Neglect by healthcare staff in prison contributed to the death of a man on his first night remanded to prison following a prolonged restraint
An inquest jury has found that neglect (gross failure to provide basic care) contributed to the death of JT, a 34 year old man who died on the 1 November 2023 at HMP Elmley on the Isle of Sheppey. JT became unresponsive and died during a prolonged period of restraint by multiple prison custody officers, whilst he was suffering from acute behavioural disturbance (ABD). The jury found that approximately 4 hours after being detained in the first night center in the prison, concerns were raised after it was noticed that his behaviour had significantly altered. A decision was made to transfer JT to the inpatient department of the prison, and healthcare was called by the prison officers during the restraint who became concerned for JT´s mental health.
The jury found that there were a number of failures by prison healthcare including:
- A failure to recognise that JT was suffering from ABD
- A failure to recognise that this was a medical emergency
- A failure to call for an ambulance
The jury recorded that JT died from drug related causes following a lengthy and challenging restraint. They recorded in a narrative conclusion that ´healthcare´s failure to provide sufficient medical treatment at the earliest appropriate opportunity by calling an ambulance… was probably a significant contributing factor´ in his death and that his death was contributed to by neglect. With respect to the restraint, the jury also recorded that that control and restraint techniques were used throughout the prolonged period of the transfer, including unapproved methods of restraint which were performed to adapt to the continuing struggle. At one stage JT was placed in a seated position, where his head was bent forward with the hands of more than one officer on his head. The jury recorded however that it was unclear for how long or what level of force was used during this time and that this did not cause or contribute to his death.
The Coroner has expressed an intention to make a prevention of future deaths report following the inquest´s conclusion.
Keio Yoshida of the Doughty Street Chambers Inquests and Inquiries Team represented the family of JT, instructed by Becky Randel of RWK Goodman.
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