Raphael “Napa” André, an itinerant Innu whose body was discovered in a chemical toilet in Montreal on January 17, 2021, died of hypothermia, the autopsy confirmed.
Mr. André was heavily intoxicated with alcohol at the time of his death, but it was the cold which was fatal to him, explained the Dr Yann Dazé, pathologist at the University of Montreal Hospital Center (CHUM), who testified Tuesday before coroner Stéphanie Gamache, who chairs the public inquiry into the death of Raphael André.
On the evening of January 16, 2021, when the 51-year-old man entered the chemical toilet, the outside temperature was hovering around 0°C. “To fall into hypothermia, you do not need to be exposed to polar cold,” explained the Dr Dazé. “As long as we are below the usual ambient temperature, there is a risk of developing hypothermia. »
The latter is likely to occur more quickly in the context of alcohol intoxication, he nevertheless recognized. And it can also induce unusual behaviors, such as hiding in an enclosed space or undressing despite the cold, he explained.
Raphael André’s blood alcohol level was 353 mg per 100 ml at his death, which corresponds to the consumption of 14 regular beers and 4.5 times the legal limit for driving.
The time of death could not, however, be determined, the Dr Dazé considered that it was risky to move forward on this question. “There are no reliable ways to adequately estimate a time to death,” he said.
The rules of the pandemic
Raphael André was a regular at the La Porte Ouverte center, located in the Milton Parc sector. In the fall of 2020, the resource became a shelter open 24 hours a day in the context of the pandemic. In January, however, to comply with directives from health authorities, the center closed its doors at 9 p.m., recalled John Tessier, shelter coordinator.
Mr. Tessier explained that, on the evening of January 16, Raphael André fell asleep at the shelter and that the team had to wake him up so that he left the premises before closing. He seemed sad. “He didn’t want to leave. He didn’t understand why he had to leave. »
The coordinator said he did not know where Raphael André planned to sleep that evening. He raised the possibility that a taxi had been called to take him to another shelter and that Mr. André had refused to get in. However, he assured that no one left the center without adequate clothing.
Two falls
Earlier in the day of January 16, Raphael André was taken to the CHUM following a fall in a convenience store. Heavily intoxicated, he injured his head when he fell to the ground. In the CHUM waiting room, he had another fall, inflicting a second head injury.
The DD Julie St-Cyr Bourque, emergency doctor at CHUM, spoke to him at 4:40 p.m., but he was too asleep to converse, she indicated during her testimony. Given her head injuries, she requested that a brain magnetic resonance imaging scan be performed. This examination was ultimately canceled due to the patient’s aggressiveness.
Raphael André then requested to benefit from detoxification care, but due to the protocol in place, to obtain an immediate in-house consultation, he would have had to present active withdrawal symptoms, which was not the case, a explained the emergency doctor. A consultation in an outpatient clinic within 7 to 10 days was therefore recommended.
The emergency doctor released Raphael André from the hospital shortly after 6 p.m. “It’s possible that he [était] still under the influence of alcohol, but he[était] not in a state of intoxication altering his state of consciousness or his ability to make decisions. Otherwise, he would not have been discharged,” she said.
Raphael André then went to the Projets Autochtones du Québec (PAQ) shelter, located at the Guy-Favreau complex, but according to Jonathan Lebire, coordinator of PAQ-2, he did not enter because he refused to submit. to a COVID-19 screening test. He described the Innu as someone who did not cause problems in the shelter. “He was not a conflicted person. »
The public inquiry continues on Wednesday.