Robert Sinclair feels the weight of his family's history when he has no choice but to go to an emergency room in Winnipeg.

He feels anxious, uncertain and sometimes angry.

A few years ago, he had a serious accident with a chainsaw in the woods and was taken to the Winnipeg Health Sciences Centre. He figures his name must known at the hospital because the care came immediately.

"I hit that little button — it's like they were standing at the door or something," he said. "They probably didn't want another Sinclair dying in their hospital."

An inquest into Brian Sinclair's death concluded it was preventable and made 63 recommendations, largely about structures, procedures and hospital policy. (CBC)

It was a Friday afternoon 10 years ago when Robert's cousin Brian Sinclair visited the same emergency room.

The 45-year-old had been in a wheelchair since he lost his legs to frostbite in 2007. At his community clinic that Friday, he was given a letter from his doctor and told to go to Health Sciences Centre's emergency room to have his blocked catheter changed.

He checked in at the triage desk and wheeled himself over to a spot near security in the waiting room.

Over the next 34 hours, Brian Sinclair sat in his wheelchair, occasionally vomiting on himself and eventually succumbing to sepsis.

Later, it emerged staff assumed he was homeless, intoxicated or had already been seen and was waiting for a ride. By the time his body was discovered, rigor mortis had already set in.

"It's terrible to remember that he actually died that way," Robert Sinclair said. "I'd like to think that he passed away teaching us all something, teaching us that as human beings, we have become so insensitive to each other."

An inquest into Brian Sinclair's death, which began in 2013, concluded it was preventable and made 63 recommendations, largely about structures, procedures and hospital policy.

His family and others say it didn't address the real issue — racism in the health-care system.

Robert Sinclair said Indigenous people regularly contact him to ask for advice or share their stories about facing racism in hospitals.

"The racism, the stereotyping, none of that has been addressed," he said.

Robert Sinclair said Indigenous people regularly contact him to ask for advice or share their stories about facing racism in hospitals. (Ryan Hicks/CBC)

Mary Jane Logan McCallum, a member of the Brian Sinclair Working Group and a history professor at the University of Winnipeg, also said Indigenous people still face prejudice in the health-care system 10 years later.

"There are a number of people who have similar stories — what people have been calling 'Brian Sinclair stories' — where they have individuals in their family or their community who also experienced inadequate care," said McCallum, a member of the Munsee Delaware Nation in Ontario.

In her new book, co-written with University of Manitoba history Prof. Adele Perry, called Structures of Indifference: An Indigenous Life and Death in a Canadian City, McCallum said Brian Sinclair's story shows how deep-seated racism in the community seeps into hospitals.

"Staff at the hospital saw him through kind of a stereotypical lens and that led to the failure to kind of see him as someone needing medical attention," she said, noting some of the findings of the inquest.

A still image from security video shows Brian Sinclair sitting in his chair in the ER waiting room at Health Sciences Centre. (Brian Sinclair inquest)

Many Indigenous people still do not feel safe going to the hospital, McCallum said in an interview with CBC News.

"Most people don't want to go to the hospital in general but more specifically, Indigenous people prepare for and anticipate racism still.

"There may have been some changes going on, but this is in no way an issue that has gone away and I don't think we can expect it to go away any time soon. Until people feel safe going to the hospital, we can't really say that very much substantial change has happened."

Ignored to death

The book says Sinclair was "ignored to death," which Perry said is rooted in settler colonialism and anti-Indigenous racism "that have worked to produce the structures of indifference."

"Hospital staff responded to Mr. Sinclair in ways that kind of denied his full humanity and failed to see him as somebody who needed medical attention," she said.

The health authority made changes to the layout of the emergency room, triage procedure and other policies after Brian Sinclair's death.

And Lori Lamont, the authority's chief operating officer, said cultural training is now mandatory for staff and there is an increased focus on Indigenous health services.

"We failed him when he came to us for care. I think that we have learned a lot as a system as a consequence of that," she said. "We can't let our guard down. We need to continue to work on that."

Robert Sinclair plans to grab a coffee with Brian Sinclair's brothers on Friday, the anniversary of his death. They won't visit the place where he took his last breath, the downtown emergency room.

"It probably wouldn't bother me if I never went there again," he said.

"We just want Brian to be remembered as somebody who — even though the way he passed away — he's going to leave something behind and that's hopefully a better health-care system where they are going to be more attentive to people regardless of race."

With files from the CBC