RESPONSE TO THE INITIAL SUBMISSIONS OF THE GOVERNMENT OF CANADA
case No. 970/2001
1. After many months of delay, I have finally received the initial submissions of the Government of Canada dated November 29, 2001. A general remark: I was informed on November 22, 2001 that I shall be transferred to British Columbia for an angioplasty, 7 (seven) days prior to the date of the submission, in which Government of Canada still denies any need for angioplasty - this emphasizes the falsity of submissions.
My response is structured as follows: the paragraph(s) in the Government submission is(are) indicated, and the response to this(these) paragraph(s) is presented.
2. Paragraph 2. I have not specified which Article of the Covenant was violated because at the time of my initial submission I did not have a copy of the Covenant and because I thought that the nature of the violation was self-evident. Denial of medical care in the life-threatening situation is equivalent to the violation of the right to life (Article 6). Articles 7 and 10(1) can also be retained.
3. Paragraph 3. Government of Canada still insists that it is not in my best interest to have angioplasty, while knowing full well at the time of submission that my life was in danger and that it has already decided to transfer me to British Columbia for an angioplasty. Falsity at its best.
4. Paragraph 8. The heart attack of 1998 was totally preventable: I felt it coming and I demanded on several occasions orally and in writing to bring me to the hospital. For example, in Tab 16 of Government of Canada submission, there is a document dated January 20, 1997 (1998?), which is claimed to be my refusal of treatment, and which in fact is, on the contrary, demand of a stress test. On May 7, 1998, I wrote to Infirmary:
“I have had strong chest pain during last night. I do not have the pain now, but I feel my heart is not well. Please, bring me to the hospital for a stress test today. I believe the matter is urgent. Thank you.” My demands were ignored. I had a heart attack in the evening of the next day, May 8, 1998.
5. Paragraph 9. I did initially refused bypass surgery, because I did not get a proper explanation as to why it was necessary. Later on I have contacted 2 Quebec heart surgeons - Pelletier and Teijiera. Both did NOT recommend bypass surgery, while those who did recommend bypass (see Government of Canada Tab 2) were not surgeons themselves. Presuming that Pelletier and Teijiera opinions were right, I made a correct decision by refusing bypass surgery.
6. Paragraphs 10-15. Government of Canada falsely claims that it has provided me with “all necessary and appropriate medical care”. •All I was provided were various pills, which did me no good. Indeed, in 1998, I had only left side of the heart affected (Circumflex blocked 60%, LAD - 90%, First Diagonal - 95% and Marginal - 100%.), while in 2002 LAD, First Diagonal and Marginal were blocked 100% and Circumflex was blocked 90%. My life was hanging on 10% still open in Circumflex artery. In addition, in 1998, the right side of my heart was clean, while in 2002 it was severely blocked. I attach Exhibit 1, where the results of 1998 are indicated and Exhibit 2 with 2002 results.
There are numerous studies stating that patients treated by medication only have double the mortality rate of those treated by angioplasty. I attach Exhibit 3 - the latest study published in Am. Heart 3., 142(1): 119-126 entitled “Long-Term Survival in 11,661 Patients with Multivessel Coronary Artery Disease ...“ The results of the study show that after 5 years, the mortality rate of patients treated by medication was 17%, while those treated by an angioplasty had the mortality rate only 8%. The results due to bypass surgery are not any better than the angioplasty results. Quebec doctors knew or should have known about these studies.
Dr. Hilton is a specialist in catheterization, he is not a surgeon and he does not do bypass surgeries. He did reiterate his recommendation for a bypass surgery, because he was misled by jail doctors that bypass surgery was available in Quebec and it was I who was refusing. When he finally learned from me that 2 cardiac surgeons in Quebec did NOT recommend bypass surgery, he no longer recommended it.
In general, the decision concerning medical care are not made by a majority vote. One opinion from a Catheterization Lab Director at Harvard (Dr. Palacios, see Canadian Government Tab 5) is more important than a thousand of opinions of Quebec doctors: Quebec doctors are the worst in Canada and Quebec has the highest cardiac mortality rate.
7. Paragraphs 16-18. The list of legal proceedings I undertook trying to save my life and the response I got is the best illustration of just how corrupt to the core Canadian judiciary is. A prisoner comes to a judge rightfully claiming his life to be in danger due to the denial of medical care, and instead of saving prisoner’s life, the judge declares this prisoner a vexatious litigant. It happened not in one but in 2 major Canadian courts: Superior and Federal. Indeed, nothing is too low for a Canadian judge.
Yet another pinnacle of moral low was achieved by Honourablet(?) Blais, JFC, he did not even allow me to file a Motion (see Canadian Government Tab 8) under the pretext of insufficient information. I asked him in writing several times, what additional information did he need. Each time, he refused to answer. Canadian Government have included Blais’ order, but did not include the text of my Motion. I include it as Exhibit 4. By reading it, it becomes very clear that it contained more than enough information to allow its filing. This is why Honourablet(?) Blais refused to answer my question as to what additional information he needed.
Though the final judgment is not rendered in Attorney General of Canada v. Fabrikant, I am forbidden since June 2001 to file any personal complaint against any Quebec doctor, nurse or lawyer. Yet another Honourablet(?) judge Durand has issued such an order under the disguise of an order to preserve the rights of the parties. At present, Attorney General of Canada does his best to postpone the final adjudication of the action. Attorney General has got all he wanted, he does not need any final judgment.
The level of corruption in Canadian Professional orders rivals that of Canadian judiciary. Indeed, my complaint against jail doctor Corbin was rejected as unfounded, though the facts showed that Corbin was the one who played a major role in bringing me to the brink of death, as was confirmed during the angioplasty performed on January 7, 2002 (see Exhibit 2).
8. Paragraph 19. Canadian Government falsely claims (Tab 16) that I refused treatment. My refusal to see a psychiatrist on July 28, 1994 is not a refusal of treatment - I have no psychiatric problems, and even if I had, it has nothing to do with my cardiac problems, which is the subject of my complaint. I did refuse to wear a nitro-patch, because its negative side effects were overwhelming, and its wearing would not prevent the heart attack in 1998.
In February of 1996, I was repeatedly given nothing but a vegetable salad, so I had no choice but protest by refusing to take the diet (It was a low-fat diet, not a vegetarian one). Accumulation of medication was minor taking into consideration that it took place over several years.
The most remarkable is the document dated by me as January 20, 1997 and dated by a witness as January 20, 1998. I suspect, it was 1998 indeed. I remember having chest pain, and instead of sending me to a hospital for a test (I have not seen a cardiologist for 2 years by 1998), jailers offered me to stay for observation. There was nothing to observe, a test was needed, and this is what I had written there. I was right: four months later, I had a heart attack.
I refuse flu shots every year, because in my case the negative side effects overweigh the possible gains; I either do not get flu or get it very mild.
August 6, 1998: blood test is not a treatment and neither is staying in the jail infinnary, so none can be classified as refusal of treatment.
There was neither an offer nor a refusal of bypass surgery on October 27, 1998: Dr. Roy is not a surgeon, and she has no knowledge either to recommend or not to recommend bypass surgery. I saw surgeon Pelletier in 1998 and he did NOT recommend bypass surgery.
On May 6, 1999, Dr. Roy was still writing recommendations for bypass surgery, though she knew or should have known (being not surgeon herself) that surgeon Pelletier did NOT recommend it. I refused not a treatment but unnecessary tests (October 18, 1999 - angiogram is a test).
9. Paragraphs 22-26 show dishonesty and hypocrisy of the Canadian Government. Indeed, it writes that I am receiving medical treatment “in accordance with highest professional standards”, knowing full well that this treatment has brought me to the brink of death, as was admitted by Quebec doctor Ayas, and at the time of submission the Canadian Government has already decided to transport me to Victoria B.C. for an angioplasty. I was right after all: I needed angioplasty!
10. Paragraphs 27-30 show further dishonesty of the Canadian Government. It pretends that the issue is whether I have the right for a treatment of my choice as opposite the “treatment” recommended by “overwhelming majority”. The latest facts showed that “overwhelming majority” was wrong, there is a documental evidence that I was brought to the brink of death, and that the angioplasty, as belated as it was, saved my life. So it has never been a choice between 2 different treatments: it was the question of life and death.
11. Paragraphs 31-37. Canadian Government pretends not to understand that the main issue is covered by Article 6 - denial of a life-saving medical care is equivalent to the denial of the right to life. Articles 7 and 10(1) can also be retained.
12. Paragraphs 38-40. According to the law, prisoners in Canada are entitled to exactly the same medical care as general population. The problem though is in the fact that Canadian Government does not respect its own laws. The problem encountered by me would not have been encountered by a regular citizen, indeed, a regular citizen would have taken a plane, went to Victoria B.C. and had his angioplasty done in 1999. For an ordinary citizen, it is not a jail doctor (or any other doctor), who decides on what treatment to follow, the citizen himself decides it. Officially, a Canadian prisoner has exactly the same rights.
Indeed, Sec. 26 of CD-800 (see Canadian Government Tab 17) reads:
26. All inmate-requested services deemed nonessential by the institutional physician will be at the inmate’s complete expense including consultation fees and at the discretion of the institutional heads, any associated escort costs. Health Services shall be responsible for the coordination of arrangements for all inmate-requested services.
If we presume, for the sake of argument, that my request for an angioplasty was unnecessary and qualifies therefore as non-essential medical service, still Canadian Government should have given me the opportunity to obtain these services at my expense (my relatives and several university professorst-tcolleagues of mine were prepared to provide the money) and jail doctor should have made necessary arrangements. It is NOT up to the jail doctor (or any other doctor) to rule that the procedure I want is too risky; this is a subject only between me and the doctor willing to perform the procedure. Canadian Government has denied me this opportunity, thus displaying total disrespect for its own laws.
I refer also to Sec. 8 of CD-803 (see Canadian Government Tab 17):
8. When an offender refuses to consent to a specific treatment or procedure, no punitive action shall be taken and alternative treatment shall, possible, be made available.
Sec. 8 of CD-803 makes it very clear, that it is the prisoner, not a jail doctor, who makes the fmal decision on the treatment to follow. I emphasize the fact that Sec. 8 of CD-803 does NOT say that a jail doctor consent or recommendation is needed to provide the “alternative treatment”. Canadian law is very clear: as long as there exists a properly licensed medical doctor ready to perform a procedure and there exists a prisoner, ready to undergo this procedure, Correctional Service is obliged to make proper arrangements and to deliver the prisoner to the doctor. In the case where jail doctor does not consider the procedure necessary, the prisoner has to pay the expenses. Canadian Government did not respect its own laws.
13. Paragraphs 41-57. Yet again, reiteration of a false statement that I refused bypass surgery.
Once again: those who recommended bypass surgery, were not surgeons themselves; I have consulted 2 cardiac surgeons (Pelletier and Teijiera) and both did NOT recommend bypass surgery.
Yet again: those who recommended bypass surgery, were not surgeons themselves; I have consulted 2 cardiac surgeons (Pelletier and Teijiera) and both did NOT recommend bypass surgery.
Would the above be enough for Canadian Government to understand the falsity of its statement or should I repeat again?
It is kind of ironic to read 7 pages of quotations of opinions of numerous Quebec doctors, which were all wrong: the cardiologists, who were not surgeons, recommending bypass surgery, and latest recommendations that the best treatment for me is to swallow numerous pills. It is this “treatment” which brought me to the brink of death: on January 7, 2002, Dr. Hilton told me that my life was hanging on 10% of still open Circumflex artery, while the remaining 3 were blocked 100%.
14. Paragraph 58 deserves special attention. Here Canadian Government uses the same trick it used in Federal Court. It writes that nobody can order a doctor to perform a medical procedure, as if this was what I was asking. Canadian Government knew very well that I never asked for such a nonsense.
15. Paragraphs 59-61. Once again, Canadian Government falsely claims that I am asking the Committee to pass a medical judgment on which treatment is better for me. I do not.
Canadian Government falsely claims that I was receiving the best medical care available, while it knew from at least September 12, 2001 (see letter of Dr. Ayas in the Canadian Government second submission, Tab 1) that my life was in danger. The first submission is dated November 29, while I was told on November 22 about the decision to transfer me to British Columbia, and clearly, Canadian Government knew it earlier than that, which makes the falsity of the submission even more appalling.
RECORD OF THE LATEST EVENTS
16. On July 3, 2001, I had a Thallium stress test which came out very bad. My cardiologist at that time Ayas did his best to waste time: first, he wrote a letter to Montreal Heart Institute asking them whether they could do angioplasty, knowing full well, that I have contacted them in 1998. An honest doctor would have used telephone and in 5 minutes know the answer; writing a letter allowed Ayas to waste about 6 weeks.
Due to my unrelenting pressure, Montreal Heart Institute fmally responded that there was nothing they could do (which, of course, was a lie). Instead of recommending my transfer to British Columbia, Ayas has decided to waste more time and wrote yet another letter to Jewish General Hospital. It was not until September 12, 2001, that Ayas finally wrote a letter to jail doctor McFadden saying that my angina was severe and that it may put my life in danger.
McFadden was not in a hurry: he waited until November 2, 2001, when he fmally responded, and I quote:
“Could you please provide us with a summary that describes what steps have been taken with respect to this patient? Furthermore, it would be very useful to know exactly what you mean by the expression ‘it may put his 4fe in danger’. Should action be taken urgently and, if so, in what regard?”
Everyone prior to becoming a medical doctor takes the Hippocratic Oath where he swears to do his best in saving human life. McFadden receives a letter in September saying that his patient’s life is in danger and instead of immediately lifting a telephone to find out what needs to be done, he waits until November to write a letter asking for a clarification! Both Ayas and McFadden were playing a disgraceful game of wasting time, hoping that I die during this game.
There were 2 more letters from Ayas to McFadden to which he did not respond.
17. On December 12, 2001, I was transferred to British Columbia to receive the treatment of my choice. The requested procedure (angioplasty) was performed on January 7, 2002 in Victoria B.C. by Dr. Hilton. If it could be done in 2002, it certainly could have been done three years earlier.
18. Back in 1998, an angiography was performed, which revealed 4 important coronary arteries blocked, namely, Circumflex - 60%, LAD - 90%, First Diagonal - 95% and Marginal - 100% (see Exhibit 1). At the time of angioplasty on January 7, 2002, it was revealed that Circumflex artery was blocked 90%, and the remaining 3 arteries were blocked 100% (see Exhibit 2).
My life was hanging on the 10% of still open Circumflex artery. I could die any moment should a blood clot block the 10% opening of Circumflex artery. In addition the right coronary artery was stenosed in several places, while it was clean in 1998 (see Exhibits 1, 2). According to Dr. Hilton’s estimation, I would certainly have died with complete closing of Circumflex artery within maximum of one year, if no angioplasty was done.
19. Dr. Hilton has managed to open the Circumflex artery, while for the remaining 3 arteries it was too late to dilate them. He also dilated 4 new blockages in the right side of my heart. Dr. Hilton has stated, that he would have been able to open all arteries if I were brought to Victoria 3 years ago. Dr. Hilton considers my life no longer to be in immediate danger, though the invalidity inflicted by the 3 still blocked arteries remains.
20. These events proved with certainty, that my complaint against Canada was valid and correctly reproached to Canadian Government reckless disregard for my life: the prescribed medication did not stop progression of blockages, kept me invalid, and brought me to the brink of death.
21. I asked Dr. Hilton after the angioplasty whether Quebec doctors were sufficiently qualified to do the same. He responded that many Quebec doctors would be able to do the same. Now a good question to ask is why did all Quebec doctors refuse to save my life and lied that the angioplasty was not possible, too dangerous, etc. Quebec doctors hate me because I exposed their dishonest actions and pursued them in court, Canadian judges hate me because their former Chief Justice Gold was in 1992 Chancellor of Concordia University and he personally contributed into provoking me into shooting; the Canadian Government hates my political views which I posted on the internet on numerous occasions (see Exhibit 5 for examples).
22. The claim of Canadian government that I am getting medical care of the highest quality is false. Here are the facts.
In June of 2002, I started feeling chest pain during the night. This was an indicator that my dilated arteries were re-closing again. I needed a new angioplasty to open them up.
Each time, when I came to Infinnary, claiming chest pain and demanding to be sent to a hospital, criminal nurses took my blood pressure and lied that it was normal, while I have my own apparatus and usually take my blood pressure myself. They were “cooking books”, writing in my medical file all false information, like I refuse to take medication, so that in case of my death they would have a justification saying that my vital signs were OK; there was no need to send me to a hospital and that I died because I refused to take the prescribed medication.
Here is what happened on July 4, 2002. I had chest pain in the morning. A call was made to the Infirmary and a nurse there agreed to see me. I was not given a written pass. When I came to Infirmary, a guard there told me that I can not come in without a pass. He told me to walk
back and to get a pass. I explained to the guard that I had chest pain, it might be urgent, I asked him to inform the nurse. He refused.
Nurse Miller appeared at a distance of 3 meters, I started shouting at the top of my lungs that I had chest pain, she pretended not to hear me. The Head Nurse Duquet passed by. I told him that I had chest pain and that the guard does not let me enter. Duquet nodded as if he was to fix the situation, and did nothing. Jailers let me in the Infirmary about 30 minutes later, still without a pass, when it became obvious to them that I was not going to die that day.
Jail doctor Coche plays the same dishonorable game as his predecessors did. He saw me on July 2, 2002. I told him that I felt like the arteries dilated back in January were affected by restenosis. If this was so, it was life-threatening and the only way to deal with it was to perform a new angiography and angioplasty. He told me that he had recommendations of 5 (?) cardiologists saying that I needed only medication and this was what he wished to discuss with me. This is exactly the story I heard for the past 4 years that I needed only medication, and it is well known how it ended: a year ago, this medication had brought me to the brink of death, and I had to be transported to B.C. for an angioplasty.
I attach Exhibit 6, representing the requests written by me from June 23 to July 15, 2002. They describe in detail my symptoms and the deterioration of my health. The history repeated itself: jail doctor Coche has brought me to the brink of death yet again.
On July 15, 2002, Coche has finally decided to send me to the hospital Emergency. In the past, each time I was sent to the hospital, an ambulance was called. Jail doctor Coche not only refused to call an ambulance, he made me walk all the way from Infirmary to jail car (about 200 meters) despite my acute chest pain and high blood pressure 180/120 (he also falsified in his records my blood pressure). It is well known that patients with chest pain are not allowed to walk because of possible death. Jail doctor Coche just wanted to use his last chance to have me dead. I have offered to pay for the ambulance and Coche refused.
When I came to the hospital Cite de Ia Sante, I was not seen by a cardiologist until the next day, July 16, 2002. Cardiologist Mayrand then told me that since I did not follow their recommendation for a bypass surgery, there was nothing they could do for me. She also wanted me dead.
Here I had to remind Mayrand, that it was not I, who refused the bypass surgery: I consulted 2 cardiac surgeons and both did not recommend it, while the cardiologists, who did recommend bypass surgery, were not surgeons themselves.
Next, I reminded Mayrand that it was her colleague Ayas, who recommended the angioplasty and he did it because he felt my life to be in danger. Mayrand still insisted that I had to undergo bypass surgery, she could not though tell bypass surgery of WHICH artery. Finally, she understood the stupidity of her position and hastily exited. While she was getting out, I told her that as soon as she figured out which artery should be bypassed, I agree in advance.
Several minutes later, she returned back and admitted that it were indeed Quebec surgeons, who did NOT recommend bypass surgery. Her next idea was to call B.C. doctor and ask him whether he would be ready to perform a new angioplasty, and if yes, she would send me there. Imagine the stupidity: to go from one end of the country to another for an elementary procedure, which can be easily done here. By the evening of July 16, 2002, I was fmally told that the angiography will be done at the Sacre-Coeur hospital on July 19. I guess, Quebec doctors understood that their actions were clear and shameless murder, so they backed off.
Angioplasty was performed on July 19, 2002, and it showed that I was right yet gain: jail doctor Coche brought me to the brink of death indeed. Almost all arteries were re-stenosed, and the main Right Coronary artery was blocked 80%; a small clot there would kill me for sure. It also showed that Quebec doctors were perfectly qualified to do the job, and were refusing out of maliciousness, helping Canadian Government to kill me.
On my return from the hospital I spoke with jail doctor Coche. I asked him whether the results of the last angioplasty convinced him that he made serious mistakes by ignoring my symptoms for over 3 weeks, by refusing to call an ambulance, and by effectively bringing me to the brink of death yet again. He admitted that I could have died, but insisted that he did nothing wrong.
23. There is no doubt that the re-stenosis in my arteries will continue, and I shall need yet another angioplasty several months from now. I have no doubt that when my symptoms reappear, jail doctor Coche will do his best to delay delivering me to the hospital until I die. This is why I feel that my right to life is in jeopardy and I ask the Committee to adjudicate my complaint at the earliest possible date.
24. I would be prepared to withdraw my complaint, if Canadian government
a) fmds a doctor, who would be able to open the remaining 3 blocked arteries. The fact that Dr. Hilton was unable to open them does not mean that no other doctor would be able to do it; in the alternative, if I find such a doctor, Canadian Government will undertake an obligation to deliver me to the doctor;
b) accepts the following interpretation for Sec. 8 of CD-803: it is the prisoner, not a jail doctor, who decides which medical procedure he wishes to undergo and which medical doctor is going to perform it; the role of jail doctor is to determine whether CSC (Correctional Service Canada) should pay all the related expenses. As long as there exists a properly licensed doctor, willing to perform a procedure and there exists a prisoner willing to undergo such a procedure, it is the duty of CSC to deliver the prisoner to the doctor on a predetermined date.
25. Taking into consideration that Canada deliberately endangered my life, drastically diminished my quality of life making me disabled and keeping me disabled, I ask that Canada be condemned for the violation of Articles 6, 7 and 10(1) of the Covenant.
Dr. V.I. Fabrikant
prisoner #167 932 D
August 2, 2002