Hamilton woman still wants accountability after inquest into brother's 2017 death in jail

The sister of a 34-year-old man who died in the Hamilton-Wentworth Detention Centre nearly eight years ago says the team who conducted the inquest was "fabulous," but she's frustrated she wasn't able to hold anyone accountable through the process.

Amy McKechnie, whose brother, Ryan McKechnie, died on June 29, 2017, said it was also a "kick in the face" that it took nearly eight years to hold the coroner's probe. 

Ryan accidentally died of combined fentanyl, methamphetamine and amphetamine intoxication, the inquest jury found in February. But coroner's inquests aren't tasked with assigning blame or make findings of guilt or innocence, something Amy found frustrating since she believes the jail could have taken steps to prevent his death.

"We're going to prevent future deaths hopefully, but what about my loved one?" Amy said in an interview with CBC Hamilton.

Amy believes jail staff erred in putting Ryan in a cell with another inmate after guards found contraband in the cell they were sharing. She said a body scan of the other inmate showed anomalies, suggesting he had ingested packages of drugs. The next morning, Ryan didn't wake up for breakfast and his cellmate called for help.

Amy said people who worked as corrections staff at the time testified at the inquest. She said one witness told the jury he would have done things differently looking back. None of the other workers said they'd change their actions, she said, adding she found that "disgusting."

Since Ryan was incarcerated, an inquest into his death was mandatory under Ontario's Coroners Act. During such procedures, lawyers for the coroner's and parties, including family members of the deceased, ask questions of witnesses — they can include eyewitnesses, experts, and institutional workers and officials. 

Inquest juries may make recommendations aimed at preventing future, similar deaths. The jury in Ryan's inquest issued 18, most of them focused on the Ministry of the Solicitor General, which oversees corrections. They include:

In December, a weeks-long inquest for six men who died at the Hamilton jail between 2017 and 2021 led to 55 recommendations. They included developing a plan to offer a safe drug supply within the institution, ensuring inmates won't be penalized for reporting overdoses and improving access to treatment for substance use disorder. 

Ryan's death was originally going to be included in that inquest, Amy said, but it was held virtually and she pushed for an in-person proceeding, feeling it would be more "humane." On her request, Ryan's inquest was in person. The coroner's office held it in Toronto.

Amy said she followed the fall inquest and she attended one in 2018 that examined eight deaths at the detention centre between 2012 and 2016. It resulted in 65 recommendations, but close to half of them haven't been put into force, the fall inquest heard. Recommendations by inquest juries are non-binding — another thing Amy said she wishes would change.

For Amy, one of the key recommendations in Ryan's inquest is that the ministry fund support for families of inmates who die. She said she received little, if any, support after she learned through a friend that Ryan had died and then went to the jail to confirm it. 

In a brutal coincidence, she said, her dad died the same day.

"I don't think I ever grieved for them. I just kept on going."