'Just stay still, bud. Help's on the way.' Inquest into AIM death hears details of rescue efforts
How paramedics at the scene and doctors in the ER worked on Darrell Richards, attempting to save his life
William McLeod, an inspector at American Iron & Metal in Saint John, doesn't remember hearing any loud or unusual noises the day Darrell Richards was fatally injured cutting into a pressurized calender roll at the scrapyard nearly two years ago.
He just remembers Richards's cousin Justin saying, "Look at the flock of birds," and seeing the sky "dark," "just filled with stuff."
As McLeod wondered to himself, "Are these birds?" the debris "just kept coming. It was falling down to the ground."
"And then Justin right away said, 'Anybody got eyes on Darrell?'"
'No idea what happened'
McLeod rushed to the scene and found the 60-year-old contractor lying on the ground. He called out his name and shook his arm as he checked him over for injuries and called 911.
Richards sat up and grabbed his hand to get up. "I thought he was going to break my hand," said McLeod. "Darrell was a very strong man."
"I said, 'Darrell, you've been in an accident. … Just stay still bud. Help's on the way.'"
McLeod's testimony was one of several a coroner's inquest heard this week about the dramatic efforts June 30, 2022, to save the life of Richards.
McLeod had "no idea what happened, what was going on," but saw Richards's jeans were torn and that he was bleeding from his groin area.
"I ripped my shirt off to plug the hole [and] put pressure there," and asked another employee who came over to lean on him to keep from getting up, he said.
Richards had been working alone, attempting to strip cotton material from the calender roll — a 24,000-kilogram cylinder of steel used in paper production, so it could be chopped up and recycled, the inquest heard.
These rolls are typically lined with 13,000 to 15,000 pounds of cotton sheets, which are compressed under as much as 2,600 tonnes of pressure.
Richards was sitting on the roll when he cut into it with a circular saw. The inquest saw a short security video showing the sudden release of energy that wounded Richards and sent pieces of the blue material flying high in the air and scattering across the west side facility.
The jury recommended changes in safety, communication, purchasing and inspection to try to prevent future deaths or injuries.
Was joking around, 'Darrell being Darrell'
There were "no tags, no warnings, no nothing" on the calender rolls, said McLeod, who, like other employees, testified he was unaware of the potential dangers of decommissioning them. "When I looked at [the material], it looked like Bristol board, things that kids would do projects on," he said.
"If Darrell would have known anything about these things, he would have been [nowhere] near that," he said, describing Richards as very safety-conscious and the first to speak up if someone wasn't wearing their protective gear.
Despite his severe injury, Richards was still talking and joking around as they waited for emergency crews, said McLeod. "Darrell being Darrell," he said, as members of Richards's family nodded knowingly from the front row of the courtroom. "To know Darrell was to love Darrell."
Ambulance not equipped for this type of injury
Saint John police Const. Jennifer Bergeron was the first to arrive on scene. She was working on the north side with an auxiliary member when the call about an industrial accident at AIM came in at 1:32 p.m.
"The report we got was that an explosion occurred and that there was a male who was injured," she said.
They were not dispatched, but were on the Wall Street overpass and Bergeron "figured that was a quick hop on the highway, get right there."
Four minutes later, AIM security escorted them to Richards, who "was complaining of being hot, that he was having a hard time catching his breath," she said.
Bergeron instructed McLeod to continue applying pressure and "not a minute later … medics arrived."
Norma Hicks, a primary care paramedic with Ambulance New Brunswick, said she and her partner arrived within seven minutes, which is a standard response time. They weren't sure where they were going, but saw the police vehicle's flashing lights and followed those.
"There was a lot of people standing around and … obviously a lot of chaos because people are scared and excited," said Hicks, who has about 24 years of experience.
This is a type of accident or injury that doesn't need me, he needs a hospital.- Norma Hicks, paramedic
Richards was lying on his side, so she asked others to help roll him onto his back so she could assess him.
He was "cut quite badly in between the legs," she said. "I asked my partner to grab towels, blankets, anything" to try to pack the wound and control the bleeding. "We have medical equipment, but not for that type of injury."
Hicks called for an advanced care paramedic, who is able to administer a blood-clotting medication. Unfortunately, none were working that day, she said.
"This is a type of accident or injury that doesn't need me, he needs a hospital. So it's very quickly noted that we need to get out of there."
Trauma team ready
After just seven minutes on scene, they were en route to the Saint John Regional Hospital and radioed ahead to let them know they were coming, she said.
Richards was conscious and alert but bleeding profusely and became very confused, said Hicks. They lost his pulse just down the street from the hospital so she began CPR and they went straight to the trauma area where a medical team was waiting for them, she said.
Dr. Sharon Chiu, a general surgeon who specializes in abdominal trauma, was among the more than a dozen doctors, nurses and other specialists. She said Richards underwent about 40 minutes of CPR.
"When you've lost so much blood, the heart stops beating. So what you have to do is what we call fill up the tank." They activated the "massive transfusion protocol," and Richards received about 22 units of blood at that point, as well as platelets, plasma, and blood-clotting medication.
An endovascular balloon was inserted to close up the aorta, the main blood vessel that comes out of the heart, to reduce the blood flow to the rest of the body, said Chiu. That helped slow the bleeding enough to transport him to the operating theatre, she said.
Blood vessels torn, muscle and bone bleeding
Chiu and another surgeon checked Richards's groin area to see if there was anything they could clamp or close but were unable to control the bleeding. They tried to go through his belly instead and a vascular surgeon joined them.
"We found that everything was bleeding," she said. "All the blood vessels, the big ones, were torn." They clipped and tied as many as the could, said Chiu, but discovered there was also muscle and bone bleeding. "It was not good."
"The only way to stop those kinds of things is with an interventional radiologist in the interventional radiology suite … and you have to have a stable patient to get there."
They decided they had to stop. Richards was entering the "lethal triad," where a patient gets cold, their platelets that help with clotting stop working and their pH drops.
The best option at that point is to close the patient up and move them to intensive care, where they can be warmed up and transfused, said Chiu. "Then hopefully if everything stables out, 24 to 48 hours, you go back to the operating theatre."
'Not survivable'
But Richards never stabilized. He was pronounced dead at 2:05 a.m. on July 1.
The cause of death was deemed to be hypovolemic shock, or severe blood loss causing organ failure, said community coroner Fred Fearon.
Chiu credited the quick actions of those at the scene and the emergency responders with helping Richards survive as long as he did. "Unfortunately his injuries were too severe."
They were "not survivable." Not in 2022 and not today, she said.
Deputy chief coroner Michael Johnston, the presiding coroner at the inquest, thanked Chiu.
"You would be one of the several folks that are often unseen by the community or obviously by the patient during such a tragedy. And I think this has been a good explanation of what goes on behind the scenes to try to save a life," he said.
"And I really want to sincerely thank you for what you do every day."