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Kinew James, 35, shown in a Facebook photo, was found unconcious in her cell at Saskatchewan’s Regional Psychiatric Centre early in the morning of Jan. 20.

Corrections Canada has quietly changed its rules for dealing with medical emergencies after an inmate died of an apparent heart attack in a Saskatchewan prison earlier this year.

Kinew James, 35, was found unconscious in her cell at the Regional Psychiatric Centre in Saskatoon in late January. Inmates at the prison told the Canadian Association of Elizabeth Fry Societies that Ms. James and others had repeatedly pressed the emergency call buttons in their cells over the course of an hour or more before help arrived.

Both the Correctional Service of Canada and the Office of the Correctional Investigator have said they are looking into the circumstances of Ms. James's death, and Saskatchewan's chief coroner says he will launch an inquest when those investigations are finished.

About two weeks after Ms. James's death, Corrections Canada tweaked its policy on responding to inmates' call alarms, removing a phrase that said corrections officers should put their own safety first when responding to emergency calls. The shift in priority appears to run counter to recent legislative changes that have given increasing weight to officers' safety concerns.

The new text specifies that all responses must be handled by primary workers or correctional officers and removes a previous line stating that "staff safety is paramount." The revised policy was circulated to staff on Feb. 4 according to a recent posting on the Corrections Canada website.

Corrections Canada declined to comment on whether the change in policy was related to Ms. James's death, citing privacy concerns.

"All cell call alarms are treated seriously and designated staff are expected to respond to these alarms in accordance with established procedures," Corrections Canada spokeswoman Sara Parkes wrote in an e-mailed response to questions about the change.

Kim Pate, executive director of the Canadian Association of Elizabeth Fry Societies, said inmates told her that Ms. James's initial calls for help were not answered, prompting those in neighbouring cells to press their own emergency call buttons. Some inmates tried to persuade others to press their call buttons as well because they thought those individuals might be more likely to elicit a response from staff, Ms. Pate said.

"I think that just speaks to the fact that the call buttons are not a trusted method of getting any kind of staff response, much less emergency medical care," she said.

Jason Godin, Ontario regional president for the Union of Canadian Correctional Officers, said he doesn't believe the change is related to Ms. James's death. But he called the change in policy "absurd" and said it was done without any consultation.

"It's pretty surprising that they'd just unilaterally remove, in our minds, one of the most important elements of that policy – making sure the staff is safe before we do what we have to do," he said. He added that it's becoming more difficult for prison staff to deal with emergencies as a growing number of inmates are double-bunked in cells designed for one.

A spokeswoman for Public Safety Minister Vic Toews said the minister is not typically informed of changes to operational documents.

Howard Sapers, the federal correctional investigator, said he viewed the policy change as "helpful," adding, "I don't think it minimizes or dismisses staff safety concerns, but I think it properly focuses the attention on their legal duty of care."

A 2007 report for the Office of the Correctional Investigator, titled Deaths In Custody, found that there were problems with the staff response to medical emergencies in nearly two-thirds of cases reviewed.

Similar allegations have emerged in some provincial institutions. Last fall, Julie Bilotta gave birth prematurely in her segregation cell at the Ottawa-Carleton Detention Centre, a provincial prison. Her mother told reporters that Ms. Bilotta's cries for help were ignored for hours, a claim the province has said it is investigating.

Ms. James entered the corrections system when she was 18. At the time, her sentence was six years, but she accumulated a string of other charges that increased it to more than 15 years. Her charges included manslaughter, assault, uttering threats, arson, mischief and obstruction of justice.

Her death has prompted comparisons to Ashley Smith, a 19-year-old inmate who strangled herself to death in an Ontario prison while staff watched but did not intervene. An inquest into Ms. Smith's death is continuing.

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