“Peter and I have discussed the fact that he has an incurable malignancy and that survival is likely measured in months.”
Christopher Booth, MD, FRCPC, Medical Oncologist
“…the Board finds your risk would not be manageable in the community without proper supervision…”
Parole Board of Canada, November 20, 2014
Peter Collins had just been diagnosed as being terminal and having a matter of months to live. His Parole application had been denied. His friends and family hoped that his keepers would have mercy and that Peter’s last days would be relatively pain and stress free.
This is a continuation of the post “Healthcare in the CSC“. It is a summary of emails and letters sent mostly to and from Bath Institution, from January 2015 to Peter’s death in August 2015.
Parole Board of Canada
We tried to get the Parole Board to give Peter a hearing for Compassionate Release, but they stalled. We received a last negative decision the day Peter died, saying he was still a threat to the community.
Hospital bed, wheelchair and neck brace
Peter asked for a hospital bed and neck brace but Dr. Dianna Wyatt of Bath Healthcare took the position that there was no medical indication for these things. This was in spite of Peter having already been prescribed them to accommodate a pre-existing condition in his back. The prison finally capitulated in mid to late July 2015 after MP Paul Dewar wrote to Steven Blaney, the minister for Public Safety.
Peter was always in pain. Getting his medication increased was difficult. He was sometimes told he had to “verbalize” his wishes to the nurse. Other times, he was told to put a written request in.
January 21, 2015: Peter told us that his Parole Officer Cheryl Kerr told him she didn’t think he appeared close enough to death to warrant support for compassionate release
February 25, 2015: Robert, Hailin, Owen and I visited Peter. Unfortunately, we were given special rules because Rob “rang off” on the Ion Scanner (morphine on his glasses). So, no hugs, no leaving the table.
April 1, 2015: Peter’s brother Robert Collins to Deputy Warden Kathy Hinch
“I received a disturbing call from my brother today. While your doctor is on holidays, the staff appear to be mismanaging his pain medication.”
April 2, 2015: Kathy Hinch to Robert Collins
“It should be noted that your brother see’s health services daily for medication each morning. They advise that he has not once verbalized that he would like an increase in his medication. Health Services will follow up with the on-call doctor today about this.
Again, if Peter see Health Services daily and if he is having issues he needs to verbalize these when he sees the nurse.”
May 8, 2015: We had the first of three trailer visits. Peter was mostly confined to his wheelchair or his bed. They wouldn’t give him a neck brace so he had made one of his own. It seemed to work OK and he wore it almost all of the time.
May 27, 2015: In an audio clip for radio, Peter said thanks to friends and family for messages. Hello to prisoner-related radio shows on CKUT, CFRC and Start Raven. “I love you all. Good luck and I’ll see you later.”
June 4, 2015: Peter was experiencing more pain in his neck, so he went to the Healthcare department and an X-ray was given. He asked again for a proper neck brace but they wouldn’t give him one until the results came back.
June 4, 2015: Robert Collins to Kathy Hinch
“I was talking to Peter today and I was concerned when he told me that he had asked a number of times for an increase in his pain management, but was denied.”
June 5, 2015: Nurse Krista Fraser called correctional supervisor Mr. Green to report the neck brace Peter had made because it was not approved by Bath Healthcare. His X-rays came back showing a calcium buildup in his neck
June 10, 2015: Nurse Krista Fraser to Robert Collins
“I can’t speak to how long it would take to have a request actioned because there are too many uncontrollable variables. Peter sees a nurse twice a day for his pain meds, I think it would be best if he verbalized the need for an increase at that time that way it could be acted on immediately.
I mentioned earlier that Peter currently has a neck collar. Is he not happy with it? If not, he would need to fill out a 532 (he will know what this is) and submit to health care. Once funds are secured the item could be ordered.
In regards to the hospital bed, I should be receiving a quote today. He will need to submit a 532 for this as well.”
June 13, 2015: Attempts to get a hospital bed.
June 17, 2015: Denise Preston at the Parole Board of Canada to Robert Collins about a parole hearing for Compassionate Release.
“As Regional Director General, it would be inappropriate for me to intervene in any decision making processes taken by Board Members who are appointed as independent, objective and impartial decision makers.”
June 17, 2015: Nurse Krista Fraser to Robert Collins
“Peter requested a rigid neck brace during an appointment with Dr. Wyatt and based on her assessment she felt that it was not medically required. Her physical assessment included an x-ray. I cannot authorize an item that is not medically indicated by the institutional physician. He will have to go to inmate purchasing for this item. This also includes the “medical bed” that Mr. Collins is requesting. This type of bed is not medically indicated at this juncture in time.”
June 19, 2015: Trailer visit. Peter was in more pain. He and his friend Giselle Dias drafted up a letter to send to Paul Quick, Peter’s lawyer
June 23, 2015: Giselle sent a letter to Paul Quick concerning Peter’s healthcare, talking about Dr. Wyatt claiming no medical indication for a medical bed or neck brace, Peter being told to deal with Inmate Purchasing, and pressure for Peter to move to the palliative ward in Millhaven.
“To suggest that Peter will need to purchase a bed and neck brace through Inmate Purchasing is essentially inaction on behalf of health care. Inmate purchasing will be closed until September 7th”
June 24, 2015: A letter from Robert Collins to Paul Dewar.
“As the cancer spreads through his bones, Peter is acutely aware that having a proper neck brace and medical bed would significantly change the ways he is experiencing pain and his eventual death.”
June 24, 2015: Letter from Peter’s lawyer Paul Quick to Warden Ryan Beattie
“Mr. Collins is experiencing significant pain and nausea as a result of his deteriorating condition. I am advised by Mr. Collins that Dr. Dianna Wyatt has taken the position that there is no medical indication for a medical bed or neck brace. (As I expect you are aware, Mr. Collins has previously made a successful complaint to the Canadian Human Rights Tribunal with respect to Dr. Wyatts’s failure to recommend an accommodation that was in fact medically indicated, and that CSC was thereby held to be reckless in its discrimination against Mr. Collins: 2010 CHRT 33, affirmed by the Federal Court of Appeal, 2013 FCA 105.)
June 26, 2015: Email from Cheryl Russell, Parole Board of Canada to Robert Collins
“Although I cannot provide a date when the decision will be made; I have attached a Request for Decision Registry application that you can complete and return to me. Completion of this application will provide you with access to the decision when it is made.”
June 29, 2015: Peter tried to get an oncologist from Kinston General Hospital to visit him, but they said no. He had hoped to talk to a doctor not connected to the prison about treatment and medication options.
June 30, 2015: response from Paul Dewar (cyndy Lee Scott)
“I have spoken to some colleagues at the John Howard Society and, while they were appalled, they were sad to say that they were not surprised. They have found that palliative and end-of-life care for inmates is a systematic failure of the CSC.”
July 2, 2015: An appointment with Community Palliative Care Office in Kingston seems to be dependant on a request from the prison.
July 6, 2015: There was still no request made to Community Palliative Care on Peter’s behalf from the prison.
July 7, 2015: Community Palliative Care doctor will see Peter on 8th or 9th, according to Krista.
July 7, 2015: Peter’s sister Lucy Collins and friend Joan Ruzsa contact the Correctional Investigator, Sheraz Kausar, concerning insufficient pain medication. Nurse Krista Fraser tells Mr. Kausar that Peter needs to make a written request for a change in medication, and not go through “indirect channels”.
July 7, 2015: Peter’s friend Joan Ruzsa phoned the Millhaven Regional hospital. “…when I told her about the difficulty getting the medical bed she was shocked, and told me that the hospital has medical beds which can be transported to people’s cells in circumstances like Pete’s – all it would have taken was a request from (Bath) Healthcare.”
July 9, 2015: letter from Joan Ruzsa to Krista
“Since Peter was diagnosed with terminal cancer in January, the people who love him have been trying to figure out the best way to advocate for him. It has been tricky, because none of the approaches we have tried seem to make any difference. Reasonable and polite requests by his family for pain management and medical accommodations have been called “aggressive”, appeals for compassion have been ignored, the excruciatingly slow pace at which things happen (or often don’t happen at all) is justified as proper procedure”
July 9, 2015: letter from Paul Dewar, MP to Steven Blaney, Minister of Public Safety
“On behalf of my constituent, I urge you to investigate this case to ensure that Peter receives the medical care necessary, not to prolong Peter’s life, but to prevent unnecessary pain and suffering.”
July 13, 2015: Hospital bed is delivered.
July 23, 2015: The wheelchair pad and mattress arrived.
July 29, 2015: The neck brace arrived somewhere between July 23 and July 29.
July 31, 2015: We had our last trailer visit. It was for six days, but only Giselle was able to stay for the whole time. Peter was very weak, almost helpless and in constant pain after his twice daily trips to Healthcare and being made to get in his wheelchair for the count.
From Giselle Dias:
“Our last PFV (Private Family Visit) was 6 days and unfortunately they tried to kick me out at 8am on the 4th day with only 10 minutes notice. I was able to convey to the Keeper that I was allowed to be in the PFV as they had cleared me as part of his ‘family’. I also talked to the Keeper about showing some ‘compassion’ as it was likely the last time that Peter would have time with loved ones. After an hour and a half, the Keeper allowed me to stay for the remaining PFV. Unfortunately, the stress of the situation caused Peter significant pain that day. In fact, it was the most pain that I had ever seen him in. I think it reinforces all our concerns that the amount of stress Peter was under (because of the lack of care) caused him to deteriorate more quickly.
“Adam (Peter’s care taker) said that Peter had felt the best he had seen him in a long time on Thursday after the PFV (August 6th).
“Friday (August 7th) Peter went for a radiation treatment. Friday night he was really hot and brought an extra fan into his room.
“Saturday (August 8th) Peter woke up and could barely talk.
“Monday (August 10th, Prisoners Justice Day) he was in a lot of pain, could barely talk and was quite weak.
“Tuesday at 3:30AM he called another prisoner for help. They couldn’t reach the guards for 30 minutes. At 4am the guards said he would need to wait until Healthcare staff came in. At 7:30AM they put him in an ambulance.
“Wednesday, August 12th at 3PM we received notice that Peter had taken a turn for the worse and the prison was ‘unable’ to make arrangements for our visit that night. They requested that we call in the morning to make visiting arrangements. By the time Rob called in the morning Peter had already passed away.”
August 6, 2015: Letter from the Parole Board
“Having found that your risk remains undue, the Board is denying Full Parole.”
August 11, 2015: Peter was taken from Bath Institution to the Millhaven Palliative Care unit.
August 13, 2015, about 2am: R.I.P. Peter.