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Drugs and alcohol played a role in all four of the Whitehorse Emergency Shelter deaths currently being examined by a coroner’s inquest in Whitehorse, according to testimony from a forensic pathologist on April 16.
Dr. Elizabeth McKinnon, from the BC Coroners Service, was brought before the inquest as an expert witness.
She performed autopsies on two of the deceased women whose deaths are being probed, Josephine Elizabeth Hager and Darla Skookum.
Both women died in the first half of 2023.
The inquest’s six-person jury is also tasked with determining the facts and circumstances relating to the deaths of Cassandra Warville and Myranda Aleisha Dawn Tizya-Charlie.
All four of the deceased were Indigenous women from the Yukon who died inside the territorial capital’s emergency shelter.
McKinnon performed an autopsy on Hager on Feb. 3, 2023, at the request of the Yukon Coroner’s Service. Hager was reported dead on Feb. 1, 2023, at the age of 38.
Significant findings made during the autopsy of Hager were described to the inquest, namely that McKinnon found fluid in the deceased’s lungs, which were heavier than usual.
“When the heart stops, the lungs will sort of collect fluid, and so they become congested and very edematous (swollen with an accumulation of excess fluids). Additionally, lungs can become very heavy, as it was in this case, during drug intoxication,” McKinnon said.
Microscopic examination of Hager’s organs revealed evidence of “very mild” fatty liver disease, which likely resulted in reduced liver function.
Meanwhile, Hager’s kidneys showed she may have suffered from high blood pressure and had an undiagnosed kidney disease.
“Fatty liver disease is an illness of the liver in which fat builds up in the liver cells. This is usually caused by either alcoholic use (or) diabetes — there are some other entities that caused it, but those are the top two,” McKinnon told the inquest.
As for the cause of Hager’s death, McKinnon told the inquiry that her determination after reviewing toxicology reports was that the “most important” cause of death was combined alcohol and morphine toxicity.
She also identified several factors that contributed to Hager’s death, including fatty liver disease and the deceased’s kidney issues.
McKinnon conducted Skookum’s autopsy on April 19, 2023, only a few days after she was discovered dead in an overflow sleeping room at the shelter. Skookum was in her early 50s at the time of her death.
The inquest heard that McKinnon observed changes in Skookum’s brain, which the pathologist concluded were likely due to Skookum’s age, illnesses and “substance use and alcohol use.”
The changes in Skookum’s brain could cause several changes to how her body would have functioned, including “reduced consciousness, reduced reaction time for overall health symptoms similar to dementia.”
McKinnon further noted that Skookum’s lungs were “a little on the heavy side,” with a slight increase in fluids in the lungs after death.
Skookum’s autopsy also revealed about 200 millilitres of fluid in her abdomen, which is usually indicative of poor liver function.
McKinnon observed significant liver disease in Skookum and called her liver “severely compromised.” The autopsy also showed that Skookum, like Hager, had damaged kidneys.
Skookum’s cause of death was acute alcohol toxicity, according to McKinnon, with cirrhosis of the liver, severe fatty liver disease and cocaine and hydromorphone use listed among contributing factors.
“The alcohol concentration of the femoral blood was 382, and typically, blood alcohol levels exceeding 350 are considered consistent with being life-threatening,” McKinnon said, referencing the toxicology reports done on Skookum. (Femoral blood samples are taken from the legs.)
The pathologist additionally noted that she learned through Skookum’s medical records that she had hepatitis C, which is significant because “hepatitis C, on its own, can cause cirrhosis of the liver.”
In video footage played previously during the inquest, which showed Skookum being found unresponsive at the shelter, fluids are visible on the pillow her head was resting on. McKinnon testified that the substance was likely “purge fluid,” which is a decomposition fluid that may be ejected from the mouth and nose following death. No vomit was found in Skookum’s airways.
A legal counsellor participating in the inquest noted that the video footage previously aired during the proceedings showed that Skookum was placed on her stomach on a mattress on the floor and that she did not move between the time she was placed on the mattress and when she was discovered the following morning — a roughly 12-hour period. McKinnon was asked if Skookum might have been dead for 12 hours, to which McKinnon responded, “Yes, it’s possible.”
Under cross-examination by a lawyer for Little Salmon/Carmacks First Nation, McKinnon confirmed that a person’s body position could contribute to respiratory depression (slow and ineffective breathing). McKinnon further confirmed that lying a person in the “recovery position” (on their side) will allow them to breathe better than lying them on their stomach, which could exacerbate respiratory depression.
When asked if positional asphyxia (when someone’s body position prevents them from breathing properly) could have contributed to Skookum’s death, McKinnon said it was “possible.” However, she later clarified that she found no evidence of positional asphyxia when analyzing Skookum’s body.
McKinnon did not perform autopsies on Warville or Tizya-Charlie. However, she did review several reports and relevant documents related to their deaths. Warville, 35, and Tizya-Charlie, 34, both died at the shelter on Jan. 19, 2022; their unresponsive bodies were found in a shower room at the shelter.
Based on the information available to her, she concluded that Warville died from complications of alcohol and fentanyl intoxication, with cocaine use as a contributing factor.
McKinnon also concluded that Tizya-Charlie’s death could be blamed on the consumption of drugs and alcohol.
“After reviewing the preliminary draft report and final toxicology for this decedent, I concluded that the cause of death was complications of combined drug and alcohol intoxication. And the drugs in question are doxylamine, fentanyl and etizolam, and with cocaine use as a contributing factor,” McKinnon told the inquest.
However, under cross-examination from a lawyer for the Yukon government, McKinnon acknowledged that, since she didn’t perform the autopsy on Warville and Tizya-Charlie, it’s possible that other factors — such as disease — could have played a role in their deaths.
The coroner’s inquest began on April 8 and is anticipated to last three weeks.
Inquests held by the Yukon Coroner’s Service are intended to serve three main functions: determine the facts related to a death (or deaths), make recommendations — if appropriate and supported by evidence — to prevent future deaths in similar circumstances and assure the community that the death (or deaths) is not being overlooked or ignored.
Coroner’s inquests are not an adversarial process or trial and are not intended to assign blame.
Rapid access counselling is available in the Yukon from Mental Wellness and Substance Use Services by calling 867-456-3838. Additional support includes the Suicide Crisis Helpline (call or text 988), Hope for Wellness (1-855-242-3310) and the 24-Hour Residential School Survivor Crisis Line (1-866-925-4419). The Selkirk First Nation, the Little Salmon/Carmacks First Nation and the Vuntut Gwitchin Government are offering counselling and support specifically for their citizens.
Contact Matthew Bossons at matthew.bossons@yukon-news.com