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Cynthia Blackjack

Utmost was done to save woman: paramedics

Two paramedics who medivaced Cynthia Blackjack from Carmacks to Whitehorse testified Friday that the critical care team did everything in their power to save her life.

By Gabrielle Plonka on January 27, 2020

Two paramedics who medivaced Cynthia Blackjack from Carmacks to Whitehorse testified Friday that the critical care team did everything in their power to save her life.

“I felt confident in our skill set and how it was applied, and we advocated for this patient appropriately,” Mark Loewnberger told counsel at a coroner’s inquest.

“I felt confident Cynthia Blackjack had the best care applied to her.”

Loewnberger and fellow paramedic Erik Miller were providing care to Blackjack, alongside Dr. Jake Morash, when she suffered cardiac arrest on the flight from Carmacks to Whitehorse on Nov. 7, 2013.

The inquest, which entered its sixth day of proceedings today, is investigating whether systemic racism in the Yukon’s medical system led to Blackjack’s death in 2013.

Friday’s testimony included a detailed review of the timeline from Blackjack’s arrival by ambulance at the Carmacks health centre on Nov. 7, to the arrival of the plane in Whitehorse that evening, where she was pronounced dead on-scene.

One question the inquest seeks to answer is whether Blackjack should have been transported to Whitehorse sooner.

Friday’s review of the timeline found a medical evacuation (medevac) was requested for Blackjack 25 minutes after she arrived at the Carmacks health centre by ambulance. The evacuation was requested at 10:54 a.m., and the plane left Whitehorse at 12:45 p.m., arriving in Carmacks at 1:10.

Both Loewnberger and Miller testified this is a reasonable timeline to prepare a medevac plane, which includes the gathering of all necessary equipment.

It was noted that Miller was on scheduled leave that day, with plans to attend the funeral of a colleague.

He was collecting some belongings from the medevac room when he received the call to assist Blackjack. He subsequently cancelled his leave to accompany Loewnberger on the flight.

Miller testified that Blackjack was “critically ill” when the medevac team arrived in Carmacks that afternoon.

“It was consistent with, but actually worse than, what was described to us,” Miller said. “Not to say the previous report was wrong, but the patient was continuing down a disease pathway.”

The situation’s severity caused a three-hour delay in leaving Carmacks.

“Prior to flight, we had to identify and correct any conditions we can that would compromise her safety during transport,” Miller said.

“I’ve had flights which have taken eight hours prior to departure –– sick patients often take a very long time to prepare.”

Both Loewnberger and Miller said they fought to bring Blackjack to a place of stability before beginning transport; however, faced with loss of light that afternoon, they were forced to begin the transport process.

The medevac plane departed Carmacks at 5:18 that evening.

While in flight, Loewnberger, Miller and Morash continued to provide care to Blackjack.

Miller noted that an aircraft is a “terrible work environment” because it’s dark, loud, there are changes in pressure and care must be provided in a cramped space that only allows access to one side of the patient.

It was testified that Blackjack suffered cardiac arrest minutes before landing in Whitehorse and was pronounced dead on-scene.

The coroner’s report that followed Blackjack’s passing accused the medevac team of delaying intubation treatment and bringing the wrong equipment to the scene.

Loewnberger and Miller said the representation in the report and in media reporters were misconstrued, and they felt confident in the treatment they provided.

“The allegations that have been levelled against us by the previous coroner’s report stung a little,” Miller said.

Both were asked to address how the incident has affected them on a personal level.

“We are trained to distance ourselves a little bit for our own mental health which is meant to be protective, but that can be really hard to do when you work really really hard to try to save somebody for hours on end and you don’t have a positive outcome,” Miller said.

“I’m somebody who cares about doing the best job I can for my patient. 

“I was emotionally upset by having worked so hard and having a patient fatality. She was a person who died young.”

The inquest continued today with scheduled testimony from Matt Lewis, a Carmacks nurse, and Corey Banks, a Yukon government expert witness.

Peter Chisholm, a territorial court judge, is presiding over the proceeding at the Kwanlin Dün Cultural Centre. It’s designed to determine the facts behind a death but not assign responsibility to any person or agency.

The inquest is taking place after several years of court proceedings that originated with the Yukon Coroner’s Office’s initial refusal to hold an inquest, which Blackjack’s family and the First Nation had sought.

Comments (13)

Up 8 Down 1

drum on Feb 1, 2020 at 6:06 pm

Only answer - have only First Nations nurses and paramedics in First Nations communities.

Up 20 Down 1

yukoner on Feb 1, 2020 at 8:34 am

JC, you say "The barriers that First Nations face in school, in receiving health care, in employment, etc are real and large."
FN's have access to the same education as everyone else, even more scholarships to be had if you apply for them. YTG advertises jobs which read " FN's preferred" and we are not only talking low entry jobs here. Health Care - same as everyone else. It's about choices in life and self responsibility. I am a visible minority too and get along in life just fine. So, please enlighten me about the "barriers" FN's have that others don't.

Up 14 Down 1

Martin on Feb 1, 2020 at 7:06 am

JC: recently our community saw a fellow member dying due to lack of service for his specific illness. Our medical system could not provide it; ..... was that racist?. His family and friends didn't play the race card. I guess this shows something about all of us.

Up 24 Down 3

Josey Wales on Jan 30, 2020 at 5:28 pm

Hey JC...comments above? ...below.
Kinda ironic but you are 180 degrees off, in virtually everything you just espoused.
I get the point though...victim, racism, whitey bad.

I do agree with you on the tragic nature of this ladies passing.

Up 37 Down 2

Keep on playing the race card on Jan 30, 2020 at 4:30 pm

Hi JC,
What made you comment and blame racism for this preventable death?
When this person chose to drink themselves to death before their 30th birthday, was that racist?
Or perhaps all her friends and family in Carmacks not being able to give her a 2 hour ride to Whitehorse, was that racist?
Maybe the nurses and medevac workers were racist for helping her and telling her what to do?
Jeez, I am so sick and tired of this word, racist and racism being thrown around when it comes down to personal responsibility and choice. Did anyone put a gun to her head and tell her to drink? Exactly.

Up 4 Down 44

JC on Jan 30, 2020 at 10:47 am

Based on the comments above, systematic racism is alive and well. The barriers that First Nations face in school, in receiving health care, in employment, etc are real and large. For such a young person to die this way is tragic, First Nation or not. But something different needs to be done to prevent these senseless deaths, and it starts with empathy and a willingness to learn about culture, healing, history and truth. There may have not been anything the first responders could of done, but what about the community health care system as a whole? We need to do better.

Up 10 Down 45

Community Resident on Jan 28, 2020 at 3:35 pm

I as a person who has had to deal with a community station can sympathize as I have had a similar experience. My health condition severely acted up just before Christmas holiday time. I went to the station on the Saturday and was informed that yes you need to get to Whitehorse hospital because there is nothing we can do for you. So I ask how do I get there if I can not drive and was told good luck and sent along my way.

I finally found someone in Whitehorse that came and got me but I should have been taken by ambulance whether it was air or ground, that is the condition I was in. I also should have been admitted but because I came in on my own. I was treated like nothing was that wrong~~not WGH fault. My diaphragm, heart and lungs were being affected hence the Doctors wouldn't let me go home for 2 weeks and had to find a couch to make a home.

Anyone in a community that requires an ambulance of sorts, if it is a volunteer EMS and no one is available, the Nursing Station is supposed to call the Whitehorse line and something is dispatched whether its air/ground.
I got this information after I sent email to the Minister of Community Services because EMS falls under that branch of Yukon Government. When it got looked into, and very quickly I must say, I got calls from the Directors of the EMS as well as Manager of Community Nursing and when they all reviewed the file, all I heard was "we can not apologize enough, you should have been taken to WGH by ambulance" and then informed me of What Should Have Been Done.
Now they think I am over reacting when I inquire about EMS coverage when I have certain Medical procedures done because if there is NO ONE available, I have to know how I am going to get to the medical professionals if an emergency should arise again.

In this situation the medevac persons were dealing with something that probably shouldn't have happened to begin with if policy and procedures were followed and not brush a person off because of personal judgments or lack of knowing policy or plain just don't care anymore.
I can tell you that even a year later the station that I have to deal with still treats me like there is nothing wrong with me regardless of the medical history I have and they know it.

Again, I feel for the family and I am glad that they haven't given up on fighting for fair/equal rights and treatment.

Up 70 Down 6

RG Jones on Jan 28, 2020 at 11:41 am

It is unfortunate but it seems like her health issues and chronic conditions are at the root of this. Knowing both of these Flight Medics I would entrust my family to their care knowing they were going to get the best care available. So sad for all involved in this case.

Up 68 Down 8

Wes on Jan 28, 2020 at 7:43 am

Ultimately, it’s an individuals responsibility to live a healthy lifestyle.
You also have the right to live at risk, but don’t expect others to magically put you back together again time after time.

Up 23 Down 5

JC on Jan 27, 2020 at 5:17 pm

Rob, I could answer your last question, but won't. I lived in Carmacks for some time a few years ago.

Up 77 Down 9

John on Jan 27, 2020 at 4:30 pm

First you blame the nurses, then the paramedics and doctor, then the government and the system...enough! As sad as this story is, place the blame where it belongs. It is a lifestyle choice and risks with consequences, stop blaming others.

Up 142 Down 21

Rob on Jan 27, 2020 at 4:07 pm

She was told to find a ride to the Whitehorse hospital. Did she actually phone any family or friends? Probably not. I find it hard to believe one person in the community wouldn’t drive her to town if she put in the effort into looking for someone. Even if she did put the effort in multi-organ failure caused by hyper-acute liver failure isn’t something paramedics can make magical disappear... I know this well cause because I used to drink a lot but have chose life over my drinking problem and I used to be a paramedic....it’s ludicrous to bring discrimination into trying to give someone the best medical service they can.
It’s sad that’s for sure...but where were her people, her friends and family before it got to this point.

Up 158 Down 4

Thanks on Jan 27, 2020 at 4:02 pm

Thank you to the paramedics for doing what they could and even answering the call on a scheduled day off. What happened to Cynthia is a tragedy, but flight paramedics are extremely high quality medical professionals. Even the best lose patients some times.

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