CEDH · CASELAW;CLIN;ENG — 14 décembre 2006

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Russia - 4353/03 Judgment 14.12.2006 [Section V] Article 2 Article 2-1 Life Inadequate medical care leading to prisoner's bleeding to death, and failure to conduct an effective investigation: violation   Article 3 Degrading treatment Inhuman treatment Handcuffing of prisoner recuperating from internal surgery, and transport in standard prison van two days thereafter: violation   Facts : The applicant's son, Mr   Tarariyev, was born in 1976 and died in 2002. In 2000 he was convicted of grievous bodily harm and sentenced to six years' imprisonment. In 2001 he fell ill and was diagnosed with an acute ulcer and prescribed medicines. He was later taken to a prison hospital, where he received treatment. On his return to the Khadyzhensk prison colony he was examined and diagnosed with chronic gastroduodenitis. Certain medicines were prescribed. Following a new round of criminal proceedings, in April 2002 Mr   Tarariyev was sentenced to six years' imprisonment and sent back to the prison colony. According to the applicant, upon his arrival all medicines were taken away from him and no medical assistance was provided. In August 2002, after complaining about acute pain, he was diagnosed as having a perforated duodenal ulcer and peritonitis and was operated on at the Apsheronsk public hospital. The applicant maintained that her son's left hand had been shackled with handcuffs to the hospital bed when she had visited him. In support of her statements she produced a written affidavit by a friend of hers, who had also visited the hospital. Later in August 2002 Mr   Tarariyev was diagnosed with a breakdown of sutures in the duodenum, duodenal fistula and peritonitis. He was discharged from the hospital and transported by prison van to a prison hospital, 120 km away. After undergoing further surgery he died there. An autopsy established that the death had been caused by acute blood loss provoked by massive gastrointestinal haemorrhaging. Charges were brought against medical staff at the two hospitals for negligent manslaughter resulting from incompetent performance of their duties. The case against the doctors of the prison hospital was subsequently referred to the regional prosecutor and then abandoned for want of indications of a criminal offence. The head of the surgery department of the Apsheronsk hospital was put on trial but a district court acquitted him for lack of evidence. The judgment said nothing about the applicant's civil claim. The prosecutor office later informed the applicant that an additional inquiry into the actions of the staff of the prison hospital had been carried out but that no negligence on their part could be established. Law : Article   2 – Failure to protect the right to life : For more than two years preceding his death Mr   Tarariyev had been in detention and the custodial authorities had been fully aware of his health problems. There was no consistency in his medical records, most of which were either mislaid or incomplete. At the correctional facility he was not properly examined and did not receive any medical treatment. Although he was promptly transferred to a public hospital, the surgery performed was defective. The doctors of the Apsheronsk hospital authorised his discharge to the prison hospital in full knowledge of the post-operative complications requiring immediate further surgery. They also withheld crucial details of his surgery and developing complications. The prison hospital staff treated him as an ordinary post-operative patient rather than as an emergency case with the consequence that surgery was performed too late. Furthermore, the prison hospital was not adequately equipped for dealing with massive blood loss. The existence of a causal link between the defective medical assistance administered to Mr   Tarariyev and his death was confirmed by the domestic medical experts and was not disputed by the Russian Government. Conclusion : violation (unanimously). Article   2 – Adequacy of the investigation : The criminal investigation was slow and its scope was restricted, leaving out many crucial aspects of the events. The applicant's right to effective participation in the investigation was not secured because she was not properly informed about the procedural decisions taken in the case. The prosecution had prepared the evidentiary basis for the trial in a poor manner, which ended in the acquittal of the suspect. Following the failure of the criminal proceedings the applicant did not have at her disposal an accessible and effective civil-law remedy, either because a civil claim was barred by operation of law or because it had no chances of success in the light of the existing judicial practice. In sum, the Russian authorities failed to discharge their positive obligation to determine, in an adequate and comprehensive manner, the cause of death of Mr   Tarariyev and to bring those responsible to account. Conclusion : violation (unanimously). Article   3 – Handcuffing at the civilian hospital : It was not in dispute that Mr   Tarariyev had not presented any danger of absconding or causing self-harm or injury to others. He was attached to the bed on the day after a complex internal surgery. He was on a drip and could not stand up unaided. It also appeared from a witness's detailed deposition that a police officer armed with a submachine gun was present in Mr   Tarariyev's room and two other officers remained on guard outside the room. In those circumstances, the use of handcuffs was disproportionate to the needs of security. Having regard to his state of health, to the absence of any cause to fear that he represented a security risk and to the constant supervision by armed police officers, the use of restraints in those conditions amounted to inhuman treatment. Conclusion : violation (unanimously). Article   3 – Conditions of Mr   Tarariyev's transport to the prison hospital : The vehicle at issue was designed for the transport of detainees rather than post-operative patients. A stretcher on wheels was used to bring Mr   Tarariyev to the vehicle, and inside the vehicle he was placed on padded mattresses. The distance between the civilian and prison hospitals being more than one hundred kilometres, Mr   Tarariyev was transported for more than two hours in those conditions. He had had internal surgery merely two days beforehand and on the day of transport he was diagnosed with a breakdown of sutures, a condition requiring further surgical intervention. As the medical experts subsequently found, Mr   Tarariyev had been “unfit for transport”. In those circumstances, the presence of a medical nurse could not compensate for the inadequate transport conditions. Having regard to Mr   Tarariyev's serious condition, the duration of the journey and the detrimental impact on his state of health, his transport in a standard-issue prison van must have considerably contributed to his suffering and therefore amounted to inhuman treatment. Conclusion : violation (unanimously). Article   41 – EUR 25,000 for non-pecuniary damage.   © Council of Europe/European Court of Human Rights This summary by the Registry does not bind the Court. Click here for the Case-Law Information Notes