Abdirahman Abdi had serious heart problems before death, court hears

Abdirahman Abdi unknowingly suffered from "severe" blockages in his heart before he lost vital signs outside his apartment building during a violent altercation with police, according to a pathologist's report.

Abdi's health leading up to the events before his death in July 2016 was the focus Monday in the trial of Ottawa police Const. Daniel Montsion, who has pleaded not guilty to manslaughter and aggravated assault and assault with a weapon in relation to Abdi's death.

Abdi was pepper sprayed, hit with a baton, kicked and punched by police in their attempt to subdue and arrest him, the court has heard, but the defence is building a case that Abdi died of natural causes.

Abdi had a number of heart issues, including major blockages in his arteries, according to a report by Dr. Kristopher Cunningham, a forensic and cardiac pathologist who examined Abdi's heart after his death.  

"The severity of the atherosclerotic luminal stenosis would have significantly increased the risk of cardiac arrhythmia and sudden death," Cunningham wrote, noting that Abdi's heart problems were unknown before his death.

Portions of Cunningham's report were read aloud during the testimony of Alexander Bain, the lead paramedic who treated Abdi on scene.

Arteries up to 80 per cent blocked

Cunningham found Abdi's left descending artery and right coronary artery were both up to 80 per cent blocked.

"That's very significant," Bain said. "It would be hard to come back from a cardiac event with that sort of issue."

When Bain arrived on scene he found Abdi limp and without a pulse, his eyes fixed and unblinking. He instructed Montsion to remove Abdi's handcuffs and begin chest compressions.

Paramedics worked to revive Abdi at the scene and en route to the hospital, but they could not get a regular heartbeat.

He was revived about half an hour later by a team at the hospital, but he died the next day.

Crown prosecutors acknowledge Abdi experienced a fatal heart attack during his arrest, but they intend to prove it was caused by Montsion's unjustified punches to Abdi's head and body with reinforced knuckle gloves.

'Delerium' reported to paramedics

Abdi's mental health is also a major focus for the defence, who expect an expert to testify that Abdi suffered from excited delirium,  a condition that causes erratic behaviour and even hallucinations. 

Earlier in the trial, the Crown's use-of-force expert testified that sometimes police need to react differently to cases of excited delirium. Even punches to the face may be justifiable in some cases, the expert said.

There is so far little evidence that Abdi showed signs of excited delirium, but a reference to it was entered into the paramedic call detail report. 

The information may have come from police dispatch, Bain said, but it was not passed on to him at the scene. 

Even if he knew about Abdi's health condition or purported mental state, he would not have done anything differently, he said.