There have been changes in the way prisoners are monitored and cared for at the Whitehorse RCMP detachment since the death of Raymond Silverfox.

But the policies now in place have always been there, they just weren't being followed on the day the 43-year-old Carmacks man died after spending 16 hours in police custody.

Yesterday, the fourth day of the coroner's inquest into Silverfox's death, the guard who was in charge of monitoring Silverfox during the day of Dec. 2, 2008, took the stand.

Heather Balfour said she had no concerns about Silverfox's health, in spite of the fact he was vomiting profusely. Balfour's log book shows the guard noticed Silverfox throw up five times during her shift. A surveillance video of the drunk tank where Silverfox was lodged shows the man vomiting at least 23 times between the hours of 8 a.m. and 4 p.m.

At one point the surveillance audio and video shows Balfour going to the door of the cell block and telling Silverfox to stop vomiting on the floor and use the toilet. "You'll have to clean it up,” she told him.

After that, Silverfox crawled to the toilet where he continued to be sick, sometimes making it to the bowl and other times vomiting where he lay on the floor.

She said she was used to people vomiting in the cells, and saw no reason to call for medical help.

"Even if it had been my own children, I wouldn't have done anything different,” Balfour said.

She said she thought Silverfox was drunk, not sick, and that she'd seen lots of people in his condition during her eight years as a guard. By the end of Balfour's shift, Silverfox had been in police custody for 11 hours and was still vomiting.

The amount of bodily fluids on the floor of the cell did not go unnoticed by other staff. At one point, another guard entered the guard room and looked at the monitor showing Silverfox's cell.

"Oh my God, what is that?” the guard asked.

"Puke,” Balfour responded.

"Oh dear God,” the other guard said.

At one point, an RCMP officer, Heather Kaytor, came into the cell block and noticed the condition of Silverfox's cell. She asked, "Are you sure he's OK?” and Balfour said he was, according to Kaytor's statement.

No one ever attempted to clean Silverfox or his cell. Even when the janitor arrived, no one asked him to clean the room Silverfox was in, though it was by far the most dirty.

Silverfox died later that night. He was taken to the hospital after being found "unresponsive” in his cell, according to police. He was pronounced dead shortly after 9 p.m.

There has been some indication during the inquest that Silverfox had pneumonia, but no medical evidence has yet been heard.

At the end of Balfour's testimony, she outlined seven changes that have been made at the detachment since Silverfox died: if prisoners vomit more than twice, they must

receive medical attention; if a prisoner vomits, urinates or defecates in the cell, they must be moved immediately and the cell cleaned; if a prisoner is considered "high-risk” a second guard must be called in to monitor that person one-on-one; if a person has a blood alcohol level of over 350 mg per cent, the ambulance must be called; the RCMP watch commander must go to cells and note the condition of all prisoners; any time the ambulance attends, it must be noted in the emergency medical services log book; and guards must note if they do a physical check or a monitor check of the prisoners.

But as lawyer Lee Kirkpatrick pointed out this morning, these are long-standing policies, which were not being followed at the time Silverfox died.

The corner's inquest into Silverfox's death is scheduled to continue until Friday. The two-woman, four-man jury will then be asked to determine how Silverfox died and will be invited to make recommendations on how such a death may be prevented in the future.

Their recommendations are non-binding and they are not supposed to find fault as in a trial.