The State’s prison watchdog has expressed concern that legal obstacles are affecting its ability to conduct thorough and effective investigations into the deaths of prisoners in custody by preventing it from accessing medical records of deceased inmates.
The Office of the Inspector of Prisons (OIP) has also called on the Irish Prison Service (IPS) to ensure that all relevant CCTV footage is preserved after key recordings of checks on the cell of a prisoner and his removal to hospital where he later died could not be located after originally being assured they were available.
The OIP said it had not been possible to verify the number of checks made on the prisoner and the duration between them.
Recommendations to address such concerns have been made by the OIP in a new report of its investigation into the death of a prisoner with suspected mental health issues – identified only as Mr R – three years ago.
The report also reveals that a complaint was made that prison officers had not paid adequate attention to Mr R when he was in hospital as he fell out of a hospital bed and suffered a head injury.
The 38-year-old male had been remanded in custody to Cloverhill Prison on October 16th, 2019 for breaching a barring order but died on December 16th, 2019 in Tallaght University Hospital where he was moved after suffering an earlier head injury in prison.
On the advice of the Office of the Attorney General, the IPS will only provide the medical records of prisoners who die in custody to the OIP where the consent of the deceased’s next-of-kin has been obtained.
However, the OIP claims this arrangement means medical records cannot be reviewed in cases where the next-of-kin cannot be located or refuses to provide consent.
It noted that Mr R’s next-of-kin was in very poor health at the time of his passing and several unsuccessful attempts were made to obtain consent to access the deceased’s medical records.
The OIP report revealed that another prisoner warned prisoner officers in the early hours of November 4th, 2019 that he would physically harm Mr R unless one of them was removed from their cell as Mr R had tried to get into bed with him.
Head injury
That prisoner was removed from Mr R’s cell but two hours later Mr R was found with blood on his head and clothing.
Mr R told one prisoner officer that he got a head injury after falling out of his bed.
Other prisoner officers said Mr R did not have any injury at the time the other prisoner was removed from his cell.
Later that day around midday, the prison doctor referred Mr R to Tallaght University Hospital (TUH) where he was escorted by three prison officers because he was confused, shaking and incoherent in his speech.
The following day he was transferred to Beaumont Hospital but he was returned to TUH eight days later.
The OIP said a nurse at Beaumont had made an anonymous report criticising prison officers minding Mr R after he suffered a head injury after falling out of his hospital bed.
The nurse said the patient had been injured because the officers had not contacted nursing staff, as requested, when they saw he was trying to get out of his bed.
The escort officers denied that such a request had been made and claimed it would have been “highly irregular.”
On November 19th, 2019, Mr R’s condition deteriorated and he was moved to an intensive care unit where he died on December 16, 2019 after a decision was taken to remove life support.
However, the OIP said it did not know the reason for the transfer between the hospitals because it did not have access to his medical records.
The inspector explained it was also why it did not have any details which were “important evidence” on why Mr R had been moved between different wings at Cloverhill.
The OIP noted that Mr displayed “unusual behaviour” including hitting his head off the wall.
Following a criminal investigation by gardaí into Mr R’s death, the DPP directed that no criminal prosecution should arise in the case.
The OIP issued a number of recommendations following its investigation of Mr R’s death including a call on the IPS to review its legal advice to see if there are circumstances where the medical records can be released in the absence of obtaining the consent of the deceased’s next-of-kin.
The OIP pointed out that the next-of-kin has no legal basis in law.
The IPS accepted all four recommendations made by the prison watchdog including a call for it to update its Hospital Escort Policy including the role and responsibility of prisoner officers when a prisoner wants to get out of their hospital bed.
