Skyler Sappier knew he was sick and was scared, a coroner's inquest into the Saint John inmate's death heard Wednesday.

Dr. Mark McGraw, the emergency room physician who treated him at the Saint John Regional Hospital on Jan. 29, 2022, testified he was worried too.

Although he had dealt with many COVID-19 patients, it was very unusual to see such rapid deterioration and severity of illness within one day of testing positive, he said.

Sappier, who was double vaccinated, was visibly unwell, said McGraw.

Based on a physical exam, and with his breathing having the tell-tale coarse "Darth Vader" sounds, it was quite obvious the 28-year-old had severe pneumonia, he said. A portable X-ray later confirmed this diagnosis.

In addition, Sappier's blood work showed "severe systemic illness," with a heart rate of 144 beats per minute, instead of the normal rate under 100, and his respiratory or breathing rate was 24 to 30 per minute, when a healthy young man should be between 16 and 20, said McGraw.

A bearded man wearing a blue blazer and white collared shirt, exiting a building, holding a brown envelope.
Dr. Mark McGraw said he tried his best to reassure Sappier when he treated him at the Saint John Regional Hospital's emergency department on Jan. 29, but his condition deteriorated quickly. (Roger Cosman/CBC)

His blood oxygen saturation levels, which had been between 89 and 93 per cent at the Saint John Regional Correctional Centre, had "normalized" to above 94 per cent after nurses put him on oxygen. But Sappier, who initially was able to converse with him in "somewhat full sentences," soon tired.

"I certainly as much as I could … tried to reassure him," said McGraw, noting it can be difficult to develop a rapport when wearing full personal protective equipment. "But he was sick and unfortunately he did appear scared as well."

Sappier died Jan. 31, shortly after 3 a.m. — just nine days before he was scheduled to be released from custody.

Emotional day for family

A jury of four women and one man will determine the facts surrounding Sappier's death and have an opportunity to make recommendations aimed at preventing deaths under similar circumstances.

During Wednesday's proceedings, several members of Sappier's family looked on from the front row of the Saint John courtroom, where a blanket with images of him and the message "Forever in our hearts," was spread out for the jury and presiding regional coroner Michael Johnston.

A sad-looking woman looks down at a tiny urn in her hands.
Before Wednesday's proceedings, Skyler Sappier's sister, Raeann Michaud, clutched a tiny urn containing some of her brother's ashes. (Roger Cosman/CBC)

The family, members of Neqotkuk First Nation, also had sprigs of cedar scattered at the feet of — and taped above — the courtroom doorways, with the intent, they said, that it absorb all the negative energy of the day and later be burned.

During a morning recess, one of his sisters, Raeann Michaud, sobbed in the hallway.

'He told me to do whatever I could for him'

The family heard that McGraw realized soon after Sappier's arrival at the hospital that he would have to be transferred to intensive care and intubated — "the most aggressive form of care anyone can get," and not something they do lightly.

"Despite everything we had done, he continued to deteriorate," McGraw said.

Crown prosecutor Patrick Wilbur asked if Sappier could have had pneumonia for a number of days before he was admitted to hospital. McGraw said it was possible.

He said he told Sappier he was "unfortunately quite ill," and while he didn't think he was going to die, they did have to intubate him. He asked Sappier if he wanted the hospital to call anybody for him, but he refused.

"He told me to do whatever I could for him."

By about 8:53 p.m., Sappier was in a medically induced coma.

It was only three days earlier that Sappier had started feeling unwell, McGraw said. It started with a sore throat, progressed to a cough and then shortness of breath that day, he said.

Sappier first reported feeling unwell to jail staff on Jan. 28 and tested positive for COVID-19 on Jan. 29, shortly before he was transferred to the hospital, the court heard Tuesday.

Nothing delayed Sappier's treatment, said McGraw. In fact, there was a blizzard that day, so the emergency department was less busy than usual, with only 51 patient visits, about half the daily average, he said.

The inquest continues Wednesday afternoon and is scheduled to continue through Friday.

An inquest is a formal proceeding that allows for the public presentation of all evidence relating to a death. The New Brunswick Coroner Service is an independent fact-finding agency that does not make any finding of legal responsibility.

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