Inmate health care improving, warden tells inquest

Health care for inmates struggling with addiction has improved in the three years since a 33-year-old man died of an overdose in his cell at the Vancouver Island Regional Correctional Centre in Saanich, a senior B.C. Corrections warden told a coroner’s inquest on Thursday.

The inquest is probing the circumstances around the death of Bradley Martins Graham on the morning of March 6, 2016, after he was found unresponsive in his cell.

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Warden Elliott Smith said the health-care improvement is largely because the province’s Public Health Services Authority has taken over inmate health care from a private for-profit contractor, Chiron Health Services. The private contractor had been providing inmate health care in 10 correctional centres across B.C., including the one in Saanich, since 2015. Its contract ended in October 2017.

The PHSA offers “better continuity of care” for inmates, Smith said, ensuring patients receive uninterrupted treatment before they’re incarcerated, during their incarceration and once they’re released.

Smith chaired the critical incident review team that was charged with investigating the circumstances around Graham’s death, which a forensic pathologist said was caused by mixed- drug poisoning and a lethal amount of fentanyl.

Smith said despite the prevalence of drugs in jails, fatal overdoses are very rare.

The team made eight recommendations after a three-day investigation that included interviews with 18 people and a review of incident reports and video footage.

Four of the recommendations related to providing adequate health care to inmates struggling with addiction and two of those directly relate to Chiron giving inmates timely access to opioid- replacement therapy.

Graham’s friend and cellmate Chris Wilson testified on Tuesday that Graham had asked repeatedly to be put on Suboxone to deal with his heroin addiction but faced medical roadblocks and delays.

Graham and Wilson took heroin laced with fentanyl and methamphetamine in the days before the 33-year-old Graham was found unresponsive in his cell.

The critical incident review found that Graham twice visited the jail’s doctor in February and the doctor indicates he wanted to wait until after Graham’s court date in March to start Suboxone treatment. “In my opinion, the court date shouldn’t have mattered,” Smith said.

Inmates now have much more timely access to Suboxone, said Smith, a view that was echoed by Dr. Nader Sharifi, medical director for Correctional Health Services. Sharifi said the quicker acccess to opioid replacement therapy for inmates is due to increased staff in the PHSA.

An estimated 60 per cent of inmates have mental-health and addictions issues, Sharifi said.

When the province announced it would be taking over inmate health care from Chiron in 2017, Dean Purdy, the union representative for B.C. Corrections officers, said the change would likely improve care for inmates with drug-addiction and mental-health issues.

There is nothing to indicate Graham’s death had any impact on ending the contract with Chiron.

Testimony from witnesses concluded on Thursday and the seven-person jury will come up with recommendations, which could be released publicly as early as today.

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