclair "didn't look good."

"I believe he heard me," Van Den Oever said. "I thought he would follow up."

Van Den Oever said everyone was "dumbfounded" when informed Sinclair had died.

Another security guard has testified he also raised concerns with a triage nurse about the length of time Sinclair appeared to have been waiting. The guard said he was told Sinclair had been treated and released but had returned to the hospital.

Garth Smorang, lawyer for the Manitoba Nurses Union, suggested there are often many people in the emergency department who aren't waiting for treatment. Some people are waiting for test results, homeless people come in to take shelter and family and friends of patients can also be found there, he said.

The inquest has heard that Sinclair was well-known in the emergency room and had come there dozens of times. He lost both his legs to frostbite in 2007 when he was found frozen to the steps of a church in the dead of winter.

The hearing adjourned Thursday and is to resume in October when it is scheduled to hear from medical staff who were working the weekend Sinclair died.

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