A homeless alcoholic man dropped off in an alley by Vancouver police would have been extremely hypothermic before he died, says a forensic pathologist who examined Frank Paul's body.

Dr. Laurel Gray told a public inquiry into his death Wednesday that hypothermia would have resulted because alcohol leads to rapid heat loss from the body.

She said the condition would have been accelerated because Paul was left outside in the cold in soaking-wet clothes in the early hours of Dec. 6, 1998.

According to Environment Canada, the temperature was 2 C that night, the inquiry heard.

"He just basically lost a lot more heat than his body could generate,'' Gray testified. "The conclusion that he died of hypothermia would be a valid one.

"It's not the summit of Mount Everest. We're only looking at just a few degrees below the normal body-core temperature to become fatal, that the organs just can't maintain life.''

In the final stages of hypothermia, Paul's brain, lungs, heart and kidneys would have failed.

Gray said her examination revealed there was no irreversible damage to the chronic alcoholic's liver and that he did not have cirrhosis despite years of drinking excessively.

She also said Paul had a brain injury at the back of his head where he could have struck it, although it wasn't recent.

Paul, 48, was left in the alley behind a detox centre by Const. David Instant, a rookie officer who had initially taken the man to the city drunk tank after picking him up in a police wagon for being intoxicated in a public place.

The Mi'kmaq from New Brunswick was a regular at the drunk tank, where he'd been admitted 33 times between July and December 1998.

But on the evening of Dec. 5 that year, the sergeant on duty refused to admit Paul, saying he'd been there only a few hours earlier and could not have had time to get drunk yet again.

Sgt. Russell Sanderson ordered Instant to drive Paul, who was homeless, to an intersection on the west side of Vancouver.

But not knowing exactly where to leave Paul, Instant took him to an alley behind the detox centre on the east side of the city after another senior cop told him that was the best place for the homeless man.

Instant has testified he propped Paul against a wall and believed he would soon get up and be on his way, perhaps finding shelter at one of two fast-food restaurants in the area.

About six hours later, Paul was found dead on his back on a pile of gravel, several metres from the wall.

A paramedic who arrived at the scene has told the inquiry the gravel underneath Paul's body had shifted like a snow angel to indicate he may have had a seizure before he died.

Gray said Paul could have seized as part of the hypothermic process but that he may have experienced an effect called hide and die syndrome, also known as terminal burrowing behaviour.

She said people who are dying of hypothermia sometimes try to hide, and that if they're indoors they may attempt to get under a bed or other furniture.

In such cases, people facing death may also attempt to remove some of their clothing because they feel hot, something that could be real or imagined, she said.

A photo entered as an exhibit at the inquiry shows he was found with his sweatshirt pulled up to his chest and his shoes off, contrary to how Instant described leaving him.

On Tuesday, a forensic pathologist who conducted an independent review of the case said he concluded that Paul's death could have been prevented if he'd received medical attention at the city jail.

Rex Ferris, who testified at the inquiry via video link from New Zealand, said Paul was already in serious condition when he arrived at the jail.

During his last day of testimony, Instant tearfully apologized for leaving Paul in the alley, saying he'll wear the scars of what happened to the man for the rest of his life.

But aboriginal leaders said they didn't believe Instant and felt he should have been charged for what he did.

Instant and his superior received brief suspensions after an internal police investigation.

They also said racism played a part in how Paul was treated.

First Nations groups have blamed the B.C. government for not calling an inquiry into his death until late last year.

That was almost a decade after they and the B.C. Civil Liberties Association began pushing for a public examination of why Paul was dumped in an alley to die.