CLINIC SHOULD HAVE CONVINCED ADDICT LIFE AT RISK - LAWYER

The drug addiction clinic that served Wade Hatt a deadly dose of
methadone downplayed the significance of the overdose, a coroner's
jury was told yesterday.

Donna Crabtree, the Hatt family's lawyer, said the doctor and two
nurses at the Ontario Addiction Treatment Centre (OATC) on Somerset
Street should have made it abundantly clear that Mr. Hatt's life was
at risk if he did not go to hospital.

But the clinic's staff did not "take ownership" of the overdose, and
they failed to seize control of the situation, Ms. Crabtree said. She
said the staff gave the impression of being "totally unprepared" to
deal with the overdose.

Dr. Andre Moolman, who was on duty at the clinic, testified previously
that he told Mr. Hatt his life was at risk and urged him to go to
hospital. He said Mr. Hatt refused.

The jury also heard that Mr. Hatt, who was addicted to pain
medications and cocaine, may have had an inflated sense of his
tolerance for drugs.

In her closing submission to the jury, Ms. Crabtree also said Dr.
Moolman should have insisted Mr. Hatt sign an "Against Medical Advice"
form as a way of bringing home to him the seriousness of the overdose.

The treatment centre's policy and procedures manual contains
guidelines on methadone overdoses. "If the patient refuses to proceed
to hospital, or follow the advice of the OATC physician while in the
clinic," the manual says, "he will be asked to fill out an 'Against
Medical Advice' form." George Kolbe, a clinic doctor, testified
earlier that Mr. Hatt was not asked to sign such a form.

Mr. Hatt, 41, died of heart failure on the morning of Oct. 15, 2005,
more than 12 hours after the accidental overdose. He mistakenly drank
a methadone dose intended for his partner, Julie Maloney. Her
methadone drink was 10 times stronger than his regular dose.

Meghan O'Brien, the lawyer representing the clinic staff, said in her
submission to the jury that it was likely Mr. Hatt died as a result of
a combination of cocaine and methadone in his system. The
toxicologist's report showed that the traces of cocaine in Mr. Hatt's
blood were in the "overlap" range between recreational use and
toxicity, she said.

Ms. O'Brien said Mr. Hatt made "a bad decision" when he chose not to
go to hospital, but as a rational adult, it was his choice to make.

She compared Mr. Hatt with a cancer patient who rejects mainstream
treatment in favour of homeopathy, or a person who refuses a blood
transfusion on religious grounds.

She said clinic staff did not take the situation lightly and that Dr.
Moolman spoke to Mr. Hatt for 30 minutes, attempting to persuade him
to go to hospital.

Both lawyers gave the jury a list of suggested recommendations for
their consideration.

Ms. Crabtree's recommendations included placing more emphasis on
formal training for staff at methadone clinics, and that telephone
numbers for clinic patients be confirmed on a regular basis.

In her recommendations, Ms. O'Brien asked the jury to consider a
colour-coded system labelling small, medium and large doses of
methadone. To prevent dosage mixups, she also called for methadone
clinics to strictly enforce the present policy of serving only one
client at a time.

The jury began its deliberations about noon yesterday.