By Keith Lacey
Robert Smilanich, a cancer patient, was expected to die at any time. But an expert witness testified the cause of his death Jan. 27, 2001, was lack of air after being accidentally cut off from supplied oxygen in his hospital bed.
Dr. Stewart MacLeod, a professor of medicine at McMaster University in Hamilton, testified Thursday that he wrote a medical report based on all the information he received in relation to Smilanich?s death.
Smilanich had been diagnosed with terminal cancer of the larynx, which had spread to his lungs, and was suffering from several other serious illnesses, when he died just after midnight Jan. 27, 2001.
In an unexpected turn of events, coroner Dr. Shelagh McRae adjourned the Smilanich inquest until Monday morning at 9:30. McRae informed those involved in the inquest that new information had been produced that needed to be investigated.
McRae said this investigation could take a couple of days or even a bit longer. Those involved in the inquest will decide Monday morning if and when it should continue.
Smilanich was near death when the Laurentian site was undergoing an ?oxygen shutdown? as part of a hospital construction project.
The inquest heard a valve which brought oxygen to Smilanich and two other patients in a chronic care ward was accidentally turned off and Smilanich died within minutes of his oxygen being cut off.
Smilanich?s overall very poor health, the high dosages of morphine and fentanyl he was taking, his terminal cancer and being cut off from oxygen all contributed to his death, said MacLeod.
?He was clearly in a state of oxygen dependency and add onto all of that background...the interruption of oxygen was the critical event in his death at that moment,? MacLeod testified.
It was ?an absolute certainty, 100 per cent? that Smilanich was going to die within days or hours, but being cut off from supplied oxygen was the reason he died that evening, he said.
Toxicology reports clearly indicate Smilanich was heavily sedated with both morphine and fentanyl, but the readings were not unexpected for an elderly man with terminal cancer and in such terrible health, said MacLeod.
?At first glance the readings are high...but the truth is the readings were entirely appropriate and not unusual? for a man who had been on such strong medication over a long period of time, he testified.
Smilanich?s regular dose of supplied oxygen had increased from 28 per cent when he first arrived in October of 2000 to 70 per cent at the time of his death.
Patients who become increasingly dependent on supplied oxygen and are then suddenly cut off are prime targets to go into respiratory failure and it?s his expert opinion this is what happened to Smilanich, he testified.
The inquest, before a three-man, two-woman jury, is expected to last all week and into early next week.
Dr. Shelagh McRae is the presiding coroner.
