MONTREAL — Joyce Echaquan was in tremendous pain and told hospital staff she was dying, but she was instead ignored and mocked, a witness told a Quebec coroner's inquiry on Tuesday.

Annie Desroches was in tears as she described the poor treatment Echaquan received at the hospital in Joliette, Que., northeast of Montreal, last September. Desroches, who had been on a stretcher next to Echaquan, read Tuesday from a handwritten 10-page letter she wrote the day after the Indigenous woman died.

"They didn't give her help and comfort; no, they gave her death," Desroches told the coroner's inquest.

Echaquan was a 37-year-old Atikamekw mother of seven who filmed herself while a nurse and an orderly were heard insulting and mocking her shortly before she died last September, not long after being admitted to hospital with severe stomach pain.

Desroches said Echaquan told her she had visited the hospital a few times for her stomach but was only given morphine and didn't want it because she would experience withdrawal symptoms.

She told the inquiry Echaquan was never disrespectful toward hospital staff. Desroches said Echaquan was in pain and began to yell and cry out as it got worse but staff ignored her.

"More and more, I understood that it was not normal to leave a person in such a state," Desroches, 34, said in tears. "Ms. Echaquan also shouted, 'You're letting me die, I will die, I will die.'"

She said about four nurses where laughing at Echaquan as she yelled. Desroches said she couldn't hear them because of Plexiglas barriers, but she said the nurses were clearly mocking and laughing at the Indigenous patient.

"If I had known what would have happened the next day, I would have hugged her," Desroches said, concluding her testimony.

She was one of several witnesses who reported hearing racist comments aimed at Echaquan on Sept. 28, the day the patient died.

Stéphane Guilbault was visiting his daughter at the hospital that day and he told the inquiry Tuesday he overheard staff saying, "Indians like to complain and screw and have children."

Josiane Ulrich, who was also visiting her hospitalized daughter on Sept. 28, testified Tuesday she overheard several disparaging comments from staff toward Echaquan.

Ulrich said she heard staff say, "We're paying for her" or "She's an Indian, it doesn't matter." After Echaquan had passed away, Ulrich said she heard a staffer allegedly say, "Finally, we will have some peace, she's dead."

Also Tuesday, Barbara Flamand, an Atikamekw woman who took on the role of liaison officer in March 2019 at the hospital to help support Atikamekw patients, testified that her role was never taken seriously and she was often ignored or unused as a resource.

On the day of Echaquan's death, Flamand said she received a call from the patient's mother and rushed to get information in the emergency room, but she said she was barred access despite having a hospital identification.

"I was afraid for her (Joyce) because I had heard it in her mother’s voice," Flamand said. She was with Echaquan's sister-in-law in a family room when the death was announced.

Flamand said community members often complained about the way they were treated at the Joliette hospital.

She said she had thought she would be welcomed with open arms when the Atikamekw health officials assigned her to the facility in March 2019. Instead, she said she wasn't formally introduced to hospital staff, lost her office space within six months and had to explain her role over and over. She said she was often ejected from the emergency room.

Burnt out and without support, she left the job in January 2021.

"I tried to defend patients and no one wanted to help me, no one wanted to hear me," Flamand said.

The inquiry heard Tuesday from three nurses who were on duty the day of Echaquan's death. Hospital staff have appeared with a publication ban on their identities.

One of them, who was an emergency room nurse at the hospital for a decade and now works elsewhere, testified she had heard disparaging comments from colleagues about Indigenous people and other patients, including those who didn't speak French.

Earlier Tuesday, coroner Géhane Kamel told the inquiry she has been impartial and committed to transparency from the outset and didn't mean to offend anyone with comments last week challenging health-care workers on the witness stand. Kamel's comments had been criticized in Quebec media.

"Some of my comments may have given the appearance of a certain bias on my part, but I affirm that at all times, since the first day of this inquest, I respected the important duty of independence and impartiality as a coroner," Kamel said.

"I can understand that my comments may have upset some people, and I’m really and truly sorry. I take note of this seriously for the future."