Prisoner dying of cancer was handcuffed on hospital trips
PRISON staff used “disproportionate” force against an inmate who was dying of blood cancer, a report has found.
Gareth Micallef had been jailed for drug offences before being transferred to HMP Parc in Bridgend.
Months after being handed a lengthy prison term he was diagnosed with blood cancer. Less than a year later, and following a stem cell transplant, he died in hospital at the age of 32.
Because his death happened while he was a prisoner, an investigation was automatically launched by the Prisons and Probation Ombudsman.
The watchdog said the overall standard of care he received was good. However, it criticised the private prison – run by G4S – for not having a clear protocol for managing prisoners who repeatedly refused to go to hospital.
And it also questioned the decision to use restraints on Micallef when he was in incredibly poor health.
A report said: “When Mr Micallef was taken to hospital, he was accompanied by two prison officers and restrained using an escort chain. The risk assessments judged he was a medium risk of escape, and a medium risk to the public should he do so.
“Although there were no objections made by medical staff to the use of restraints on the risk assessments, there are many entries in Mr Micallef’s medical records that suggest that he was extremely unwell. We consider this was disproportionate given the seriousness of his medical condition and his impaired mobility, particularly during his final admission.”
Micallef was arrested during a massive sting on hard drugs in Newport in April 2017 and two months later found himself jailed by a judge at Newport Crown Court – receiving a prison term of five years and seven months.
But the following November, he was hit with the news that a rare form of blood cancer called myelodysplasia.
Micallef, who also had bipolar disorder, was told in January 2018 that he needed a stem cell transplant, but needed to have treatments including blood transfusions and radiotherapy for it to have the best chance of success.
However, the ombudsman report added: “Unfortunately, he was not always compliant and often refused to go to hospital for treatment or discharged himself once there. The management of Mr Micallef’s condition was complicated by his unwillingness to follow the advice given to him by both hospital and healthcare staff.
“Entries in his medical records show he took the decision to discharge himself from hospital against advice on nine occasions, four of those within a 48-hour period between April 13 and 15, 2018. The transplant was postponed on more than once because Mr Micallef was not well enough.”
Micallef finally had the transplant in June 2018, the report stated, but he did not respond well and his liver and kidney function deteriorated.
The report said: “On June 7, during a meeting held at Singleton Hospital, hospital staff raised concerns at the level of restraint Mr Micallef was subjected to while an inpatient. They pointed out his worsening condition and how it affected his level of mobility. Following the meeting, the decision was taken to remove Mr Micallef’s restraints. They were not reapplied.”
He remained in hospital and, on July 15, his condition deteriorated rapidly and he suffered organ failure.
His cause of death was recorded as sepsis and veno-occlusive disease – obstructions in the veins in the liver – caused by the stem cell transplant.
An investigation found healthcare staff at Parc provided Mr Micallef with a good standard of clinical care that was equivalent to what he could have expected to receive in the community. It also said staff had tried to encourage Micallef to attend hospital for treatment on a number of occasions.
But the ombudsman added: “The prison did not have a clear protocol for managing prisoners who repeatedly refuse to go to hospital for treatment or self-discharge and have recommended that a protocol is put in place.”
The report also recommended HMP Parc’s governor should ensure all staff completing and authorising risk assessments should “fully take into account the health of a prisoner” when the inmate is taken to hospital.
Director of HMP Parc, Janet Wallsgrove, said: “We have fully accepted the Prison and Probation Ombudsman’s recommendations and the risk assessment we conduct when prisoners need to attend appointments outside of the prison has been reviewed and refresher training for staff has been provided.”
Micallef is the 16th prisoner to die under the care of HMP Parc since July 2015.