One year ago Tuesday, Bill Pearl saw his stepson’s final moments.

According to a Special Investigations Unit report, Kieran Kay was in his Cambridge home on May 22, 2017, when he took off his clothes and started saying he was seeing snakes. Worried – and aware that he had finished a drug rehab program the previous day – family members in the house called 911. They told the SIU they had seen a syringe sticking out of Kay’s body, and their first attempts to calm him down had failed.

Seeing no other options, Kay’s relatives started trying to physically bring him under control. A coffee table was flipped. A lamp was smashed. The struggle ended when one relative was able to pin the 26 year old down on a couch and hold him there for eight minutes until an ambulance arrived.

The SIU found that paramedics decided they could not treat Kay while he was in his agitated state. They called police for backup. It took them eight minutes for an officer to show up. A few more moments elapsed before Kay was handcuffed.

It wasn’t until the cuffs were on that the relative who had been pinning Kay down let go. According to the SIU, it was obvious that Kay was now in the grips of a medical emergency. He was unresponsive, and was pronounced dead in hospital later that night. Post-mortem tests determined that he had died of a cocaine overdose.

Last Friday, the SIU announced that it had cleared Waterloo Regional Police of any wrongdoing contributing to Kay’s death.

“(The officer) was acting at all times appropriately, professionally and in direct response to the emergency situation that was ongoing at that time,” SIU director Tony Loparco wrote in his report.

“It appeared that there was a general feeling of relief when the (officer) arrived and subdued (Kay) so that he could get the help that he desperately needed.”

Pearl says Kay’s family has no issue with the SIU clearing police in the case, as they themselves never believed police did anything wrong.

“Our concern has always been with the EMS and how the situation was handled that night,” he said Tuesday.

“We still have a lot of questions.”

The SIU’s mandate is to look into cases in which someone dies or is seriously injured around the time of an interaction involving police. It does not provide any oversight to paramedics. The Office of the Ombudsman of Ontario is reviewing the current framework governing patient complaints about paramedic services.

Kay’s family says the paramedic crew that arrived at their home could have done more to save Kay, instead of waiting eight minutes for police to show up.

The case was also the subject of an internal review conducted by Region of Waterloo Paramedic Services.

“Staff followed policy, procedure and protocols as indicated in Regional police and the Ambulance Act of Ontario,” the EMS organization said in a statement.

“We are satisfied that the actions of the paramedics were in line with the training received for these types of situations.”

Pearl disagrees with that finding, and says he and the rest of Kay’s family will continue to work toward some sort of reform.

“We can’t bring Kieran back, but maybe it’ll help someone in the future,” he said.

With reporting by Tina Yazdani