Doctor who examined Lionel Desmond tells fatality inquiry what he saw

Shanna and Lionel Desmond hold their daughter Aaliyah in a photo from the Facebook page of Shanna Desmond.

An inquiry investigating why a mentally ill Afghanistan war veteran fatally shot three members of his family before killing himself has heard from an emergency room doctor who assessed Lionel Desmond two days before the killings in rural Nova Scotia.

Dr. Justin Clark told the inquiry Monday that Desmond was initially assessed by a triage nurse at St. Martha's Regional Hospital in Antigonish, N.S., when he sought help following a heated argument with his wife Shanna on the night of Jan. 1, 2017.

Clark told the inquiry Desmond received a score of 2, which on a scale of 1 to 5 indicated he required treatment as soon as possible, given the fact that a score of 1 is regarded as a full-blown emergency.

The doctor, who at the time had six months of experience in emergency rooms, said when he met with Desmond around 7 p.m., he was aware the patient had been diagnosed with PTSD in 2011 and was suffering from a post-concussion disorder.

However, Clark said the 33-year-old former infantryman was calm and co-operative when he revealed he had damaged some furniture while arguing with his wife, who insisted he had to leave their home for the night.

Despite the fact Desmond did not appear to have any suicidal or homicidal thoughts, Clark said he was concerned enough about Desmond's mental health that he recommended he receive a further assessment by a psychiatrist, which happened in the hospital shortly after 7:30 p.m.