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SOMBA K'E/YELLOWKNIFE
A coroner's report released Friday is finally shedding some light on the circumstances surrounding the sudden death of 29-year-old nurse Tara Osmond after a Halloween party in 2009.

Tara Michelle Osmond worked as a medevac nurse after arriving in Yellowknife in 2009. NWT Coroner Cathy Menard has determined the 29-year-old died after a night of partying and injecting intravenous drugs. - Facebook photo

Coroner Cathy Menard has ruled that Osmond's death on Nov. 1, 2009 was accidental, the result of what she calls "multiple drug and alcohol toxicity."

Osmond, a Newfoundlander who had moved to the NWT in 2009, was originally employed in Yellowknife as a medevac nurse for Advanced Medical Solutions Inc. but had moved to Behchoko that September to work as a community health nurse.

According to Menard's report, Osmond's friends were concerned the nurse was abusing expired narcotics, injecting them intravenously. Both the narcotics and the intravenous supplies were being taken from Advanced Medical Solutions Inc., they said.

The night before she died, the 29-year-old had travelled to Yellowknife from Behchoko for Halloween. She had dressed up as 1980s pop icon Cyndi Lauper and had begun her night with a few drinks in a hotel room among friends.

Around 11 p.m., the group headed to the Raven Pub, where they remained until about closing time, according to Menard's report. Osmond, her then-boyfriend and another female friend then left the pub to go to a friend's apartment.

The friend, the report states, was a female nurse who worked for Advanced Medical Solutions Inc.

While the boyfriend went to sleep in one bedroom, Osmond and two friends went into the other bedroom, sat on the bed and inserted IVs into each other's hands. They injected each other with drugs and went to sleep.

Around 11 a.m. the next morning, Osmond's boyfriend found Osmond lying on the living room floor unresponsive. He ran to the bedroom and woke up the still-sleeping friends, who started CPR while emergency personnel were on their way to the apartment.

Osmond was pronounced dead at Stanton Territorial Hospital at 11:50 a.m.

Police initially called Osmond's death "suspicious in nature" but announced more than a year later, in November 2010, that the investigation was complete and no charges would be filed.

Menard's report states that Osmond had a history of depression and was being treated with an anti-depressant called Citalopram.

A post-mortem toxicology screening showed the drug was in her system, along with alcohol, narcotic pain relievers fentanyl and meperidine, minor tranquilizers lorazepam and diazepam and an antihistamine called diphenhydramine.

"The combined toxic effect of these drugs and the alcohol was thought to be sufficient to account for death," wrote Menard.

An autopsy found two fresh skin puncture sites on Osmond's left hand and wrist and two, possibly three, fresh skin puncture sites on her inner right elbow.

"There were no other injuries and no obvious natural disease processes identified to account for death," Menard stated.

According to Menard's report, Advanced Medical Solutions Inc. operates two sister companies under its umbrella. One company is under contract with Stanton Territorial Hospital to provide medevac services to residents of the NWT. The other provides medical services to a variety of mining, exploration and construction companies through remote site support.

The companies share a narcotics locker, which all employees were able to access. The locker contains kits carried by the nurse or paramedic on the medevac flight and also contains a stockpile of extra drugs.

Menard's report states that certain safeguards were in place to hinder drug theft.

The supply of narcotics for the medevac flights is counted daily. Employees must sign out any narcotics needed for the flights in a logbook, verified the next day in the daily check.

Patients' charts and the drug log record usage of the narcotics. Wasted medication must be destroyed and the destruction witnessed by another health care professional. Employees must account for broken narcotic vials on a drug control list.

Some narcotics are kept in an unlocked fridge, though these are also counted by staff. Each Monday a drug inventory is completed over and above the daily check.

Things proceeded somewhat differently under the second sister company's regime.

"The narcotics from the industrial side of the business are narcotics that have come back from different site camps," wrote Menard.

"These narcotics, which are expired, are counted when they come back to the company for placement in the narcotic locker. They are stored in the locker until the company has heard back from Health Canada with instructions on how to dispose of them.

"Prior to Ms. Osmond's death, the last time there was a disposal drug count completed was March 2009, before the manager of the industrial side left the company," wrote Menard.

Menard's report states that during her investigation there was no logbook located with the records of the incoming drugs for disposal.

After Osmond's death, however, all expired drugs were removed from the locker and kept in the owner's office.

"Today those expired drugs are kept in a separate locker with an up-to-date logbook and the expired drugs are destroyed in a timely fashion," she wrote.

Reached by phone on Friday, Sean Ivens, president of Advanced Medical Solutions Inc., offered his condolences to the Osmond family.

"Tara did work here and was part of our work family and she was quite close with a lot of our staff," he said. "So when this happened, you know, she was no longer working here but it did impact our staff and it was a tragic and sad time, for sure, for everybody concerned."

For Ivens, the question lingers as to whether the drugs that contributed to Osmond's death were, in fact, stolen from his company.

"There was no evidence that the drugs had ever come from our location," he said. "If the drugs did come from there then we're a victim of crime just like anybody else would be in the event of theft. The people involved worked at other health-care facilities and potentially had access to narcotics at other health-care facilities as well."

Though he defended the company's former policies, he said its practices have been updated to minimize any future risk.

"We had a good system before.

We've made our system better. And, you know, if a thief wants to get access to something they can do so. It doesn't matter how big a lock you put on it, there's always a way around the system. And so we try to do our best to minimize that risk and when events happen similar to this then you strengthen your security.

"I can tell you that we do go above and beyond what's required and we have a very robust narcotic handling procedure."

Menard's report contains just one recommendation: "We recommend that the Stanton Territorial Health Authority complete an independent audit during the lifetime of all medevac services contracts to ensure policies and proper procedures are being followed for quality assurance."

The Health Authority is not required to implement the recommendation but Ivens said he would be receptive to an audit. The company is still under contract with Stanton Territorial Health Authority.

"I'm more than OK with that and in fact it actually strengthens the system because it makes us all take a good look at the procedures," he said. "I'm a firm believer that the more you get looking at something the better your product is going to be."

Osmond was the only child of Sharon and Leonard Osmond of Newfoundland. She grew up in Hermitage-Sandyville, a town of fewer than 500 people, her father told Yellowknifer five days after her death.

Osmond had worked as a nurse in St. John's and Halifax before moving to Yellowknife in January 2009. "She said, 'Dad, I want to go up there because the money is better.' She had a car she wanted to pay for and student loans," Leonard Osmond told Yellowknifer more than two years ago.

Osmond's parents could not be reached for comment for this story.

A few months before her death, Osmond had a scare that could have saved her life. She told friends she had taken narcotics intravenously and had been unconscious for about 24 hours.

"It was stated that this had scared her and she promised she would never do this again," Menard wrote.

News/North is still awaiting information from Health and Social Services spokesperson Damien Healy regarding the current status of the contract between Advanced Medical Solutions Inc. and Stanton Territorial Hospital.

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