A judge has recommended that Winnipeg emergency service workers develop better protocols for dealing with people experiencing a mental health crisis, following an inquest into the death of a man who died after police subdued him with a stun gun during a 2019 arrest.
Viengxay Chommany, 42, was pronounced dead at St. Boniface Hospital on Aug. 4, 2019. His death followed a police chase two days earlier after officers were called about a domestic assault on Consol Avenue, in northeast Winnipeg.
At the age of 21, Chommany had been diagnosed with bipolar disorder and schizophrenia, and required medication to control his symptoms, according to the inquest report signed by provincial court Judge Lindy Choy.
On the night of police encounter, Chommany was “having a bad night” and exhibiting erratic behaviour. His wife called 911 and asked police to come pick him up, indicated that he had a mental illness, was refusing to take his pills and was yelling and harassing her.
Police testified during the inquest that Chommany prevented his wife from answering the door, and felt “she had a look of terror on her face.” the report says.
The officers forced their way inside and separated the couple. They told Chommany to sit down in the kitchen, but he ran out the door. Police caught up with him a short time later.
The officers used verbal direction, soft, open-hand force and Tasers to apprehend him. While being restrained, Chommany stopped breathing.
CPR was administered, but he suffered an anoxic injury to the brain and died in hospital two days later, the inquest report says.
Cause of death
His immediate cause of death was described as complications of anoxic brain injury, probable arrhythmia, and excited delirium, with physiologic stress of physical struggle and restraint being a contributing factor.
At the inquest, chief medical examiner Dr. John Younes explained that even an individual with a healthy heart can die as a result of elevated adrenaline levels.
In Chommany’s case, the underlying high adrenaline state caused by the psychotic episode and the prolonged violent interaction with police “resulted in his exposure to too much adrenaline for too long,” the report says.
“His heart’s demand for oxygen would have outstripped its supply affecting its electrical system and causing cardiac arrhythmia. This caused cardiac arrest, which halted the supply of blood to his brain and caused his death.”
Recommendations
To avoid future deaths such as Chommany’s, the judge recommended that Winnipeg police review their policy and training on responding to incidents where a person is exhibiting hyperactive, agitated behaviour.
That review should include an emphasis on the use of de-escalation techniques prior to putting someone in a physical restraint, and education on the risk of a potentially serious cardiac event when someone is in crisis.
“Recognizing that officers are responding in the moment to dynamic and unpredictable situations, there could nevertheless be benefit further instruction on how to restrain and monitor hyperactive agitated individuals,” the judge’s report says.
The judge also recommended that the Winnipeg Police Service and Winnipeg Fire Paramedic Service establish a specialized unit that could dispatch a police officer and a medically trained individual who can administer a chemical restraint.
The inquest, which took place over the course of six days in April and June, heard testimony from 15 witnesses.
Chommany’s family filed a wrongful death lawsuit against Winnipeg police in June 2021.
Kris Saxberg, a lawyer representing Chommany’s family, said the lawsuit is still before the courts, and that the family is hopeful the results of the inquest will lead to a settlement.
A spokesperson for the Winnipeg Police Service previously declined to comment on the lawsuit because the matter is before the courts.
Manitoba’s police watchdog, the Independent Investigation Unit of Manitoba, closed its probe into Chommany’s death