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The Globe and Mail
Colin Perkel, TORONTO — The Canadian Press
A teenager who strangled herself in her prison cell was a happy, independent child but who became obsessed with knowing details of her parentage, her adoptive mother said Wednesday.
Testifying at the inquest into her daughter’s death, Coralee Smith said Ashley showed few signs of problems growing up but that changed drastically in her teen years.
“Most of her life, she was smiling and happy,” Smith testified.
Coroner’s counsel Marg Creal asked what Ashley liked as a child:
“Oh my goodness, what did Ashley like? Quiet time and doing her own thing. She loved her doll,” Smith answered, her hands twisting a piece of paper.
“Ashley was very independent.”
Beyond some report card comments that Ashley talked too much or could be disruptive in class, there were no issues at school until about Grade 8, Smith testified.
“I had no calls, no reports before that,” she said.
In Grade 9, however, Ashley was expelled for disruptive behaviour, effectively ending her formal education and setting off a family quest to find help for her.
At one point, Ashley saw a psychiatrist who decided Ashley was “just a normal teenager,” Smith said.
“I’m too fat and I have acne,” was Ashley’s take on the session, her mom said.
“Coming out of that, I’m feeling rest assured that things aren’t so bad.”
But the acting out would increase, and Ashley found herself in trouble with the law.
She would go to a residential facility for an assessment that was supposed to last 34 days but it ended after just 21 days because of her disruptive behaviour.
“She graduated early,” Smith said ruefully.
A psychiatric report from the stay concluded: “She has a huge personality issue in emotional borderline tendencies,”
Ashley was sent home with a prescription for the drug Zoloft.
Smith said she didn’t like giving her daughter drugs, and said she never saw the worst of her daughter’s behaviour.
“At home, Ashley was a mom’s girl.”
Smith, of Moncton, N.B., described how she and her husband of two years, Harold, adopted Ashley as a three-day-old in early 1988.
The relationship with Harold soon ended and Smith got involved with Herb Gorber, when Ashley was about 3 1/2 years old.
Ashley was a home body, who would call her mom early in the morning to come and get her if she spent the night with relatives, Smith said.
Her daughter always wanted to know about her adoptive father, but Smith said she didn’t have much information to give her.
“He never even sent a birthday card or a Christmas card,” she said of her ex. “I can see how that would play on a little girl.”
Smith also said she had held off telling Ashley about her biological parents because she felt the girl was just too young to deal with the information.
Smith, the first witness who is not connected to prison or medical systems, described visiting her daughter both in youth detention and later in adult prisons.
She had little idea about Ashley’s life behind bars, the inquest heard.
“I didn’t press her for anything,” Smith said. “I guess it was self-preservation.”
At a psychiatric prison facility in Saskatoon, Ashley confided in her mother that guards had assaulted her.
“She was held down and punched with closed fist,” Smith said she was told.
“I’m beside myself. You have no one to go to. Your whole world is just twirling.”
At the start of her evidence, presiding coroner Dr. John Carlisle expressed “heartfelt and sincere condolences” for her daughter’s death.
Smith said she had watched the inquest for the first two weeks via webcast.
“The family took the computer away from me. They didn’t think I should be watching.”
Ashley Smith was 19 when she strangled herself in her cell at the Grand Valley Institution in Kitchener, Ont., as guards, ordered not to intervene, watched. She had spent most of her last three years in segregation cells.
Smith continues her testimony on Thursday.
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Psychiatrist prescribed meds for Ashley Smith by phone — (ctv news)
TORONTO — A psychiatrist, who works with some of the most dangerous prisoners in the country, teared up Tuesday as she testified about watching video of prison staff injecting a troubled inmate with medication over her objections.
Dr. Michelle Roy told the Ashley Smith inquest that she was dismayed to discover only recently a “more than huge” discrepancy between what a nurse had described by phone about the teen’s state and the reality of the situation.
“It is still disturbing for me,” Roy said.
“The situation that was described to me was a very severe agitation, that her life was in danger.”
In fact, the inquest has seen — in the video Roy viewed three weeks ago for the first time — Smith was not out of control at the prison in Joliette, Que., when she prescribed a powerful tranquilizer for Smith over the telephone.
Prison staff, Roy suggested, had completely misled her.
“The only explanation I have is they were not used to dealing with this kind of patient,” Roy said.
Prescribing by phone was a perfectly normal practice that relied heavily on the prison nurse to convey accurate information, said Roy.
“The nurse would give me the clinical picture of a patient who would need emergency treatment,” she said.
“The nurse is on site. She has to assess the patient. It’s the nurse’s job to do that.”
CAUTION: THIS STORY HAS GRAPHIC CONTENT.
On a particularly harrowing day in July 2007, a nurse at Joliette Institution for Women called Roy to describe “a very problematic situation.”
The teenager, who had a propensity to self-harm and whose mental health had been deteriorating after years in segregation and multiple prison transfers, was apparently in a severely agitated state.
“It was a very dramatic situation,” Roy testified.
“She had objects in her vagina. She was bleeding. There was a possibility of electrocution.”
Roy advised the nurse to put Smith in four-point restraints, prescribed a powerful tranquilizer, and recommended a transfer to the general hospital for an internal exam.
“My expectation when I gave those orders was to inform security that this patient must be put on restraints immediately, and then offer her medication,” Roy said.
“The most important thing was to calm her down.”
Roy said no one ever informed her in subsequent calls that Smith had been injected over her objections.
Various nurses would call to say Smith was still extremely agitated — something not reflected in the prison video that shows the teen at times bantering and joking with staff.
“The description at that time was very dramatic,” Roy said. “I was assuming that she was out of control.”
Over a period of about 10 hours, the psychiatrist ended up prescribing five sets of injections for the physically restrained teen — believing the inmate was accepting them voluntarily.
Roy, who is currently doing a Masters in bioethics, said the only time she prescribed medicating Smith involuntarily was for a transfer flight, but even then only if the inmate was out of control.
However, the inquest has seen video of prison staff waking Smith, then telling her she had no choice but to accept the drugs even though she was obviously calm and compliant.
One of the nurses involved at the time, Melanie Boucher, has previously testified that she accurately described Smith’s situation, but Roy disagreed with that view.
Roy never met or assessed Smith, who was moved to Joliette for a month in July 2007. All she received was a small medical file that contained “very little information.”
She recommended improved communications among psychiatrists and prison staff, as well as regular meetings with other psychiatrists working in corrections to share experiences and best practices.
Smith, of Moncton, N.B., was 19 when she choked herself to death in her segregation cell in Kitchener, Ont., in October 2007.
May 08, 2013
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Ashley given several forced injections, inquiry told — (Waterloo Region Record)
TORONTO — Ashley Smith received five injections of powerful drugs — including antipsychotics — in less than seven hours while restrained in a bed at Joliette prison in Quebec in the summer of 2007.
Jurors are sitting on an inquest into the death of Smith in her prison cell in the Grand Valley Institution for Women in Kitchener in the fall of 2007. Wednesday, they watched dramatic video of the incident that started with Smith, 19, being taken from her segregation cell by several emergency response unit guards who were dressed in protective gear.
Melanie Boucher, then a registered nurse at the Quebec prison, gave evidence Wednesday and was the individual who gave Smith four of the injections July 22, 2007. Boucher said she administered the drugs under direction she received over the phone by Dr. Michele Roy, a psychiatrist.
Smith was injected four times between 1:09 p.m. and 3:31 p.m. that day. Among the drugs she received were the antipsychotics Clopixol and Haldol, and anti-anxiety medication Ativan. What the inquest hasn’t seen yet, but what has been released in a public document looking into Smith’s treatment at Joliette, is that at 7:57 p.m. that day, another nurse injected Ashley while she was still restrained in the bed.
Relying on her memory, and notes she took at the time, Boucher told the inquest that she received information from Joliette staff that Smith had put a piece of metal from her cell wall, inside one of her body cavities.
Blood was spotted on the floor of Smith’s cell and the front of her antisuicide gown was bloodied, in what was later determined to be Smith’s cut finger. An evaluation of Ashley while she was in her cell determined she was breathing normally and her life didn’t seem to be in danger, Boucher testified.
Boucher said Roy and the head nurse were informed of the situation, and Roy prescribed physical and chemical restraints. There was a fear Smith could harm herself or others with the metal she’d hidden, the inquest heard.
After being taken out of her cell by prison guards, Smith showers, and is seen on the video being escorted by the emergency team, arms cuffed behind her, to another room where she’s strapped into the special bed by her arms and feet, wearing a clean gown.
That’s when she starts getting the medications. The first injection is a slow-acting, longer-lasting mixture; the second, quicker, the inquest heard.
The video is noisy, with Ashley constantly shouting “you’re hurting me,” and “get off me” as the guards restrain her. The guards and Boucher repeatedly tell her to calm down and stop trying to get out of the restraints.
Boucher said that Ashley continued to be agitated despite the injections — the video shows Smith struggling at times, and the guards often use force to get her to lie down when Ashley sits up — and Boucher told the inquest that’s why the injections were repeated.
“I don’t want to lie down,” Smith yells at the guards at one point.
“We’ll give you some more medications, is that what you want?” a woman in the room asks Smith before the second injection.
“No,” Smith says in reply.
The goal set out by the psychiatrist Roy was to get Smith calm enough that she could be transported to a hospital, Boucher testified.
Coroner’s counsel Marg Creal asked Boucher if she had any concerns after giving Ashley the second injection.
“Our concerns were we couldn’t stabilize her sufficiently for the trip to the hospital,” Boucher replied.
“We wanted to stop the restraint measures and put her back in her cell, but she was still agitated,” Boucher said, later adding if Ashley had demonstrated 45 minutes of calm and co-operation instead of the “feverish” state, she could have been put into an ambulance.
During a break Wednesday, Richard Macklin, a lawyer at the inquest representing Ontario’s child and youth advocate, said in an interview the video raises “grave concerns” around the issue of Ashley’s consent to the “extraordinary” injections.
“There’s a flurry of ‘no’ ‘no’ ‘no’ (by Ashley) and to infer a ‘yes’ in any of that would be a stretch,” the lawyer added.