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Full investigation into baby's death should have happened years ago: Nunavut health director

A full investigation into what happened the night Makibi Timilak died should have taken place years ago, a Nunavut health director testified Wednesday at the coroner's inquest in Cape Dorset.

Coroner's inquest into 3-month-old continues in Cape Dorset

The inquest into baby Makibi Timilak's death is taking place in Cape Dorset. (Submitted by Luutaaq Qaumagiaq)

A full investigation into what happened the night Makibi Timilak died should have taken place years ago, a Nunavut health director testified Wednesday at the coroner's inquest in Cape Dorset.

A panel of six jurors listened to the testimony of former nurses, the RCMP, an infectious disease specialist as well as a government official on the second day of the inquest that's trying to determine how three-month-old Timilak died back in April 2012.

Barbara Harvey, the director ofprofessional practice at the Government of Nunavut's health department, testifiedWednesdaythat about five months after Timilak's death she was asked to review a chart written by Debbie McKeownfollowing the baby's death.

Looking back, Harvey said a fuller review was needed.

"It should have been an investigation," Harvey said, adding she thinks any critical incidents involving death should trigger an investigation by the territory.

Harvey also said the territory is currently revising its telephone triage policy which currently says acutely ill infants under the age of one should be assessed in person.

McKeown was the nurse who took the call the night before Timilak died.Timilak'sparents both testified earlier in the inquest they communicated toMcKeowntheir baby was having trouble breathing, something that was not indicated in her charting notes. According to her charthis mother wascomplaining of a fussy baby when she called.

McKeown will not be testifying atthe inquest.

LawyerAmyGroothuis,who isrepresenting the presiding coroner, testified thata doctor at the Homewood Health Centre, a mental health facility in Ontario, contacted her by email letting her know McKeownismedically unfit to testify.

Cape Dorset nursing station. (Amber Hildebrandt/CBC)

Second review

In the fall of 2013, following her chart review, Harvey was asked to speak with some of the nurses involved the morning Timilak passed away, including McKeown.

She said McKeown told her she remembered the case and she was not aware of any health issues of the baby prior to April.

"She said she remembered the mom calling saying the baby was fussy. Baby was drooling. No specifics," Harvey said, reading from her notes.

Disease specialist testifies

The jury also heard testimony from a pediatric disease specialist in Ontario who says it's unlikely for an otherwise healthy infant to die by a lung virus called cytomegalovirus or CSV.

Timilak was a full-term baby and otherwise healthy prior to April 2012.

His cause of death was initially ruled Sudden Infant Death Syndrome. It then changed to CSV and is now listed as unknown.

The jury is trying to have a conclusive answer by the end of the weekand will make recommendations to prevent similar deaths from happening in the future.