Commissioner's directive 048: Information Sharing and Provision of Support Services Associated with Coroner’s/Medical Examiner's Death Investigations or Inquests/Inquiries

Applies to CSC staff responsible for coordinating, managing or responding to requests and recommendations put forth to CSC during a Coroner’s/Medical Examiner’s death investigation or inquest/inquiry into the death of a federally sentenced offender

• Responsibilities
• Procedures
• Annex A - Cross-References and Definitions

Responsibilities

1. The Senior Deputy Commissioner, or delegate, is responsible for information sharing with Coroners/Medical Examiners and will develop and maintain Guidelines for information sharing (including sharing with various stakeholders, where applicable) and provision of support services in relation to Coroner’s/Medical Examiner’s death investigations or inquests/inquiries.
2. The relevant Regional Deputy Commissioner, or delegate, as instructing officer on specific/regional cases, will:
   1. immediately share the initial notification of an upcoming inquest/inquiry with the Senior Deputy Commissioner and liaise, as required, with the Regional Administrator, Communications and Executive Services, and the Deputy Commissioner for Women in the case of a woman offender
   2. provide necessary background information and documents to the Department of Justice
   3. in collaboration with the relevant Institutional Head/District Director and the Director General, Incident Investigations, consider all requests for information from Coroners/Medical Examiners which fall outside of what is normally provided.
3. The Assistant Commissioner, Communications and Engagement, or delegate, will:
   1. prepare media responses regarding CSC’s involvement in a death investigation or an inquest/inquiry and CSC’s response(s) to the recommendations when applicable
   2. ensure liaison with the Minister’s Office as necessary
   3. engage stakeholders, where applicable.
4. In the cases of non-natural deaths, the Director General, Incident Investigations, or delegate, will:
   1. coordinate with Coroners/Medical Examiners to obtain a copy of the Coroner’s/Medical Examiner’s investigation report, including the autopsy and/or toxicology reports, where available, and share them with the Regional Deputy Commissioner and the Assistant Commissioner, Health Services, for distribution
   2. in collaboration with the relevant Institutional Head/District Director and Regional Deputy Commissioner, consider all requests for information from Coroners/Medical Examiners/ Judges/inquiry counsel which fall outside of what is normally provided
   3. draft responses to the jury’s/panel’s/Judge’s recommendation(s) following an inquest/inquiry through consultation with relevant policy holders
   4. distribute Commissioner-approved responses to the recommendations to the provincial/ territorial Chief Coroners/Medical Examiners/Judges/inquiry counsel as applicable.
5. In the cases of natural deaths, the Director General, Clinical Services and Public Health, or delegate, will coordinate with Coroners/Medical Examiners to obtain a copy of the Coroner’s/Medical Examiner’s investigation report, including the autopsy and/or toxicology reports.
6. In collaboration with the Regional Deputy Commissioner, or delegate, the Institutional Head/District Director will:
   1. ensure adherence to responsibilities outlined in:
      1. CD 022 – Media Relations
      2. CD 041 – Incident Investigations
      3. CD 530 – Death of an Inmate: Notifications and Funeral Arrangements
      4. CD 568-1 – Recording and Reporting of Security Incidents
      5. CD 568-4 – Preservation of Crime Scenes and Evidence
      6. CD 568-8 – Authority for Use of Surveillance Equipment
      7. CD 701 – Information Sharing
   2. facilitate reasonable access to documentation required by Coroners/Medical Examiners/Judges/inquiry counsel
   3. consider all requests from Coroners/Medical Examiners/Judges/inquiry counsel for information and interviews
   4. make arrangements for witness briefings by the Department of Justice
   5. ensure required follow-up with Coroners/Medical Examiners/Judges/inquiry counsel in relation to any request
   6. coordinate communication, support services to staff, and technical assistance with the Department of Justice.

Procedures

7. Guidelines 048-1 – Information Sharing and Provision of Support Services Associated with Coroner’s/Medical Examiner’s Death Investigations or Inquests/Inquiries detail the processes for carrying out the above responsibilities. Adherence to these Guidelines is required in all cases where a Coroner/Medical Examiner conducts a death investigation or when notification of a public inquest/inquiry is received by CSC following the death of a federally sentenced offender.

Commissioner,

Original signed by:

Anne Kelly

Annex A
Cross-References and Definitions

• CD 001 – Mission, Values and Ethics Framework of the Correctional Service of Canada
• CD 022 – Media Relations
• CD 041 – Incident Investigations
• CD 253 – Employee Assistance Program
• CD 530 – Death of an Inmate: Notifications and Funeral Arrangements
• CD 568-1 – Recording and Reporting of Security Incidents
• CD 568-4 – Preservation of Crime Scenes and Evidence
• CD 568-8 – Authority for Use of Surveillance Equipment
• CD 701 – Information Sharing
• Corrections and Conditional Release Act
• Privacy Act, subsection 8(2)
• Treasury Board Policy on Legal Assistance and Indemnification

Autopsy report: a report prepared by the Coroner/Medical Examiner’s Office outlining the examination performed on the body of a deceased person to provide information related to cause of death.

Death investigation: provinces and territories are legislated to conduct death investigations by their provincial/territorial statutes unique to their jurisdiction. Often, when a death occurs, both an investigation and a public inquest/inquiry are completed. A death investigation is a process whereby a Coroner/Medical Examiner seeks to understand how and why a person died.

Inquest/inquiry: a public hearing on the circumstances of the death often involving a jury/panel of community members, and a Coroner/Medical Examiner (as defined by geographical boundaries within Canada). A report is often completed following the inquest/inquiry and may result in recommendations to prevent future deaths from occurring in similar circumstances.

Process server: an individual who gives legal notice to a party (usually the defendant) requiring them to respond to a proceeding scheduled to be held before a court, government body, or tribunal. Notice is usually provided by presenting the party in question with a court document such as a summons, a statement of claim, a plaintiff’s claim, etc.

Stakeholders: anyone who is interested in or impacted by CSC’s business. Primary stakeholders for deaths in federal custody include the media and inmate advocacy groups, CSC employees impacted by the death (e.g. Correctional Officers, Parole Officers, Health Services staff or any other employees who had a connection with the deceased inmate), and family/friends/next of kin of the deceased inmate. The general public can also be considered a stakeholder.

Toxicology report: a report prepared for the Coroner/Medical Examiner’s Office outlining the results of the lab procedures identifying and quantifying potential toxins, which include prescription medications and drugs of abuse, and interpretations of the findings.