The province's chief medical examiner says Brian Sinclair had been dead a few hours in the waiting room of Health Sciences Centre emergency room in 2008 before staff responded.

Sinclair, 45, had sought treatment for a bladder infection at the hospital, where he died after waiting 34 hours for care.

Rigor mortis, which usually takes 12 hours to fully set in, had already started when physicians tried to resuscitate him, said Dr. Thambirajah Balachandra, chief medical examiner.

Doctors said it's uncertain when exactly Sinclair died.

"There's no hard, fast rule to determine how long someone's been dead," said Dr. John Younes, the pathologist who examined Sinclair's body, told the inquest.

Sinclair was pronounced dead at 12:51 a.m. on Sept. 21, 2008.

Hours earlier at around 1:42 p.m. on Sept. 20, he vomited. Housekeeping employees attended but not medical staff, the inquest heard.

"I expect some health person to talk to him and ask what's going on,” said Balachandra when asked about the appropriate response to a patient vomiting.

A woman in the waiting room spotted Sinclair well after 12 a.m. Sept. 21 and alerted hospital staff that she thought the man in the wheelchair was dead, the inquest heard.

Some lawyers who are part of the inquest wonder if his identity as a poor, disabled aboriginal man, led to his lack of treatment.

"We can't predict these things 100 per cent, but it would seem from the evidence that there were many opportunities to save his life and that didn't happen," said Emily Hill from Aboriginal Legal Services of Toronto, a group participating in the inquest.

Dr. Balachandra said it was staffing inadequacies that failed Sinclair. 

"Even if Snow White would have gone there, she would have gotten the same treatment under the same circumstances," he said.

The pathologist who performed the autopsy said based on his examination it was not Sinclair's past solvent abuse that led to the death. It was a bladder infection that spread, he said.

Balachandra said it is very likely Sinclair would have lived if he had received treatment.

Balachandra said Sinclair needed about half-an-hour of medical treatment. He said Sinclair needed to have his pulse checked and catheter changed.

- with a report from Alesia Fieldberg and files from The Canadian Press