Cindy Ciarafoni was a wife, a mother of two, and a grandmother of four.

You wouldn’t have known it from the police news release about a woman struck and killed by a car in the centre lane of Highway 7 on Jan. 2.

But a family still grieving her sudden loss is seeking answers as to how the 48-year-old, who suffered from schizophrenia for 25 years, ended up in the middle of a highway at all.

Ciarafoni’s 31-year-old daughter, Renee Ciarafoni-McGrath, said that when her mother was sent to hospital on New Year’s Day, the family thought she had been admitted to the mental-health unit.

Such admissions had become sadly routine as her mother’s health deteriorated over the past three years. Ciarafoni had been hospitalized roughly once a month over the past six months, usually at William Osler hospital in Etobicoke, Ciarafoni-McGrath said.

So the family didn’t expect anything different when police dealt with her bizarre behaviour on Jan. 1 and she was taken by ambulance to the emergency room at Humber River Regional Hospital’s Church St. campus.

“We thought she was safe” for at least 72 hours, Ciarafoni-McGrath said — typically the minimum length of her hospital stays.

But the next evening, her family received a call from police, telling them a woman had been hit just after 5 p.m. by a Toyota Camry in the centre eastbound lane of Highway 7 as she crossed the roadway just east of Jane St., 10 kilometres north of the hospital.

The only identification she was carrying was a piece of paper with their phone numbers written on it.

Ciarafoni had died in surgery after being rushed to Sunnybrook Health Sciences Centre.

York Region police said the driver of the Camry that struck her was not charged.

The family’s grief is now mixed with feelings of guilt for not going to the hospital, as they often would — her mother’s care having become an exhausting ordeal.

Persuading her to take medication throughout the day had become a constant challenge, as Cindy stayed at their Woodbridge home while her husband of more than 30 years, Danny Ciarafoni, was at work.

They trusted this would be a routine visit. And they are anguished over the fact Ciarafoni never got to hold her newest grandchild, born days before she died.

Much of what happened to Cindy in the 48 hours before her death is a mystery. What is known is that a bystander called police on Jan. 1, citing “bizarre behaviour” after Cindy handed over her small dog, Romeo, while walking him in the rain near her home.

Police found Cindy, soaking wet, in a Coffee Time shop at Islington and Highway 7, coffee in hand. But she didn’t respond to questions. The officers called Danny to come to the shop using a number they had on file, having encountered Cindy in a similar situation six weeks earlier.

Paramedics were called in to take her to the hospital. The officers told Danny his wife was likely to be admitted, as she had been so many times before. He trusted she’d be taken care of.

At first she was resistant about getting into the ambulance, screaming and tensing her body, according to the EMS report released to the family. Eventually she went willingly, but unaccompanied by family members.

The report indicates she was agitated, confused and unresponsive to questions on the way, resisting the attendants’ attempts to remove her wet jacket and housecoat.

The ambulance arrived at the hospital just before 5 p.m. The triage nurse was given the details Danny had provided about his wife’s history with schizophrenia — including the fact she had been off her medication for at least a week.

Thirty minutes later, her care was transferred to the triage nurse and the EMS workers were free to go, according to the report.

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York EMS superintendent Louise Lorenc said that in some situations of this type, EMS or police would stay with the patient until she was admitted.

“If the person wasn’t in acute distress or was medically stable, that’s going to be a decision up to the triage nurse,” she said. “Once we’ve given our report . . . it becomes the hospital’s responsibility.”

Lorenc said sometimes hospitals have a quiet, locked room for mental health patients, or a security guard is assigned to watch over them, depending on the situation.

“If it’s somebody that has a true mental-health crisis, they usually would not just leave security, they would keep somebody with them that’s got some training,” Lorenc said.

It’s not known what measures the hospital took, if any, to watch Cindy Ciarafoni as she waited in the emergency room to be reassessed.

“Privacy laws prevent the hospital from disclosing the personal or health care information of any individual without consent,” said Humber River hospital’s director of communications, Gerard Power, in an email to the Star.

But the hospital emergency record obtained by the family shows that when a physician attempted to begin a preliminary assessment six hours later, at 11:36 p.m., there was no answer — indicated by a slashed zero and the word “answer.”

Danny said he never received a call to tell him his wife had left the emergency department without being assessed or admitted. The family said the hospital has been uncooperative about telling them what happened that night.

“They’re not even calling us back, so it’s frustrating,” Ciarafoni-McGrath said.

Power, responding to the Star about hospital procedures, wrote: “I can tell you that, generally speaking, in cases like the one you describe, assessment of the patient by the Emergency Physician for the potential of future harm to themselves or others would be part of the process if the patient was registered to be seen and remained to be seen.”

Asked if a patient’s emergency contact would be notified in the event they had left the hospital, Power wrote: “In the normal course, if the patient is judged to not be a danger to themselves or others, privacy legislation would prevent the hospital from contacting anyone with regard to their hospital stay, including the fact that they have been discharged.”

But Danny said that whenever his wife had been admitted to hospital before, he was always called to pick her up when she was discharged.

Without answers, the family said they can’t have closure in Ciarafoni’s tragic death.

“I just want people to pay for what they did,” Danny said.