1 2 3 IPPERWASH PUBLIC INQUIRY 4 5 6 7 ******************** 8 9 10 BEFORE: THE HONOURABLE JUSTICE SIDNEY LINDEN, 11 COMMISSIONER 12 13 14 15 16 Held at: Forest Community Centre 17 Kimball Hall 18 Forest, Ontario 19 20 21 ******************** 22 23 24 April 27th, 2005 25

2
  1                        Appearances
  2  Derry Millar      )    (np)     Commission Counsel
  3  Susan Vella        )
  4  Donald Worme, Q. C )
  5  Katherine Hensel  )
  6  Jodi-Lynn Waddilove )   (np)
  7  
  8  Murray Klippenstein )  (np)      The Estate of Dudley 
  9  Vilko Zbogar       )   (np)     George and George
 10  Andrew Orkin       )            Family Group
 11  Basil Alexander    ) (np)       Student-at-Law
 12  
 13  Peter Rosenthal  )              Aazhoodena and George
 14  Jackie Esmonde   )              Family Group
 15  Anthony Ross     )              Residents of 
 16  Kevin Scullion   )   (np)       Aazhoodena  (Army Camp)
 17  
 18  William Henderson )   (np)       Kettle Point & Stony
 19  Jonathon George  )              Point First Nation
 20  Colleen Johnson  )   (np)
 21  
 22  Kim Twohig       )   (np)       Government of Ontario
 23  Walter Myrka     )   (np)
 24  Susan Freeborn   )   (np)
 25  Michelle Pong    )

3
  1                   APPEARANCES (cont'd)
  2  Janet Clermont   )              Municipality of 
  3  David Nash       )   (np)       Lambton Shores
  4  
  5  Peter Downard    )   (np)       The Honourable Michael
  6  Bill Hourigan    )   (np)       Harris
  7  Jennifer McAleer )
  8  
  9  Ian Smith        )   (Np)       Robert Runciman
 10  Alice Mrozek     )   (np)
 11  Harvey Stosberg  )   (np)       Charles Harnick
 12  Jacqueline Horvat )   (np)
 13  Douglas Sulman, Q.C. )           Marcel Beaubien
 14  Trevor Hinnegan     ) (np)
 15  
 16  Mark Sandler       ) (np)       Ontario Provincial 
 17  Andrea Tuck-Jackson )            Ontario Provincial Police
 18  Leslie Kaufman     )  (np)
 19  
 20  Ian Roland       )   (np)       Ontario Provincial 
 21  Karen Jones      )              Police Association &
 22  Debra Newell     )              K. Deane
 23  Ian McGilp       )   (np)
 24  Annie Leeks      )   (np)
 25

4
  1                   APPEARANCES (cont'd)
  2  Julian Falconer  )   (np)       Aboriginal Legal 
  3  Brian Eyolfson   )              Services of Toronto
  4  Julian Roy       )   (np)
  5  Clem Nabigon     )   (np)
  6  Adriel Weaver     )   (np)       Student-at-Law
  7  
  8  Al J.C. O'Marra  )              Office of the Chief
  9  Robert Ash, Q.C. )    (np)       Coroner
 10  
 11  William Horton   )   (np)       Chiefs of Ontario
 12  Matthew Horner   )   (np)
 13  Kathleen Lickers )   (Np)
 14  
 15  Mark Frederick   )   (np)       Christopher Hodgson
 16  Craig Mills      )   (np)
 17  Erin Tully        )   (np)
 18  Megan Mackey     )
 19  
 20  David Roebuck    )   (Np)       Debbie Hutton
 21  Anna Perschy     )   (np)
 22  Melissa Panjer   )   (np)
 23  Danya Cohen-Nehemia ) (np)
 24  
 25

1 LIST OF APPEARANCES (cont'd) 2 3 Kelly Graham ) Malcolm Gilpin, Mark Watt, 4 Jill Sampson ) John Tedball, Cesare 5 DiCesare and Robert Kenneth 6 Scott 7 Ian Dantzer ) Dr. Marr and Dr. Saettler 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

1 TABLE OF CONTENTS 2 Page 3 Exhibits 7 4 5 ELIZABETH SAETTLER, Resumed 6 Cross-Examination by Mr. Peter Rosenthal 9 7 Cross-Examination by Mr. Anthony Ross 28 8 Cross-Examination by Ms. Andrea Tuck-Jackson 33 9 Cross-Examination by Ms. Karen Jones 37 10 Cross-Examination by Mr. Al O'Marra 48 11 12 MALCOLM GILPIN, Sworn 13 Examination-In-Chief by Ms. Susan Vella 51 14 Cross-Examination by Mr. Peter Rosenthal 159 15 Cross-Examination by Mr. Anthony Ross 204 16 Cross-Examination by Ms. Andrea Tuck-Jackson 212 17 Cross-Examination by Ms. Karen Jones 239 18 Cross-Examination by Mr. Al O'Marra 249 19 20 ROBERT KENNETH SCOTT, Sworn: 21 Examination-in-Chief by Mr. Donald Worme 266 22 Cross-Examination by Mr. Peter Rosenthal 300 23 Cross-Examination by Mr. Andrew Orkin 305 24 Cross-Examination by Mr. Anthony Ross 309 25 Certificate of Transcript 318

1 EXHIBITS 2 No. Description Page 3 P-370(a) Digital Map (hard copy) of Map No. 2 79 4 P-370(b) Electronic map of Map No. 2 79 5 P-371 Document No. 5000471 Ambulance incident 6 report 85 7 P-372 Document 5000472 85 8 P-373 Document 5000195 CACC staff involved 9 (standby request of September 11/'95 149 10 P-374 Document 2000861 OPP logs October 07/'95 11 07:58 hours to 12:51 hours. 153 12 P-375 Ambulance call report re: Nick Cottrelle 13 September 06/'95 documented by C. 14 DiCesare 159 15 P-376 Document 1002288 anticipated evidence of 16 Malcom Gilpin September 22/'95 interview 17 with investigators bob Muir and Jim 18 Kennedy SIU 164 19 P-377 Picture of Strathroy Middlesex General 20 Hospital showing Emergency entrance 248 21 22 23 24 25

1 --- Upon commencing at 9:01 a.m. 2 3 THE REGISTRAR: This Public Inquiry is 4 now in session. The Honourable Mr. Justice Linden 5 presiding. Please be seated. 6 MR. DONALD WORME: Good morning, 7 Commissioner. 8 COMMISSIONER SIDNEY LINDEN: Good morning 9 everybody. 10 11 ELIZABETH SAETTLER, Resumed 12 13 COMMISSIONER SIDNEY LINDEN: Good 14 morning, Doctor. 15 THE WITNESS: Good morning. 16 COMMISSIONER SIDNEY LINDEN: Mr. 17 Orkin...? 18 MR. ANDREW ORKIN: Quick at the mike this 19 morning, Commissioner. Commissioner, on reflection over 20 night and consultation with our clients -- my client, 21 we're going to be yielding to our other colleagues. 22 We have no questions for this Witness. 23 COMMISSIONER SIDNEY LINDEN: It's not 24 because I called you Mr. Rosenthal, is it? 25 MR. ANDREW ORKIN: Not at all. Not at

1 all. No, that is indeed a compliment to call me Mr. 2 Rosenthal. 3 COMMISSIONER SIDNEY LINDEN: Mr. 4 Rosenthal...? 5 MR. PETER ROSENTHAL: That is indeed a 6 compliment from Mr. Orkin to say that he was complimented 7 by calling Mr. -- being called Mr. Rosenthal. 8 Good morning, Mr. Commissioner. 9 COMMISSIONER SIDNEY LINDEN: Good 10 morning. 11 12 CROSS-EXAMINATION BY MR. PETER ROSENTHAL: 13 Q: Good morning, Doctor. 14 A: Good morning. 15 Q: My name is Mr. Rosenthal, Peter 16 Rosenthal. I am Counsel to Aazhoodena and George Family 17 Group, a -- a group of Stoney Point People, First Nations 18 People. 19 In light of your time constraints I'm 20 going to be much more brief than I otherwise would. You 21 obviously have a lot of information to offer us but with 22 our serious time constraints, unfortunately. 23 Now, with respect to Cecil Bernard George, 24 with respect to the forearm injury you told us yesterday 25 that you looked at those injuries as being likely the

1 result of being struck while attempting to protect his 2 head or -- from blows. 3 And then I believe in -- in one of your 4 earlier interviews you said something to the effect of 5 the injury to the ulna aspect of the right arm is typical 6 of trying to ward off blows; is that correct? 7 A: That is correct. 8 Q: Now, Dr. Marr told us that he was 9 tender diffusely over the distal forearm from halfway 10 down towards the wrist, abrasion marks and tenderness; do 11 -- do you agree with that assessment? 12 A: Yes, but I would add, as I recall, 13 there was visible bruising in addition to abrasions. 14 Q: Yes. Visible bruising and abrasions 15 in -- 16 A: Yes. 17 Q: -- addition, yes. But -- now, with 18 respect to the diffuse -- the use of the word "diffuse," 19 Dr. Marr explained to us that that meant it was in a 20 widespread area. 21 A: Correct. 22 Q: Now, given that, if it was as a 23 result of ward of blows that he received those injuries, 24 would you agree that it suggests that there were a fair 25 number of blows that he warded off with that forearm?

1 A: Yes. Yes, I would agree. 2 Q: Not just one (1) or two (2) but a -- 3 a fairly large number? 4 A: Right. 5 Q: And, it would be hard to estimate the 6 exact number I presume; is that correct? 7 A: Yes. 8 Q: Now, you told us yesterday that while 9 Mr. Cecil Bernard George was in the ambulance he might 10 have a transient drop in blood pressure due to the 11 abdominal injuries or other factors; is that correct? 12 A: Are you asking me if that was the 13 information received or whether that was possible? 14 Q: I -- I believe what you said 15 yesterday was to the effect that: 16 "I was attuned to the idea that he 17 might have had a transient drop in 18 pressure, partly because of those 19 injuries in his abdomen." 20 So, is that -- 21 A: I can't -- 22 Q: -- that -- that could have occurred, 23 not that you were informed of that, but it's your 24 estimate that that could have occurred; is that correct? 25 A: Well, we were informed that he might

1 have had a loss of vital signs during transport. 2 Q: Yes. 3 A: And, because he had been kicked in 4 the upper abdomen, I thought that might be possible as a 5 consequence of injuries to the liver or spleen. 6 Q: Yes, but even if it hadn't resulted 7 in the heart stoppage, could it have resulted in a 8 lowering of blood pressure so that the pulse would be 9 very weak and hard to detect? 10 A: It -- it's possible, but it would be 11 unlikely for the blood pressure to then spontaneously 12 improve. 13 Q: I see. Okay, thank you. 14 Now, regarding Mr. Cottrelle, and I'm 15 moving along very quickly, unfortunately. 16 A: Sure. 17 Q: I understand that -- that he use the 18 word, "vehicle" to you according to one (1) of your 19 earlier statements in describing what he was in at some 20 point; is that correct? 21 Do you recollect that or should I turn you 22 to it? 23 A: I -- I don't have -- I don't have a 24 direct recollection of which word he used -- 25 Q: Yeah. No -- no, we all -- we all

1 recognize that it's ten (10) years ago and -- 2 A: Right. 3 Q: -- it's very difficult to remember -- 4 A: I have used the word, "vehicle," and 5 "car," I think. 6 Q: -- but if you could turn to your -- 7 your Tab 13 in page 8 of that document. 8 A: Hmm hmm, right. 9 Q: And, with your indulgence, Mr. 10 Commissioner, I'm going to get my Tab 13 as well. 11 12 (BRIEF PAUSE) 13 14 A: Perhaps I could say a word while 15 you're getting ready. I appreciate your efforts to 16 ensure that I can be on my plane to Winnipeg today -- 17 Q: Yes. 18 A: -- but I wouldn't wish that to 19 constrain your questions or to -- to limit the amount of 20 information that I can provide for you, so please proceed 21 as you need to. 22 Q: Thank you Doctor. 23 COMMISSIONER SIDNEY LINDEN: Thank you 24 very much. 25

1 CONTINUED BY MR. PETER ROSENTHAL: 2 Q: If we could turn to page 8 of Tab 13? 3 COMMISSIONER SIDNEY LINDEN: It's Tab 13? 4 MR. PETER ROSENTHAL: It's -- sorry? 5 COMMISSIONER SIDNEY LINDEN: What are you 6 looking at, is it the audio -- 7 MR. PETER ROSENTHAL: Tab 13 of Dr. -- 8 statement -- 9 COMMISSIONER SIDNEY LINDEN: Of Dr. -- 10 MR. PETER ROSENTHAL: -- at page 8. 11 COMMISSIONER SIDNEY LINDEN: This is 12 September 29th/'95; is that the document? 13 THE WITNESS: That's correct. 14 MR. PETER ROSENTHAL: I'm sorry? 15 COMMISSIONER SIDNEY LINDEN: I'm just 16 wondering what document you're looking at. 17 MR. PETER ROSENTHAL: It's an interview 18 of... 19 THE WITNESS: The OPP interview of the 20 29th. 21 COMMISSIONER SIDNEY LINDEN: Yes, I just 22 want to make sure we're on the same one. 23 MR. PETER ROSENTHAL: Dr. Saettler 24 conducted on the 29th of September 1995. 25 COMMISSIONER SIDNEY LINDEN: That's fine.

1 On page 8 of that interview. 2 3 CONTINUED BY MR. PETER ROSENTHAL: 4 Q: On page 8 of that document. Just to 5 refresh your memory, Doctor, if you could look 6 approximately a quarter of the way up from the bottom, 7 you're talking about Nick Cottrelle and he talked about 8 Mr. George and then -- then you say: 9 "With relationship to his own injuries 10 he was less certain as to what 11 happened. He told me that he was 12 inside a vehicle and he heard shots 13 fired." 14 Does that refresh your memory? 15 A: Yes. 16 Q: So, this is what you reported 17 relatively soon after the event -- 18 A: Right. 19 Q: -- as opposed to ten (10) years after 20 the event; is that correct? 21 A: That's correct. 22 Q: So, we -- we can take it it that that 23 was likely accurate that he used the word, "vehicle." 24 A: Well, in another of my statements I 25 appear to have used the word, "car" and...

1 Q: I see, or -- okay. 2 A: So, I'm -- I'm not sure, really. 3 Q: So, he might have used either word. 4 A: I can't tell you. 5 Q: Well, I suggested Dr. Marr yesterday 6 indicated she wrote down, "car" also. 7 A: Hmm hmm. 8 Q: I suggested to her the possibility 9 that if he had said, "vehicle," -- 10 A: She might have... 11 Q: -- she might have assumed, "car" and 12 written, "car." 13 A: Correct. 14 Q: Is that fair? 15 A: Yes. 16 Q: And, here you did report the word, 17 "vehicle." We now know that he was in a bus, in fact, 18 so... 19 A: Right. 20 Q: Thank you. Now, it's generally, as 21 we've heard, I believe, from you and from Dr. Marr, very 22 useful for Emergency Room personnel to know about the 23 cause of an injury as they begin to treat that injury, 24 right? 25 A: Right.

1 Q: And, also it would be very useful to 2 know the history of the patient, both enroute to 3 hospital, whether he was unconscious, not unconscious and 4 so on, right? 5 A: Correct. 6 Q: And also the history of the patient 7 in other respects; is she or he allergic to penicillin? 8 All sorts of questions like that might arise; is that 9 fair? 10 A: That's true. 11 Q: Now we've had some evidence in these 12 proceedings that with respect to all three (3) of the 13 patients that you dealt with on that evening in the 14 emergency room, there was some interference in the 15 possibility of information getting to the emergency room. 16 And, in particular, with respect to the 17 people who brought Dudley George into the emergency room, 18 his brother Pierre and his sister Carolyn, we've had 19 evidence that they were arrested upon arriving in the 20 parking lot outside the hospital, charged with attempted 21 murder, released the next day because there was no basis 22 for those charges, but that they were apprehended by the 23 police before Dudley George was brought into hospital. 24 Now, given that, would you agree that it 25 would be useful for future, and as you know, the

1 Commissioner is concerned not only about what happened in 2 the past but about making recommendations for the future, 3 that police officers be informed that it's important that 4 information about a patient get to the emergency room 5 personnel when a person is being brought to that 6 emergency room, and they should take steps to ensure that 7 information is given to those people. 8 A: It has been my experience in dealing 9 with the police and in the Emerg. with trauma patients 10 that they are aware of that in general, and usually do 11 present information as best they can to help us in our 12 efforts. 13 Certainly, if they are unaware of that, 14 that would be helpful to make them aware, but my 15 experience has been that it is usual for the police to 16 come into the emergency room to provide whatever 17 information they have about the victim of whatever trauma 18 has occurred. 19 Q: Yes, but in this case and in all 20 three (3) cases there is evidence suggesting that they 21 interfered with the flow of information rather than 22 assisted the flow. 23 COMMISSIONER SIDNEY LINDEN: Yes, Ms. 24 Jackson...? 25 OBJ MS. ANDREA TUCK-JACKSON: Good morning,

1 Mr. Commissioner. I anticipate you know what my 2 objection's going to be. 3 In my respectful submission, that's not 4 what the evidence has been to date. Indeed, yesterday it 5 was quite clear from Dr. Marr that it was quite the 6 contrary. 7 COMMISSIONER SIDNEY LINDEN: I don't 8 think there's any evidence of interference. Is that what 9 you're saying, Ms. Jackson? There's no -- 10 MR. PETER ROSENTHAL: Mr. Commissioner, I 11 tried to abbreviate what I did at the beginning of 12 yesterday, but perhaps I'll go over the evidence if 13 necessary, and I'm happy to do so -- 14 COMMISSIONER SIDNEY LINDEN: Well -- 15 MR. PETER ROSENTHAL: -- with respect to 16 each of the three (3). 17 COMMISSIONER SIDNEY LINDEN: You can 18 abbreviate it as long as it's accurate -- 19 MR. PETER ROSENTHAL: Yeah. Well, okay, 20 with respect to Mr. Cotrelle, we have evidence that his 21 mother attempted to accompany him to the hospital. His 22 mother, presumably, would be someone who would know 23 something about his history, and she was prevented from 24 so doing and she was not given any assistance by officers 25 on the scene to attend to the hospital in any way.

1 COMMISSIONER SIDNEY LINDEN: Well, it 2 looks like we're going to have a bit of a discussion 3 here. 4 MS. ANDREA TUCK-JACKSON: My 5 understanding, Mr. Commissioner, is that it was the 6 ambulance attendant who didn't want for -- for medical 7 reasons to have Gina George in the back of the ambulance. 8 It had nothing to do with the police and, indeed, the 9 ambulance attendants from whom we've heard, confirmed 10 that the police did nothing to impede their ability to 11 treat any of the patients. 12 MR. PETER ROSENTHAL: With respect, Mr. 13 Commissioner, we had evidence that both officers and 14 ambulance took that position, and it certainly would have 15 been possible for officers to send Gina George there in a 16 different car, if it was a question of evidence. 17 But perhaps we don't need to go into -- 18 argue about the details now in front of this Witness. 19 I just -- I just wanted to suggest that if 20 -- perhaps I could rephrase it more hypothetically. 21 22 CONTINUED BY MR. PETER ROSENTHAL: 23 Q: If -- if the Commissioner -- it will 24 be, as you can tell, we're going to be arguing about what 25 the details of the evidence mean in this case, and we'll

1 be doing that six (6) or eight (8) or ten (10) months 2 from now when we're making final submissions and you 3 won't need to be concerned with that. 4 You won't need to be concerned with that, 5 but if there is evidence suggesting that the police did 6 not take steps to ensure the information be appropriately 7 forwarded to emergency personnel, would you agree that it 8 might be useful to make a recommendation that in future 9 they do so? 10 A: If that is shown, then I would agree. 11 Q: Thank you. Now, you told us 12 yesterday that you heard, you don't recall now how and 13 what the basis of the rumours were, but that there were 14 so many police in the hospital because they were 15 concerned about some disruption by First Nations people. 16 Is that -- 17 A: Right. 18 Q: -- correct? 19 A: That is. 20 Q: But, we had evidence from Dr. Marr 21 that she specifically was told the words to that effect 22 by a police officer, so that might have been one of the 23 sources of that information, and perhaps we can 24 conjecture that officers might have told other people 25 about --

1 A: Yeah. Information like that would 2 spread pretty quickly through our little hospital. 3 Q: Yes. You yourself were not told that 4 directly by a police officer? 5 A: No. 6 Q: But, you heard it from several other 7 people; is that correct? 8 A: I think so, yes. 9 Q: Now, am I correct in inferring that 10 that led to a rather tense atmosphere in the hospital, 11 that notion that you might be attacked? 12 A: Yes. 13 Q: And that kind of tension does not 14 assist people in providing medical care; is that fair to 15 say? 16 A: No. In fact, as -- as I recall, 17 later in the day the CEO of the hospital requested that 18 police presence be reduced or eliminated because, in 19 fact, he felt it was interfering with the functioning of 20 the hospital. 21 Q: I see. And what -- what happened as 22 a result of that request? 23 A: The -- the police disappeared. 24 Q: I see. 25 A: But I can't -- I can't testify to

1 that directly because I was in the operating room and 2 then gone to the airport, so -- 3 Q: I see, yes. So there was a request 4 that the police presence be lessened at least, and there 5 was some response to that -- 6 A: Yes. 7 Q: -- is your understanding? 8 A: As I understand it, yes. 9 Q: Now, with respect to -- to that 10 aspect, is there any recommendation that you would 11 suggest, that the Commissioner might make? 12 A: You're pressing me for 13 recommendations and I'm -- I'm a little uncomfortable 14 with that. I felt at the time that -- I felt at the time 15 that that degree of police presence was excessive and, as 16 I've said, somewhat intimidating. And I -- I have not 17 encountered that sort of -- that sort of police presence 18 in the hospital on any other occasion. 19 When there's a prisoner or someone charged 20 with a crime who's -- who's brought in with trauma or any 21 other illness, you know, they may be shackled, there may 22 be an officer at their door, but there isn't -- there 23 aren't people walking around in body armour and -- 24 Q: Right. 25 A: -- patrolling the halls sort of

1 thing. It was a very strange situation. 2 Q: Thank you. Well, perhaps we can deal 3 with formulating a recommendation ourselves without your 4 assistance, but thank you for your efforts. 5 Now, you told us at the end of yesterday 6 that -- to the effect that if police are aware of the 7 possibility of serious injury, you would want some prior 8 warning both for hospitals and also with respect to 9 paramedics being available, and you in particular 10 referred to the possibility of paramedics being available 11 who have the capacity to intro -- introduce intravenous 12 lines and intubate patients as required. 13 A: Right. 14 Q: Now, so would you agree that it would 15 be a useful recommendation that such paramedics, such 16 advanced -- advancedly trained paramedics with 17 appropriate equipment be available in this area at least 18 on an emergency basis of that type? 19 A: I think if they're was anticipation 20 of gunshot injuries, that the only prospect of -- of 21 providing resuscitation to those types of patients with 22 those injuries is to have paramedics available who can 23 start intravenous and intubate, provide fluid 24 resuscitation almost at the scene or soon after. 25 Q: Yes. And if such paramedics had been

1 available then, in the case of somebody like, Dudley 2 George, for example, presumably they -- they would have 3 done the stabilization right at the scene to the best of 4 their ability -- 5 A: Right. 6 Q: -- and then go on to a trauma centre, 7 such as at London Hospital, to -- where there was the 8 only real prospect of repairing his wounds; is that fair? 9 A: That is my opinion, yeah. 10 Q: Thank you. And then, related to 11 that, I gather that you would recommend that if police 12 are aware of the potential for -- of an incident like 13 this, that they should also inform the local hospital 14 that they might be receiving such patients, to -- to be 15 ready and -- well, let me stop there. 16 In particular, in this case, it would have 17 been useful if Strathroy Hospital had been notified a 18 couple hours earlier that there was this potential; is 19 that fair? 20 21 (BRIEF PAUSE) 22 23 A: I'm not sure I can -- I can agree to 24 that unequivocally. I -- 25 Q: Okay.

1 A: -- am not sure what sort of 2 differences in the setup at Strathroy would have -- would 3 have been helpful in that case. I guess one could have 4 asked a surgeon to be there on standby. 5 Q: Yes. A vascular surgeon might have 6 then been on standby? 7 A: There is no vascular surgeon attached 8 to -- 9 Q: There isn't one in any event. 10 A: -- to Strathroy Hospital. 11 Q: But, I think, you've told us that it 12 was fortuitous that you happened to be in the hospital 13 doing paper work? 14 A: Yes, entirely. 15 Q: So, at least there could have been -- 16 it would not have been fortuitous that there be a second 17 or third doctor present if -- if the hospital had been 18 informed that there might well be some serious -- several 19 serious casualties coming in? 20 A: Right. 21 Q: Isn't that fair? 22 A: Yes, I -- I think that is done, at 23 least in other -- other situations where a mass, sort of, 24 trauma is anticipated. 25 For instance, I have a friend who works in

1 Bridgewater, Nova Scotia and when the Swiss Air flight 2 went down they were warned that there might be multiple 3 serious casualties coming to them and they were able to 4 prepare to some extent. 5 Q: Yes, so -- so -- 6 A: So, I think that would be appropriate 7 if -- if they had an expectation of multiple injuries or 8 serious injuries. 9 Q: Yes. So -- so, you're reluctance to 10 -- to answer affirmatively at the beginning of my 11 question in this area, I gather, was due to the fact that 12 the capacity of Strathroy Hospital, even upon warning 13 would be rather limited; is that -- is that fair? 14 A: Yeah, I wouldn't like to leave the 15 impression that -- that Dr. Marr or anyone else 16 associated with Strathroy Hospital had failed to make 17 appropriate -- 18 Q: Oh. 19 A: -- preparations for this sort of 20 trauma because that -- 21 Q: No, certainly. 22 A: -- that isn't my feeling. 23 Q: Certainly, I didn't intend any such 24 implication from the question. But -- but it would have 25 been easier, presumably, on Dr. Marr and you, also, if

1 you had had a couple of hours to anticipate this 2 possibility; is that fair? 3 A: Yes. 4 Q: Thank you very much, Doctor. Given 5 time constraints those -- those are all my questions. 6 COMMISSIONER SIDNEY LINDEN: Thank you, 7 Mr. Rosenthal. 8 THE WITNESS: Thank you. 9 COMMISSIONER SIDNEY LINDEN: Mr. Ross...? 10 11 (BRIEF PAUSE) 12 13 CROSS-EXAMINATION BY MR. ANTHONY ROSS: 14 Q: Thank you, Commissioner. 15 Good morning, Dr. Saettler. 16 A: Good morning. 17 Q: My name is Anthony Ross and I 18 represent the occupiers of Aazhoodena, which was once 19 called the Army Camp. 20 And, my questions are very few and relate 21 only to police conduct in the hospital. 22 A: Okay. 23 Q: I take it, Dr. Saettler, that you 24 were not involved in the intake of Nicholus Cottrelle? 25 A: No, the patients were all in the

1 trauma room when I arrived. 2 Q: Thank you. And, I take it that you 3 were not advised that Nicholus Cottrelle was under 4 arrest, were you? 5 A: No. 6 Q: And if, in fact, there is evidence 7 that Constable Boon accompanied Nicholus Cottrelle to the 8 Strathroy Hospital and if, in fact, Constable Boon did 9 accompany Nicholus Cottrelle to the hospital and Nicholus 10 did not have a parent present, I take it that you would 11 expect Constable Boon to really step up and give some 12 indication of why Nicholus Cottrelle is there? 13 A: That seems a reasonable expectation, 14 yes. 15 Q: And, it's not inconsistent with past 16 police practises with respect to people that they 17 accompany to the hospital? 18 A: That's true. 19 Q: Yes. And, the police that were in 20 the hospital, is it fair to say that there were quite a 21 number of police at the hospital? 22 A: I actually don't have recollection of 23 police in the hospital on the night -- during the night 24 of the resuscitation and the assessment of injuries in 25 Emerg.; either they weren't in the Emerg. per se, or I

1 was just focussed on other aspects of what was happening. 2 It was the following day that I really felt there was a - 3 - a lot of police presence. 4 Q: And, I take it that the police in the 5 hospital, apart from their body armour, they also had 6 their own sidearms? 7 A: I -- I didn't -- I don't have direct 8 recall; I expect they did. 9 Q: Okay, that's fine. And, I take it 10 that you were not involved in the discharge of Nicholus 11 Cottrelle or, indeed, any of the -- neither -- Cecil 12 Bernard George? 13 A: No, neither one. 14 Q: Now, in the Will-Say, there's a 15 statement here which is a broad general statement I'll 16 read to you, with respect to yourself: 17 "She felt that the prominent police 18 presence in the hospital was 19 intimidating to staff --" 20 MR. DONALD WORME: Just a minute Mr. 21 Commissioner? 22 COMMISSIONER SIDNEY LINDEN: Yes? 23 MR. DONALD WORME: I'm -- I'm just -- 24 COMMISSIONER SIDNEY LINDEN: I don't know 25 what --

1 MR. DONALD WORME: -- a little bit 2 troubled by -- by my Friend's reference to the Will-Say. 3 I think that we have specific -- 4 COMMISSIONER SIDNEY LINDEN: Yes. 5 MR. DONALD WORME: -- understandings with 6 respect to these documents and my preference would be if 7 -- if Mr. Ross would avoid that it would certainly avoid, 8 I think, other difficulties. 9 COMMISSIONER SIDNEY LINDEN: Can you put 10 the question without referring -- 11 MR. ANTHONY ROSS: No -- no problem. 12 COMMISSIONER SIDNEY LINDEN: -- to the 13 Will Say. 14 MR. ANTHONY ROSS: No problem. 15 16 CONTINUED BY MR. ANTHONY ROSS: 17 Q: Is it fair to say, Dr. Saettler, that 18 you found the police presence in the hospital 19 intimidating to staff? 20 A: Yes, it is fair. 21 Q: And it created a situation that the 22 hospital was in danger and pretty much under siege? 23 A: That, I don't know, I didn't take 24 that terribly seriously. I -- I thought that was -- I 25 thought that was overreaction and sort of fear-mongering

1 on the part of the police to justify their presence 2 there. But the simple presence of people in -- who are 3 armed and in that sort of gear I found, as I said before, 4 distracting and somewhat intimidating. 5 Q: Thank you. And finally, Dr. 6 Saettler, there is also evidence that when Mr. Cottrelle 7 was in his room upstairs, that police officers attended 8 to swab his -- his hands for the purpose of trying to 9 find gunshot residue. 10 Did any police ask permission of you to 11 deal with your patient? 12 A: No. I believe at the time both those 13 -- or at least Nick Cottrelle was officially under the 14 care of Dr. Marr, although I was listed as the consultant 15 surgeon. They did not ask permission of me. 16 Q: Very good. Thank you kindly. Those 17 are my questions, Mr. Commissioner. 18 COMMISSIONER SIDNEY LINDEN: Thank you. 19 One second. 20 21 (BRIEF PAUSE) 22 23 COMMISSIONER SIDNEY LINDEN: I think Ms. 24 Andrea Tuck-Jackson...? 25

1 (BRIEF PAUSE) 2 3 CROSS-EXAMINATION BY MS. ANDREA TUCK-JACKSON: 4 Q: Good morning, Dr. Saettler. 5 A: Good morning. 6 Q: My name is Andrea Tuck-Jackson. I'm 7 going to ask you some questions on behalf of the OPP. 8 As I understand your evidence, in 9 retrospect, having regard to the various medical outcomes 10 that followed that evening, you are satisfied that the 11 hospital was sufficiently prepared to deal with the 12 patients that arrived, from a medical perspective? 13 A: Well, with regard to Cecil George, I 14 think that in the light of what happened ultimately, we 15 had adequate resources to manage his care and to assess 16 him. 17 It would have -- if he -- if he had not 18 improved in that way, we certainly were ill-equipped to 19 assess his injuries further, that is we don't have access 20 to CT scan of the brain. Or if his abdominal injuries 21 had been more serious, we -- we would have -- well, we -- 22 we could have adequately managed those, but the 23 neurologic injury, I felt -- I felt relieved that he had 24 improved sufficiently and -- and didn't require a CT. 25 Q: So, the plan, I gather, is that if he

1 had not improved, is that you would have ensured that he 2 was stable and then he would have been transferred -- 3 A: To London. 4 Q: -- to a different hospital? 5 A: That's correct. 6 Q: All right. I want to focus on the 7 issue of preparedness because I gather key is from the 8 perspective of doctors, medical and nursing staff at a 9 hospital. The issue is they need notice; it doesn't 10 matter from who, they just need notice as to what types 11 of injuries could be enroute. 12 A: I feel a little uncomfortable 13 addressing these issues, and I will if you -- if you 14 think it's appropriate, but I'm not the person who 15 usually is the Emerg. I don't usually triage patients in 16 Emerg. or make assessments as to how prepared we are for 17 incoming -- incoming injuries. 18 I'm called -- the surgeon is called 19 generally by the Emerg. physician or alerted once those 20 decisions have been made and that information has been 21 gathered. So, I do feel a little uncomfortable saying 22 how much information is needed and how it should be 23 provided. 24 Q: Thank you. You've actually 25 anticipated some of my questions, which is -- is

1 obviously intending no disrespect, but your area of 2 expertise, based on experience and training, is not on 3 the issue of emergency preparedness, it's surgery? 4 A: Yes, and the surgical response to 5 trauma. 6 Q: Of course. 7 A: Yes. 8 Q: I understand. 9 A: That is correct. 10 Q: But, it's not specifically on the 11 issue of co-ordinating -- 12 A: That's true. 13 Q: -- emergency services? 14 A: Correct. 15 Q: All right. Thank you. You indicated 16 some concern about the presence of police on, in 17 particular, September the 7th -- 18 A: That's correct. 19 Q: -- during the day? And from what I 20 understand from what you've told us, you didn't have any 21 direct contact with any of the officers on the ground 22 about their concerns? 23 A: On the ground, meaning? 24 Q: At the hospital. 25 A: I see. No.

1 Q: And I trust also you wouldn't have 2 had any contact with any of the more senior officers who 3 perhaps weren't on the ground -- 4 A: That's certainly true. 5 Q: -- but who may have been providing 6 information to the officers on the ground? 7 A: That's correct. 8 Q: So, you weren't aware of whatever 9 information that they had that may reasonably have been 10 concerned -- of concern to them? 11 A: Other than hearing that rumour that 12 they were concerned about the hospital coming under 13 attack from -- by the First Nations people. 14 Q: I understand that, and quite frankly, 15 no one's interested in rumour, it's not a particularly 16 helpful -- 17 A: I understand -- 18 Q: -- thing. 19 A: -- that. That's correct. 20 Q: My point is that you didn't have any 21 hard information -- 22 A: No. 23 Q: -- from the police -- 24 A: That's -- 25 Q: -- as to what was informing their

1 decision to have a presence at the hospital? 2 A: No, and I certainly look forward to 3 hearing in future what informed their decisions 4 throughout this episode. 5 Q: No doubt. And I anticipate you're 6 going to hear an awful lot about that. 7 You'd also indicated that you'd never 8 experienced the presence of the officers in this fashion 9 before? 10 A: Hmm hmm. 11 Q: Would it be fair to say that 12 similarly, you've never experienced a situation where you 13 had at least one (1) gunshot injury arising from a 14 confrontation between police and First Nations occupiers? 15 A: That's true. 16 Q: Thank you very much. Those are my 17 questions, Doctor. 18 COMMISSIONER SIDNEY LINDEN: Thank you. 19 Ms. Jones...? 20 21 (BRIEF PAUSE) 22 23 CROSS-EXAMINATION BY MS. KAREN JONES: 24 Q: Good morning, Doctor. 25 A: Good morning.

1 Q: My name's Karen Jones and I'm one of 2 the lawyers for the Ontario Provincial Police 3 Association. 4 Doctor, I just wanted to follow up on some 5 comments that you had made in your evidence yesterday 6 about getting information and how that might affect how 7 you'd treat someone. 8 And you were talking specifically about in 9 relation to Mr. George that if you had information about 10 loss of consciousness or vital signs, that kind of thing, 11 that that would help direct the length of your 12 resuscitative efforts if, indeed, you made them. 13 But, you qualified that by saying if you 14 got that information from a reliable historian, and I 15 wondered if you could explain what you mean by a, 16 "reliable historian"? 17 A: Well, I -- I understand that there 18 has been -- that statements have been made indicating 19 that Mr. -- that Mr. Dudley George, I assume you're 20 referring to him -- 21 Q: Yes, I am, yes I am. 22 A: -- may have been conscious to some 23 extent, even on arrival at the emergency department and 24 in the context of his -- the observed physical findings, 25 I would -- I would have trouble accepting that as

1 reliable evidence -- 2 Q: Sure. 3 A: -- a reliable history. But, I guess 4 there are different levels of usefulness of people's 5 observations. If you have a trained paramedic, you're 6 going to get a lot of useful information about vital 7 signs and so on -- 8 Q: Because it would be information that 9 you would feel would be -- 10 A: Was helpful. 11 Q: -- taken by someone who was trained 12 in what they were doing and who was able, for example, to 13 take -- 14 A: Possibly, but I -- 15 Q: -- measurements -- 16 A: -- think that family members could 17 provide, like, the people who transported Dudley George 18 could likely have told us the time of his -- roughly the 19 time of his gunshot injury -- 20 Q: Hmm hmm. 21 A: -- the fact that there had been no 22 other injuries prior to, or in association with that, 23 just a single gunshot as far as they knew. 24 Q: Hmm hmm. 25 A: And they might have been able to tell

1 us for how long during the trip he seemed to able to 2 respond to them. 3 Q: Sure. 4 A: That sort of information would have 5 been helpful, I think. 6 Q: Sure. But, I take from you evidence 7 yesterday that when Mr. George was in the hospital you 8 and Dr. Marr assessed him carefully and you, based on 9 what you could observe, you took all the steps that you 10 thought were necessary and appropriate? 11 A: Yes. 12 Q: Yeah. I also wanted to ask you a 13 little bit, you had made some comments with respect to 14 Mr. Cecil Bernard George that one (1) of the things you 15 had specifically asked him was about the drinking of 16 alcohol. 17 And I take it that's because, especially 18 in a situation where you were concerned about someone's 19 level of consciousness you'd want to know whether or not 20 they had any drugs or alcohol on board that could affect 21 their level of consciousness? 22 A: That's exactly right. 23 Q: And, I also take it that if another 24 medical professional or first aid attendant or healthcare 25 personnel had previously assessed Mr. Cecil Bernard

1 George and made some kind of findings or lack of findings 2 in that regard, you would like that information passed on 3 to you as well? 4 A: Yes? 5 Q: And, that would be something that you 6 would expect would happen? 7 A: Correct. 8 Q: And, the reason I'm asking you that 9 question, Doctor, is because we, earlier, heard some 10 evidence where there was some criticism of one (1) of the 11 persons who had attended to Mr. Cecil Bernard George for 12 telling the ambulance attendant that he hadn't smelled 13 any alcohol on Mr. Cecil Bernard George's breath and that 14 was criticized as being something that was inappropriate. 15 And, I take it that that's not your view? 16 A: No, I think -- I think that is 17 necessary information, sure. 18 Q: And, it ought to be passed on? 19 A: Yeah. 20 Q: It's the right thing to do? 21 A: Yeah, I agree. 22 Q: Sure. You had also mentioned, I 23 think, that during the course -- and I'm sorry to hop 24 back and forth here -- 25 A: That's okay.

1 Q: -- I know that that's difficult. You 2 were talking about, during Mr. Dudley George's 3 resuscitative efforts, that his shirt had been cut away 4 so that you and Dr. Marr could look at Mr. George's back? 5 A: I think it was -- well, now I'm not 6 so sure whether it was cut up the back or whether it had 7 been just cut open along the front -- 8 Q: The -- the -- the actual question, 9 though was, he had his shirt on? 10 A: I think I -- yeah. He had his shirt 11 on. I guess I don't directly recall that. 12 Q: Okay. 13 A: I think I -- I think I know that from 14 nurses' notes or other notes that I have that -- that it 15 had been cut. 16 Q: Okay. And, you had talked a little 17 bit about the stitches and, again, I'm sorry to hop from 18 person to person, with Mr. Cecil Bernard George -- 19 A: Hmm hmm. 20 Q: -- you talked about suturing his 21 upper lip. 22 A: Hmm hmm. 23 Q: And, I understand from looking at Mr. 24 Cecil Bernard George's record that there were three (3) 25 stitches that were inserted; is that consistent with what

1 you recall? 2 A: That would be surprisingly few, 3 because I would have had to repair both the orbicularis 4 muscle as well as the mucosal surface and the -- 5 Q: Okay, if you -- if you wanted to 6 check -- 7 A: yeah. 8 Q: -- and, maybe you do and maybe you 9 don't, I had looked for your notes about what you did and 10 I didn't see that you documented that. 11 A: No. 12 Q: But, when I looked in the nurses' 13 notes and I'm looking specifically at Inquiry Document 14 Number 100047, and you may have Mr. Cecil Bernard's chart 15 included in your documents? 16 A: I have parts of it, would it be in a 17 -- a tab we could refer to? 18 Q: Well, I'm just going to see what I 19 can do for you here. 20 A: You're -- you're correct in that I 21 don't think I saw any notes made by me. 22 Q: Right. I think it's in your Tab 3, 23 if I'm not -- or, at least -- 24 A: Okay. 25 Q: -- it looks from my notes that

1 there's at least a portion of his record there, because 2 it says, "medical file." Maybe you could check. 3 A: All I have is the History and 4 Physical of Dr. Marr under Tab 3. 5 Q: Can you -- can you put that up on the 6 screen there? It's 0000328. 7 A: Three (3) -- sorry? 8 Q: These documents that -- there are 9 other documents. I take it, that you don't have Mr. 10 Cecil Bernard George's chart and -- but the Commission 11 does, and so I'm just asking them to put up on the 12 screen, so that if you wanted to look at the notes and 13 see if that refreshed your memory, that you could do 14 that. 15 If you look -- if we go down to the page - 16 - to the entry that's timed at about 1:15 you'll see 17 there, there's a reference -- 18 A: I see that, three (3) stitches into 19 upper lip. 20 Q: Yeah. 21 A: Hmm hmm. My recollection is that it 22 was a full thickness disruption of the lip and I -- I can 23 hardly imagine that it would be adequately repaired with 24 three (3) stitches, but I haven't seen it since. 25 Q: Sure, and you've got no reason to

1 question what's documented contemporaneously at the time? 2 A: Well -- 3 Q: And, in fact, Mr. Cecil Bernard 4 George had told us he had three (3) stitches as well. 5 A: It -- only that the deeper stitches 6 would be not evident to the patient and it maybe that the 7 nurse didn't observe the placement of the deeper, 8 muscular sutures. 9 Q: Sure, but you don't -- 10 A: It does seem surprisingly few. 11 Q: Okay. And you talked a little about, 12 and again I'm sorry to hop around here, about the 13 location of the bullet wound with Mr. Dudley George and 14 you described it as being super clavicular in the little 15 dip in -- the little -- 16 A: Correct. 17 Q: -- dip in the neck. 18 A: Hmm hmm. 19 Q: I take it that, then, the wound was 20 at the top of the shoulder, if that's a poor way to 21 describe it, or close to the top of the shoulder? 22 A: I guess you could use all those 23 references to explain where the supraclavicular fossa is. 24 Q: Okay. 25 A: It's behind the clavicle, at the base

1 of the neck, medial to the shoulder. 2 Q: Right, and I take it that if, for 3 example, you were pulling up Mr. Dudley George's shirt to 4 look at his chest area, you wouldn't see that; it would 5 be above it? 6 A: It is above and -- 7 Q: Yeah. 8 A: -- behind the collar bone. 9 Q: Yeah. 10 11 (BRIEF PAUSE) 12 13 Q: And you were asked some questions 14 yesterday about defensive inaggressive-type injuries, and 15 I think that you had told us yesterday was that Mr. Cecil 16 Bernard George didn't have any fractures of the 17 metacarpals and you referred to them as boxer fracture -- 18 boxer's fractures. 19 A: Correct. 20 Q: And I take it in even crude or 21 layman's terms, that would be the equivalent of fractured 22 knuckles; is that right? 23 A: Yes. 24 Q: Okay. So, that would be an injury 25 that someone would sustain, for example, by hitting

1 someone very hard with their fist? 2 A: Right. 3 Q: Okay. But, I take it that you 4 couldn't tell, for example, whether or not Mr. Cecil 5 Bernard George had had any weapons in his hand? 6 A: No, I certainly couldn't. 7 Q: No. And that's not something that 8 Mr. Cotrelle talked to you about? 9 A: No. 10 Q: No, or whether he was kicking, for 11 example; you wouldn't know that? 12 A: It -- it wasn't described and I 13 didn't inquire as to what other -- what -- what Mr. 14 George -- 15 Q: Was doing? 16 A: -- was doing -- 17 Q: That's right. 18 A: -- as part of the -- the fight, if it 19 were -- could be called that. 20 Q: Right. And those are all my 21 questions. Thank you, Doctor. 22 A: You're welcome. 23 COMMISSIONER SIDNEY LINDEN: Thank you 24 very much, Ms. Jones. 25 Mr. O'Marra...?

1 (BRIEF PAUSE) 2 3 MR. AL O'MARRA: I'll be very brief, 4 Commissioner. 5 6 CROSS-EXAMINATION BY MR. AL O'MARRA: 7 Q: Dr. Saettler, my name is Al O'Marra. 8 I'm here on behalf of the chief coroner. 9 And just with respect to the location of 10 the bullet wound on Dudley George, I take it that you 11 would defer to the pathologist, who -- 12 A: I certainly would. 13 Q: -- had the opportunity to actually -- 14 A: Describe -- 15 Q: -- chart the location? 16 A: Yes, I would. 17 18 (BRIEF PAUSE) 19 20 COMMISSIONER SIDNEY LINDEN: Is that it? 21 Thank you very much, Mr. O'Marra. 22 MR. DONALD WORME: He was indeed brief. 23 COMMISSIONER SIDNEY LINDEN: Yes, he was. 24 Any re-examination? 25 MR. DONALD WORME: There is no

1 re-examination of the witness, Mr. Commissioner, but I do 2 want to thank Dr. Saettler for her attendance here. 3 I know that she had taken time from her 4 busy schedule to come out here. It was some travelling 5 and I know that she has a busy schedule to keep and to 6 get back to Winnipeg and as well as her Counsel, Mr. 7 Dantzer, who has been present as well. 8 So, thank you. 9 THE WITNESS: You're welcome. 10 COMMISSIONER SIDNEY LINDEN: Thank you 11 very much, Doctor, for -- it looks like you're going to 12 make your plane. 13 THE WITNESS: I would also like to thank 14 you, Commissioner and parties to the Inquiry for staying 15 late last night, I appreciate that, to enable me to -- to 16 get home. Thanks. 17 COMMISSIONER SIDNEY LINDEN: Thank you. 18 19 (WITNESS STANDS DOWN) 20 21 MR. DONALD WORME: I see Ms. Vella is 22 approaching now and -- 23 COMMISSIONER SIDNEY LINDEN: Good 24 morning. Good morning, Ms. Vella, do you need some time 25 or you okay to start right up?

1 MS. SUSAN VELLA: I think we can start. 2 COMMISSIONER SIDNEY LINDEN: Thank you. 3 4 (BRIEF PAUSE) 5 6 MS. SUSAN VELLA: The Commission calls as 7 its next witness, Malcolm Gilpin. 8 COMMISSIONER SIDNEY LINDEN: Good day, 9 Mr. Gilpin. 10 11 (BRIEF PAUSE) 12 13 THE REGISTRAR: Good morning, Mr. Gilpin. 14 MR. MALCOLM GILPIN: Good morning. 15 THE REGISTRAR: Do you prefer to swear on 16 the Bible, sir, or affirm? 17 MR. MALCOLM GILPIN: I can swear on the 18 Bible, sir. 19 THE REGISTRAR: The Bible is to your 20 right, there, just take in your right hand, please, and 21 give us your name in full. 22 MR. MALCOLM GILPIN: My name is Mac 23 Gilpin, I live in Forest. 24 THE REGISTRAR: Thank you, sir. 25

1 MALCOLM GILPIN, Sworn 2 3 EXAMINATION-IN-CHIEF BY MS. SUSAN VELLA: 4 Q: Good morning, Mr. Gilpin. 5 A: Good morning. 6 Q: I understand that your name is 7 Malcolm Gilpin? 8 A: Yes. 9 Q: And that you're commonly referred to 10 as, "Mac?" 11 A: Yes. 12 Q: Your date of birth is March 16, 1951? 13 A: Yes. 14 Q: And, just before I go -- go through 15 your -- the employment background, I'd like to clarify 16 whether or not you operated a funeral parlour in 1995? 17 A: No, I've never operated a funeral 18 home. 19 Q: Do you have a relative who is a 20 funeral director? 21 A: Yes, I do. 22 Q: And, what's his name? 23 A: Ron Gilpin. 24 Q: Thank you. I understand that in 1995 25 you were the owner and operator of the Forest Ambulance

1 Service? 2 A: Yes. 3 Q: When did you become the owner? 4 A: 1974. 5 Q: And, are you currently the owner of 6 that operation? 7 A: No. 8 Q: When did you cease to be -- to own 9 Forest Ambulance Service? 10 A: I think it was December of 2000. 11 Q: Now, in 1995, were you a certified 12 paramedic? 13 A: Yes. 14 Q: And, for my information, were there 15 different levels of certifications for paramedics in 16 September of '95? 17 A: Throughout the province there was, 18 yes, sort of, advance care as well as basic life support. 19 Q: All right. So, there was a basic 20 life support; that would be like Level 1? 21 A: Yes. 22 Q: And -- and advanced training? 23 A: Referred to, generally, as P2. 24 Q: As P2? 25 A: P2.

1 Q: All right. And, what -- do you know 2 what distinguished an advanced level, or P2, from the 3 basic level paramedic? 4 A: Certainly a -- a great deal more of 5 training for a P2. And in 1995, it was a program that 6 was sort of being started by the Ministry of Health, so 7 the -- a P2 would be trained in advanced IV, and they 8 would be operating, like a manually-operated 9 defibrillator as well as a number of cardiac drugs and -- 10 and controlled drugs as well. 11 Q: All right. And what level did you -- 12 were you in September of 1995? 13 A: Just P1. 14 Q: As a P1 paramedic, what -- what were 15 you qualified to do in terms of offering any type of 16 health or medical related intervention? 17 A: Generally, the -- the skill -- skills 18 were restricted to symptom relief drugs and semi- 19 automatic defibrillator in addition to, obviously splint 20 application and bandaging and oxygen therapy, suction. 21 Q: When you say, "oxygen therapy," can 22 you describe what that involved? 23 A: Just generally administering oxygen 24 and -- and what method you're going to, obviously, just 25 deliver the oxygen.

1 Q: All right. Would that include 2 delivery of oxygen through -- with the assistance of 3 equipment? 4 A: Yes. 5 Q: All right. And what kind of 6 equipment would be used? 7 A: Generally just a normal mask, if you 8 were, or a nasal cannula, or to ventilator-assisted 9 oxygen delivery. 10 Q: All right. Were you qualified as a 11 Level 1 paramedic to administer intravenous? 12 A: No. 13 Q: Going back to 1995, what geographical 14 area did you provide ambulance service to? 15 A: Are you referring to the Forest 16 service or...? 17 Q: Well, I'm referring -- okay, for now 18 for the Forest service? 19 A: Generally, approximately twelve (12) 20 to thirteen (13) radius -- mile radius of the -- of the 21 vill -- or the town of Forest. 22 Q: All right. And did you also manage 23 or provide ambulance service to other areas beyond that 24 geographical location in the capacity as the owner of the 25 ambulance service?

1 A: Yes. 2 Q: And what additional area did you 3 provide service to? 4 A: We operated an ambulance service in 5 the village of Watford, as well as the village of Glencoe 6 and the town of Bothwell. 7 Q: Town of...? 8 A: Bothwell. 9 Q: Bothwell. All right. How many 10 ambulance units as the -- the actual vehicles did you 11 operate in your fleet in total? 12 A: One (1), two (2) -- we had five (5) 13 vehicles. 14 Q: And this is in 1995? 15 A: Yes. 16 Q: And where were those vehicles 17 physically -- 18 A: I'm sorry, six (6). I'm sorry. 19 Q: Six (6)? 20 A: We had a spare vehicle as well. 21 Q: Okay. Where were those vehicles 22 physically located? 23 A: A vehicle was at each of the 24 stations. So, we had a vehicle in Glencoe, a vehicle in 25 Bothwell, Watford and in Forest.

56
  1                 Q:   All right.  Did you typically --
  2  where would the other three (3) vehicles be maintained,
  3  typically  -- or the other two (2) I should say?
  4                 A:   You say maintenance, you mean or...?
  5                 Q:   Yes.  You said you had four (4) -- or
  6  six (6) in -- in total and you said one (1) at each of
  7  the four (4) stations?
  8                 A:   We had one (1) in Forest, one (1) in
  9  Watford, one (1) in -- one (1) in Forest, one (1) in
 10  Watford, one (1) in Glencoe, one (1) in Bothwell; so
 11  that's four (4) and then I had a spare.  So, I had five
 12  (5), I'm sorry.
 13                 Q:   Where was the spare located?
 14                 A:   Generally the spare vehicle would be
 15  utilized wherever there is some maintenance issues of a
 16  vehicle --
 17                 Q:   Okay.
 18                 A:   So it -- it often would float in --
 19  in the area.  As well, maybe the Thedford may have
 20  required it -- it was sort of a regional vehicle that
 21  could be used for maintenance issues.
 22                 Q:   Okay.  I wonder if we can put the --
 23  the map, Exhibit 349, on the screen, please.  
 24  
 25                       (BRIEF PAUSE)

1 Q: This is Exhibit 349(B); it's an 2 electronic version of a map for Lambton County generally. 3 Can you point out, using your laser -- hopefully you have 4 a laser pointer up there, do you, yeah -- and just 5 identify for the record the location of the four (4) 6 ambulance stations that you operated? 7 A: Is it -- that's Forest. 8 Q: All right. And I wonder, just before 9 you move on, can you please... 10 11 (BRIEF PAUSE) 12 13 Q: Okay. All right. I'm just being 14 advised that Bothwell isn't on this particular map, or 15 Glencoe. 16 17 (BRIEF PAUSE) 18 19 Q: All right. So, you can see then the 20 top left corner is Forest ambulance station, it's already 21 marked on this map. And in the bottom, towards the 22 bottom of the Lambton County is Watford; is that right? 23 A: Yes. 24 Q: All right. And just -- can you tell 25 me approximately where Glencoe are Bothwell are? I -- I

1 assume they're not located in Lambton County; is that 2 right? 3 A: No, actually Bothwell's in Kent 4 County, so it's immediately to the south -- 5 Q: All right. 6 A: -- and -- and Glencoe is immediately 7 to the south as well as east. 8 Q: Okay. Now, are they both in Kent 9 County? 10 A: Glencoe's in Middlesex County. 11 Q: Thank you. How many crew members did 12 you have working for you in September of 1995? 13 A: Out of the Forest Station? 14 Q: Yes. 15 A: I think I believe I had six (6) full- 16 time staff there plus myself. 17 Q: And, did you also have full-time 18 staff at Watford? 19 A: Generally, the Watford vehicle was -- 20 was known, sort of in the business, as a satellite 21 station, so we had operated at 8:00 in the morning to 22 6:00 at night and it -- the crew would leave the Forest 23 Station with the vehicle in the morning and -- and they 24 would be satellited at the fire hall at -- in the village 25 of Watford.

1 Q: Okay. So, you had essentially seven 2 (7) full-time paramedics? 3 A: I believe that's right. 4 Q: And, what -- what were their -- their 5 qualifications? What level of paramedic were they? 6 A: They were all P1. 7 Q: They were all P1's? You had no 8 advanced care paramedics? 9 A: No, no advanced care. 10 Q: All right. Do you know where, based 11 on your -- your experience, where the nearest advanced 12 care paramedics were available, that is, nearest Forest? 13 A: At that time I believe they had some 14 in Sarnia, at the Sarnia service. 15 Q: Sarnia service? 16 A: Yes. 17 Q: Know whether there were also any in - 18 - in Strathroy? 19 A: No, the closest after that would be 20 the city of London. 21 Q: All right. So, none of your crew 22 members, then, were qualified to monitor or administer, I 23 should say, an intravenous; is that correct? 24 A: That's correct. 25 Q: But they had the other skills which

1 you've associated with -- with Level I paramedics? 2 A: That's correct. 3 Q: I understand that in order to be 4 qualified to transport injured persons, you have to have 5 a particular vehicle license? 6 A: That's correct. 7 Q: And, what license is that? 8 A: It's an F Class license. 9 Q: And, how many of your crew members 10 had a Class F license out of the Forest-Watford area? 11 A: All the staff would have an F Class. 12 Q: All right. Can you just tell us very 13 briefly how do you qualify for a Class F license? 14 A: Generally, it's a written test and 15 then to obtain an F you have to -- to drive a -- a 16 vehicle, generally, it's an ambulance or a large van-type 17 vehicle on a -- a driver -- with a -- with a Ministry of 18 Transportation person with you to evaluate your skills. 19 Q: All right. And, what particular 20 items are you tested for that would distinguish a Class F 21 license from an ordinary license that -- that I might 22 have? 23 A: Generally, some of the -- as I recall 24 it, some of the -- the skill value, if you want, was, you 25 know, doing a circle check on the vehicle in the morning

1 and ensuring the vehicle's in a safe manner. 2 Q: All right. Were there also special 3 principles applied with respect to, for example, 4 operating an ambulance at a Code 4 speed? 5 A: I don't believe there was any -- that 6 I'm familiar with -- any skill values that would be 7 tested on that. 8 Q: All right. And, you've indicated 9 that you had a total of -- of six (6) -- sorry, five (5) 10 ambulance units. Focussing on the ambulance units that 11 were available at the Forest Station, can you tell me, 12 first of all, did they have to be in some manner 13 regulated or certified under the Ministry of Health? 14 A: Each vehicle would -- would have a -- 15 a safety standard certificate issued to it every six (6) 16 months, so it would -- plus it went through a very 17 rigorous preventive maintenance program, for instance, 18 changing the oil every six thousand (6,000) kilometres 19 and what not. 20 Q: Okay. All right. And were there 21 minimum requirements in terms of the equipment, medical 22 related equipment that had to be maintained on these 23 ambulances under the Ministry of Health? 24 A: Yeah, the equipment in terms of what 25 was in the vehicle is regulated under the Ambulance Act.

1 Q: All right. And what equipment did 2 your ambulance have -- ambulances have in 1995? 3 A: Well, we had everything that was 4 regulated or required in the Ambulance Act. 5 Q: Was there, for example, a C-collar in 6 each of your ambulances? 7 A: Each of the vehicles would carry -- 8 we call it a -- a cervical collar response kit if you 9 want, that had all the correct collars and the correct 10 straps to be used for the cervical board and what not. 11 Q: A survival board, did you say? 12 A: Cervical -- cervical collars and 13 fracture board, I'm sorry. 14 Q: Fracture board, okay. Did you have 15 any type of defibrillator on board? 16 A: Each vehicle would have a semi- 17 automatic defibrillator. 18 Q: Okay. Do you have any equipment that 19 would assist in measuring blood pressure? 20 A: Yes. 21 Q: What would that be? 22 A: Each vehicle had what -- had a wall 23 mounted sphygmomanometer as well as a -- each response 24 kit had a -- a hand unit that you could use for measuring 25 blood pressure as well; both a child and an adult size.

1 Q: Okay. And did you ambulances have 2 any equipment to assist with oxygen therapy on them? 3 A: Yes. 4 Q: Which equipment? 5 A: Each -- each vehicle would have had a 6 -- a Flynn Regulator, so it's a regulated by oxygen 7 delivery, if you want, and as well as portable oxygen 8 that they could take out of the vehicle. 9 Q: All right. Do you recall the -- what 10 unit -- I understand each ambulance is designated by a 11 unit number? 12 A: Yes. 13 Q: And is that coordinated under the 14 jurisdiction of the Ministry of Health? 15 A: Yes. 16 Q: So each ambulance has its own 17 distinct number? 18 A: Yes. 19 Q: All right. Do you recall what unit 20 numbers you had associated with your ambulances in the -- 21 and the Forest ambulances? 22 A: Well, the Forest vehicle was referred 23 to as 1146. 24 Q: All right. 25 A: Watford is 1145. Our spare vehicle

1 was called 1505. 2 Q: All right. 3 4 (BRIEF PAUSE) 5 6 Q: And do you recall the names of the 7 crew people that you had, the paramedics who attended out 8 of the Forest and Watford satellite stations? 9 A: That particular evening -- 10 Q: Oh, they'd be, of course, different - 11 - different paramedics associated with the ambulance from 12 time to time? 13 A: Yes. 14 Q: Okay, so that particular evening? 15 A: That evening -- 16 Q: September the 5th -- 6th? 17 A: -- of the -- our Forest vehicle was 18 staffed with John Tedball and Mark Watt. 19 Q: That's 1146? 20 A: Yes. And obviously at 9:30 the crew 21 the reported with 45 was myself and Cesare DiCesare. 22 Q: And that's for 1145? 23 A: Yes. 24 Q: Yes. 25 A: And 505, I think was later staffed

1 with Darcy Thompson and Geoff Brooks. 2 Q: All right. And these are all Level 1 3 paramedics? 4 A: Yes. 5 Q: When did you first become aware that 6 ambulance service might be required for the Ipperwash 7 park occupation? 8 A: That particular evening, you mean, 9 ma'am, or...? 10 Q: No, during the course of the 11 occupation which was at September the 4th to 6th, '95 in 12 particular is what I'm interested in. 13 A: I believe when I was working -- and 14 I'll have to refer to my notes, if I could? 15 Q: Certainly. Which notes are those? 16 A: I believe they're ones that -- in the 17 notebook here. 18 Q: Are you referring to the -- the 19 ambulance log? 20 A: No, it's -- it'd be under section 9. 21 22 (BRIEF PAUSE) 23 24 Q: What I have there is the -- your 25 anticipated evidence; is that what you're looking at?

1 A: Yes. 2 Q: All right. This is a statement that 3 was -- or an interview that was held on September the 4 22nd, 1995. 5 And first of all I'll ask, do you recall 6 being interviewed by Bob Moore -- Muir who was the 7 investigator with the Special Investigations Unit, 8 together with Jim Kennedy from that unit? 9 A: Yes, I do. 10 Q: All right. And do you recall that 11 that was a recorded interview? 12 A: Yes, I do. 13 Q: All right. You had the opportunity 14 to review this document in advance of today? 15 A: Yes. 16 Q: And does it appear to be accurate in 17 terms of the transcription so far as you can recall? 18 A: Yes. 19 Q: All right. What page would you like 20 to look at to refresh your memory? 21 A: I'm just looking for the area that -- 22 I believe it's back of the -- where we spoke -- if you 23 just give me a minute I'll just look it up here. 24 Q: Certainly. 25

1 (BRIEF PAUSE) 2 3 A: I believe it's on page 14, ma'am. 4 5 (BRIEF PAUSE) 6 7 Q: Take a moment then to review that and 8 advise me as to whether it refreshes your memory. 9 10 (BRIEF PAUSE) 11 12 A: Yes. 13 Q: Does that refresh your memory? 14 A: It helps, yes. 15 Q: All right. Can you advise me then 16 when it was that you first became aware an ambulance 17 service might be required for the Ipperwash Park 18 occupation situation? 19 A: I -- I believe it's around ten 20 o'clock in the morning on the 5th of September. 21 Q: All right. And can you tell us what 22 the circumstances of -- of that notice was? 23 A: I believe I was working at the 24 Glencoe or Bothwell station and then I was actually at 25 Four Counties Hospital and I remember getting a page.

1 And it was a call that was from Dan Grant requesting a 2 vehicle for standby duty at the Park. 3 Q: All right. And did Mr. Grant 4 identify himself to you? 5 A: I believe so, yes. 6 Q: And who was he? 7 A: He was from the OPP. 8 Q: All right. Did he tell you why it 9 was he requested a standby ambulance for -- for the Park? 10 A: I -- I don't believe he gave me the 11 specifics. Like, he just said, We would like to have a 12 vehicle down there. 13 Q: All right. And what did you do in 14 response to this request? 15 A: I believe I told him it would be 16 difficult for me to up-staff the vehicle without, you 17 know, obviously, Ministry of Health permission to -- to 18 incur additional cost. 19 Q: All right. Cost to -- to the 20 service, as you'd be charging -- you charge the Ministry 21 of Health for the ambulance services you provided? 22 A: Well, we -- we had, in those -- in 23 that particular days we'd have to be funded to provide 24 that up-staffing coverage for the crews. 25 Q: And did you take steps to request

1 that permission? 2 A: Yes, I did. I contacted at that 3 time, which would be our regional manager in London, 4 Ontario, and -- and indicated I had received a request. 5 And because I was busy at the time, I said, Why don't you 6 just call directly to the OPP and -- and talk to Dan 7 Grant about the request. 8 Q: All right. And -- and as a result of 9 any discussions that may have occurred between those -- 10 those two (2) individuals, did you receive any 11 instructions to send an ambulance unit down to the Park 12 area as requested? 13 A: No. 14 Q: All right. Were you provided with 15 any reason at to why you would not send them? 16 A: I -- I don't recall. All that my 17 notes indicate, that I think it was a conversation that 18 was between Mr. Arbour and -- and Dan Grant. So -- 19 Q: All right. 20 A: -- all I got back was that, 21 obviously, was a -- a costing to it and we wouldn't be -- 22 we wouldn't be up-staffing the vehicle as a result. 23 Q: All right. So, as a result of not 24 getting funding, you did not send an ambulance down to 25 the Park on September the 5th?

1 A: That's correct. 2 Q: All right. When did you, next, 3 receive a request for ambulance service in relation to 4 the -- the occupation of Ipperwash Provincial Park? 5 A: It'd be the next day, the following 6 evening. 7 Q: And do you recall who notified you? 8 A: It came through our dispatch office 9 at Wallaceburg. 10 Q: That's the Wallaceburg Central 11 Ambulance Communication Centre? 12 A: Yes. 13 Q: All right. And I may just refer to 14 that Centre as, "Wallaceburg" during the course of my 15 examination. 16 A: Sure. 17 Q: And who notified you from that -- 18 from Wallaceburg? 19 A: I can't remember. I think it was 20 Geoff Connors, the supervisor who was on duty that 21 evening. 22 Q: All right. Now, do you recall what 23 Mr. Connors, or at least the person from Wallaceburg, 24 what he told you was required? 25 A: I just -- can I refer to my notes,

1 or... 2 Q: Certainly. 3 4 (BRIEF PAUSE) 5 6 Q: Are you looking for the -- what note 7 are you looking at? 8 A: I was looking at my notes that I used 9 as an ambulance incident report. 10 Q: All right. I wonder if we might put 11 that on the screen and I'll ask you a couple of questions 12 about that first; it's Inquiry Document Number 5000471. 13 14 (BRIEF PAUSE) 15 16 Q: All right. I'm told that we have 17 some technical issues with respect to this. 18 19 (BRIEF PAUSE) 20 21 Q: Commissioner, I'm -- I'm going to be 22 quite relying on the Supertext database, I -- I'd like 23 permission to have a morning break at this time so that I 24 can switch computers and ensure that we can have a 25 smoothly run examination.

1 COMMISSIONER SIDNEY LINDEN: We'll have 2 the morning break now. 3 MS. SUSAN VELLA: Thank you. 4 THE REGISTRAR: This Inquiry will recess 5 for fifteen (15) minutes. 6 7 --- Upon recessing at 10:12 a.m. 8 --- Upon resuming at 10:33 a.m. 9 10 THE REGISTRAR: This Inquiry is now 11 resumed. Please be seated. 12 COMMISSIONER SIDNEY LINDEN: Carry on. 13 14 CONTINUED BY MS. SUSAN VELLA: 15 Q: Thank you, Commissioner. 16 Mr. Gilpin, you were about to refer to a 17 document. Now, it's in our database as Inquiry Document 18 Number 5000471 and the second part of that report is at 19 5000472. 20 Mr. Gilpin, this appears to be a 21 continuous narrative report. Is it -- is this continuous 22 or were there actually two (2) different reports? 23 A: There's different call numbers on -- 24 on two (2) reports but it is basically a continuous 25 report of the incident.

1 Q: So you have to read 1 and 2 to get 2 the whole story? 3 A: As we proceed on, yes. 4 Q: All right. And are you required, as 5 part of your job, to fill out an ambulance incident 6 report? 7 A: Yes, on an unusual event. 8 Q: On unusual events? 9 A: Or a VSA or a vital signs absent 10 patient. 11 Q: And did the Ipperwash occupation 12 events constitute an unusual event that required a 13 report? 14 A: In the beginning, obviously not, but 15 as we went through the evening they did, so. 16 Q: All right. When did you prepare this 17 report? 18 A: Be the next day, following the 19 incident. 20 Q: It's dated September the 7th, 1995. 21 A: That's correct. 22 Q: And does this represent your 23 recollection of the events of the evening of September 24 6th and the early hour -- mornings -- morning hours of 25 September the 7th, 1995?

1 A: Yes. 2 Q: Now because it will become, perhaps, 3 an issue later on, there are various times which you have 4 recorded in this report with respect to when you received 5 calls and when you arrived at certain destinations. 6 What was the source of your information 7 for the times that we see reflected in this report? 8 A: We obtained them from Wallaceburg 9 ambulance dispatch. 10 Q: You obtained them from the dispatch 11 logs from Wallaceburg? 12 A: Yes. 13 Q: All right. So, these aren't 14 independent recollection of times? 15 A: No, that's correct. 16 Q: And for the record, the Witness is 17 referring to Exhibit P-345, with respect to the ambulance 18 logs. 19 All right. Now, you were going to review 20 this report and refresh your memory with respect to my 21 question which was: What -- what were you told with 22 respect to the initial notification and approximately 23 what time did that occur? 24 A: It was approximately at 9:30 that 25 evening and it was in response to a request by the Forest

1 OPP for two (2) ambulances in a possible confrontation 2 that may occur at Ipperwash provincial Park. 3 Q: All right. And I see you use the 4 word "confrontation", do you recall whether that's a word 5 that you used to describe the situation or was this the 6 term that was conveyed to you? 7 A: I can't recall. 8 9 (BRIEF PAUSE) 10 11 Q: All right. And if we would look at 12 Tab 5 of your brief and Exhibit P-345, this is the -- the 13 Wallaceburg ambulance logs and front number 0009536. 14 They are consecutively numbered in the top left-hand 15 corner. 16 It's Document Number 1002002. 17 18 (BRIEF PAUSE) 19 20 Q: Are you there, with -- 21 A: This -- 22 Q: -- the -- 23 A: -- appears to be the second page in, 24 ma'am? 25 Q: All right. So, you're looking at

1 9537, are you? 2 A: The number on the top left is 3 1002002. 4 Q: Yeah, no that's a common number for 5 the whole document -- 6 A: Okay, I'm sorry. 7 Q: Right below it, is a number. It's 8 called -- 9 A: Right. 10 Q: -- a front. 11 A: Yes. 12 Q: If you look at 0009536. 13 14 (BRIEF PAUSE) 15 16 A: Yes. 17 Q: It appears to be a dispatch detail 18 report, relating to unit 1145 which was your unit and it 19 indicates that you were notified at about 21:34. 20 Now, this is a long time ago, but do you 21 recall being notified in or around 9:30 p.m. that night? 22 A: Yes. 23 Q: Okay. And were you given any other 24 details by Wallaceburg concerning what the terms of your 25 assignment would be?

1 A: I don't recall any other ones. 2 Q: Right. As a result of receiving this 3 advice from Mr. Connors, what did you do? 4 A: Well, that particular evening, I 5 really wasn't on duty, however, they called me at my 6 residence to basically up-staff a vehicle, so we 7 proceeded to the -- to the ambulance base. 8 Q: To the Forest Ambulance Base? 9 A: That's correct. 10 Q: All right. Because normally you'd 11 have one (1) car on duty and -- 12 A: On -- 13 Q: -- the request here was for two (2)? 14 A: Yes. 15 Q: All right. And what was the other 16 vehicle that was dispatched in addition to it? 17 A: It would be the Forest vehicle, the 18 1146. 19 Q: All right. And you were in 1145? 20 A: That's correct. 21 Q: Okay. Where did you go from the 22 Forest Ambulance Service? 23 A: We departed the base and proceeded 24 down 21 Highway to the Ipperwash Centre Road, I believe 25 it's called, and then down to the Ministry of Natural

1 Resources parking lot. 2 Q: All right. And is that parking lot 3 located off East Parkway Drive? 4 A: That's correct. 5 Q: And approximately between Ipperwash 6 Road and Army Camp Road? 7 A: Yes, that's correct 8 Q: And who was -- who was your partner 9 that evening? 10 A: My partner was Cesare DiCesare. 11 Q: All right. And do you -- do you 12 recall how long it took you to get from the ambulance 13 base to the MNR parking lot, approximately? 14 A: Probably about fifteen (15) minutes. 15 Q: All right. And the log -- I don't 16 know if you still have it open before you, 9536 -- 17 indicates that you arrived at the MNR parking lot at 18 about 21:53, having left the base at around 21:41; it's a 19 differential of approximately twelve (12) minutes. 20 Does that sound like about -- about the 21 amount of time it would have taken you to get there? 22 A: Yes. 23 Q: All right. And perhaps we could go 24 back to the map? Yes, thank you. 25

1 (BRIEF PAUSE) 2 3 Q: Now, we've put up on the screen a 4 different map, we'll identify it for the record as Map 5 Number 2 and this appears to be a map of the area 6 adjacent to the Ipperwash Provincial Park. You'll see 7 Lake Huron at the top of the screen; you'll see East 8 Parkway Drive going through the screen, and -- yes, 9 that's Ipperwash Road and Army Camp Road to the right and 10 if you would just point out, Mr. Emery, the MNR parking 11 lot? 12 And I see that there are tracks there. 13 Can you just -- where the circles are? Okay. Does that 14 look like the approximate location of the MNR parking lot 15 to you that you went to? 16 A: Yes. 17 Q: All right. I'd like to make this map 18 the next exhibit, please? 19 THE REGISTRAR: P-370, Your Honour. 20 COMMISSIONER SIDNEY LINDEN: P-370. 21 22 --- EXHIBIT NO. P-370(a): Digital Map (hard copy) of 23 Map No. 2. 24 25 --- EXHIBIT NO. P-370(b): Electronic Map of Map No. 2

1 2 CONTINUED BY MS. SUSAN VELLA: 3 Q: Now, once you -- when you arrived at 4 the parking lot, did you have to go through a -- a police 5 check do you recall or a -- a checkpoint? 6 A: Yes, I -- I believe there was -- was 7 two (2), but one (1) particularly, was just prior to the 8 parking lot. 9 Q: Do you recall where the first one was 10 using that map? 11 A: Right at the intersection of Parkway 12 and Ipperwash. 13 Q: Ipperwash Road? Okay, so right, 14 approximately, there? 15 A: Yes. 16 Q: All right. I wonder if you would 17 kindly, Mr. Emery, mark that map? Call it the Ipperwash 18 Road Check Point or OPP Checkpoint? 19 20 (BRIEF PAUSE) 21 22 THE REGISTRAR: Miss Vella, do you want a 23 hard copy of this to be 370(a)? 24 MS. SUSAN VELLA: We'll also have a hard 25 copy. That sounds fine, let's make the -- the electronic

1 copy be consistent "B"; the hard copy "A". Thank you. 2 3 CONTINUED BY MS. SUSAN VELLA: 4 Q: All right. And are you able to show 5 us when you arrived at the -- in the MNR parking lot, 6 where did you go? 7 A: Can I show you with the marker? 8 Q: Yes, just with your pointer. 9 A: I believe we entered right about this 10 area here. 11 Q: All right. 12 A: And, initially, that's where we 13 initially parked, right along this area. 14 Q: All right. And how long did you stay 15 there in that area? 16 A: I can't recall the exact time. 17 Q: Okay. Can you mark that, Mr. Emery; 18 Unit 1145. 19 20 (BRIEF PAUSE) 21 22 Q: Arrival time approximately 21:53, 23 September 6th. 24 25 (BRIEF PAUSE)

1 Q: Thank you. Okay. All right. Now 2 when -- when you arrived at -- in the MNR parking lot 3 was the other unit also with you, Unit 1146? 4 A: Yes, it was in front of us. 5 Q: All right. Were any other ambulance 6 units in the MNR parking lot when you arrived? 7 A: I don't recall any at the time. 8 Q: Okay. And just for clarification, 9 did you go to the Forest OPP detachment first, for any 10 type of briefing? 11 A: No. 12 Q: All right. Can you describe the 13 scene when you entered the MNR parking lot, then? 14 A: There was a number of OPP cruisers 15 there and staff that -- they were obviously OPP officers 16 that were -- appeared to be getting, sort of, dressed in 17 protective gear, I guess you might call it. 18 Q: All right. And did you observe any 19 St. John's vehicles -- ambulance vehicles there? 20 A: Later when we were directed to move 21 the vehicles, I recall a St. John Ambulance vehicle 22 arriving and it had parked behind us. 23 Q: All right. But, prior to that, were 24 there any existing St. John's vehicles that you saw? 25 A: I can't say I recall it at the time.

1 Q: All right. And once you entered the 2 MNR parking lot, what happened? 3 A: We were met by, I believe, Staff 4 Sergeant Wade Lacroix and I knew him from the Petrolia 5 Detachment, so you know, obviously we asked him the 6 duration of the -- of the incident and what was, sort of, 7 going on. 8 Q: And what did he respond to you? 9 A: If I could just probably refer to my 10 notes. 11 Q: Are you looking at the accident -- 12 ambulance incident report? 13 A: Yes. Yes. 14 Q: All right. 15 A: Asked -- we asked officer Lacroix for 16 the request for -- why the request for the ambulances and 17 the duration of the exercise and whether the OPP 18 suspected firearms were at Ipperwash Park. 19 Q: And do you recall what his response 20 was to you? 21 A: From my notes, officer Lacroix 22 indicated that, in the afternoon there had -- the natives 23 had caused considerable damage to an OPP cruiser and 24 other vehicles with rocks and stones and had -- and had 25 replaced the barriers. There must have been barriers at

1 the entrance to Ipperwash Provincial Park. 2 Q: All right. 3 A: And he indicated the purpose tonight 4 was not to remove the natives from the Park, and he was 5 not sure of the length of the duration of the exercise at 6 the time. 7 I remember a crew member asked him about 8 pepper spray and Mr. -- officer Lacroix indicated he was 9 not concerned about pepper spray, but -- but firearms and 10 suspected the possible use of firearms and the use of 11 fire. 12 For these reasons, the crews were 13 instructed that we'd be not going to the scene. 14 Q: All right. Now, do you have any 15 independent recollection of this conversation or are you 16 essentially reading from your notes? 17 A: I'm reading from my notes on that. 18 Q: Do you have independent recollection 19 of a conversation with officer Lacroix in which he 20 conveyed this information? 21 A: I remember speaking to him, but I 22 don't remember the details. 23 Q: All right. Commissioner, I'd like to 24 make this document the next exhibit. It's Inquiry 25 document number 500 -- sorry, 5000471.

1 THE REGISTRAR: That will be P-371, Your 2 Honour. 3 COMMISSIONER SIDNEY LINDEN: P-371. 4 5 --- EXHIBIT NO. P-371: Document No. 5000471 6 Ambulance incident report 7 8 MS. SUSAN VELLA: And while we're at it, 9 the second report, which is Inquiry document number 10 5000472, I'd like it to -- make -- make that the next 11 exhibit, please. 12 THE REGISTRAR: P-372. 13 COMMISSIONER SIDNEY LINDEN: P-372. 14 15 --- EXHIBIT NO. P-372: Document 5000472 16 17 MS. SUSAN VELLA: Thank you. 18 COMMISSIONER SIDNEY LINDEN: Are those 19 two (2) documents in the binder, in the brief that I 20 have? 21 MS. SUSAN VELLA: I don't believe -- 22 COMMISSIONER SIDNEY LINDEN: Are you 23 going to be referring -- 24 MS. SUSAN VELLA: No, they're not. I 25 don't believe they are.

1 COMMISSIONER SIDNEY LINDEN: That's fine. 2 Are we going to be referring to them any more. Should I 3 get a copy? 4 MS. SUSAN VELLA: Yes, we are. Yes, you 5 should have a copy. 6 COMMISSIONER SIDNEY LINDEN: Should I -- 7 all right. Is it enough to have it on the screen? 8 9 (BRIEF PAUSE) 10 11 COMMISSIONER SIDNEY LINDEN: I can follow 12 it on the screen. 13 MS. SUSAN VELLA: I'll give you this for 14 now. I see that it's stapled somewhat out -- backwards, 15 but in any event. 16 COMMISSIONER SIDNEY LINDEN: Thank you. 17 MS. SUSAN VELLA: Okay. Could you hand 18 this up? Sorry, this is for -- 19 COMMISSIONER SIDNEY LINDEN: I'm going to 20 mark it up. I'm going to mark it up, so if you give it 21 to me -- 22 MS. SUSAN VELLA: No, I'm sorry, I guess 23 it'll have to be that one. Okay. Thank you. 24 25 CONTINUED BY MS. SUSAN VELLA:

1 Q: Now, how were you dressed that 2 evening when you went to the MNR parking lot? 3 A: Just in our normal ambulance uniform, 4 and at the time it was short-sleeve shirt. 5 Q: All right. And was any concern 6 expressed to you with respect to the state of your dress? 7 A: Yes. Officer Lacroix asked us if we 8 had protective gear, and we said no. 9 Q: Do you recall what it was Officer 10 Lacroix was wearing at that time? 11 A: I don't recall what he was wearing at 12 the time. 13 Q: All right. So, essentially were you 14 and -- did you understand your task at the time to be 15 essentially on standby in the event that later on need 16 for your service would be required? 17 A: Yes. 18 Q: All right. And did you have an 19 understanding, based on what Officer Lacroix told you, 20 that there was at least a possibility that there could be 21 gunfire and the use of fire that evening? 22 A: Yes. 23 24 (BRIEF PAUSE) 25

1 Q: Did Officer Lacroix tell you what the 2 basis of his suspicion or belief was with respect to the 3 existence of firearms? 4 A: No. I don't recall that, no. 5 Q: And what happened next? 6 A: I believe he indicated that he'd like 7 to have -- I believe it was a medic by the name of Ted 8 Slomer speak to us regarding our equipment and what not. 9 Q: All right. Now, at this time are you 10 still in the position that you've referred to earlier, 11 are you still in that initial position or had you moved? 12 A: Shortly, either after or -- after the 13 -- our discussion, I believe it was just after -- before 14 our discussion with Ted Slomer, we -- we moved the 15 vehicles after we spoke to Mr. Slomer. 16 Q: All right. And looking at the map 17 behind you, are you able to show me where you moved to? 18 A: I believe we, sort of, turned them 19 around and they were pointed, more or less, in this 20 direction, with the one vehicle, 1146, approximately 21 here. 22 Q: Hmm hmm. 23 A: 45 was right behind it. 24 Q: Yes. 25 A: And at that time I believe a St.

1 John's unit was right behind that. 2 Q: All right. And how many minutes 3 after you arrived at the MNR parking lot did you move to 4 that position, approximately? 5 A: After our discussion with Mr. Slomer, 6 probably -- after we had arrived on the scene, probably 7 twenty (20) minutes, we moved the vehicles. 8 Q: Approximately twenty (20) minutes? 9 A: I think so. 10 Q: All right. So, the first marking is 11 1146. And we'll mark that at approximately 22:13, 12 approximately, as arrival. 13 14 (BRIEF PAUSE) 15 16 Q: Okay. Now, did you -- did you happen 17 to know, prior to this evening, Ted Slomer? 18 A: Yes. I was aware of him, yes. 19 Q: And were you -- how is it that you 20 were aware of him? 21 A: Ted was employed, I believe at the 22 time, with the London base hospital as a director -- or 23 as an employee of the hospital, that did training for the 24 P2's. 25 Q: Sorry?

1 A: Ted was employed by Victoria 2 Hospital, which at that time was referred to as our base 3 hospital. 4 Q: Okay. 5 A: And -- and Ted was responsible, as I 6 understand it, for training some P2's. 7 Q: For training the advanced level 8 paramedics? 9 A: That's correct. 10 Q: And, to your knowledge, was he, 11 himself, an advanced level paramedic? 12 A: That was my understanding, yes. 13 Q: All right. Were you advised as to 14 what Mr. Slomer's function was that night? 15 A: Basically, he -- he just spoke to us 16 regarding the training levels that we had and -- and 17 whatnot. 18 Q: Did you -- did you advise him that -- 19 that all of your crew were Level I paramedics? 20 A: I -- yes, and I -- Mr. Slomer would 21 have known that. 22 Q: How would he know that? 23 A: Probably because we never had any 24 P2's. 25 Q: Okay.

1 A: And, you had to be a P1 to be in a 2 vehicle, so... 3 Q: Fair enough. Did Mr. Slomer provide 4 you with any -- any indication as to what -- what your 5 role might be that evening? 6 A: Not specifically, I don't believe, 7 no. 8 Q: All right. Did he provide you with 9 any type of instruction that evening? 10 A: He -- from my notes, he indicated he 11 would be willing to assist -- assist us in the ambulance 12 if needed, and he -- he also indicated to us that we 13 would not be travelling to the scene; he would be 14 bringing patients out to us. 15 Q: All right. And the scene was 16 Ipperwash Provincial Park? 17 A: That's how I understood it, yes. 18 Q: And, did you understand why it was 19 that you wouldn't be going directly to the scene to pick 20 up any injured persons? 21 A: It appeared, he indicated, it would 22 be too dangerous for us and the fact that we didn't have 23 any gear. 24 Q: All right. And did he provide you 25 with any instruction in relation to medical care?

1 A: I'll just look at my notes. We just 2 -- I think he reviewed his fact that he was able to do 3 IV's and his advanced level of care. 4 Q: And, are you looking at your notes at 5 the page 2 towards the bottom? 6 A: Yes, and then again at the top of 7 page 3. 8 Q: All right. Now, did you discuss how 9 it would be, then, that -- or at least what the process 10 by which you would receive injured persons that night 11 from the Park? 12 A: Yes, he indicated he would be 13 transporting them out in the suburban vehicle that was 14 beside --