Testimony wraps at coroner’s inquest into overdose death of UVic student

Jury deliberations are set to begin now the witness testimony at the coroner’s inquest into the fentanyl death of a University of Victoria student has ended.

Nearly three dozen witnesses have taken the stand over two weeks to lay out the facts surrounding the accidental overdose death of Sidney McIntyre-Starko – and the emergency dispatch procedures undertaken as the tragedy unfolded.

A coroner’s inquest has heard McIntyre-Starko and two other University of Victoria students ingested fentanyl-tainted cocaine on the evening of Jan. 23, 2024, in a dorm room on campus.

McIntyre-Starko, 18, and one of the other students went into medical distress.

Other students called campus security and 911 but did not immediately tell either that drugs were involved in the medical emergency.

As a result, the 911 dispatcher began working through protocols for medical possibilities that did not involve an overdose.

Eventually, one of the students admitted to the 911 operator that the students had taken drugs.

When a security guard heard the student say that he administered naloxone, a drug that can rapidly reverse an opioid overdose.

One of the students experiencing medical distress survived, but McIntyre-Starko did not.

The inquest heard there was a 15-minute delay between the time McIntyre-Starko collapsed until security injected her with Naloxone.

• Read more: UVic’s overdose policies didn’t ‘meet the moment’ before student’s death: report

Jeff Clawson, an American medical doctor, who has spent nearly 50 years practising medicine, testified via Zoom from Salt Lake City, Utah, on Monday morning.

He helped design the Medical Priority Dispatch System used in B.C. and he told the inquest the 911 call in this case was one of the five or six most complex he’s heard in his entire career.

“It was a really tough one. My heart went out to everybody on this call, from the patients to the dispatcher – everybody,” he said.

Clawson said if the dispatcher had known immediately that the students had taken drugs, they likely would have gone to “protocol 23” in his system, which applies to overdoses.

“Multiple patients unconscious is something we want to look at in multiple ways,” he said.

Tuesday morning the presiding coroner will charge the jury with final instructions before deliberations begin.

The two men and three women will then determine an official cause of death and come up with a list of recommendations that could possibly help prevent similar deaths from occurring in the future.

They are not allowed to lay fault or blame on any person or entity for McIntyre-Starko’s death.