Helping detainees in need of medical assistance

2nd March 2020: Prince Fosu Inquest

Monday, March 2nd, 2020

Neglect contributed to the death of an immigration detainee died naked and emaciated in ‘strip cell’ – others remain at risk

 

Prince Fosu died on 30th October 2012, 6 days after being detained at Harmondsworth Immigration Removal Centre (IRC). He suffered undiagnosed, untreated psychosis and related bizarre behaviour, dehydration, malnourishment and hypothermia. He died alone, on the concrete floor of a ‘strip cell’ in segregation with no mattress, having had little if any food, fluid or sleep.  He was naked, emaciated, and covered in debris.

Prince Fosu had been found running down a street with no clothes on. He was arrested and sent to Harmondsworth IRC.  There was a complete failure by guards and doctors contracted by the Home Office to recognise that Prince was mentally ill, to follow immigration detention policies and to properly document and monitor his wellbeing. Where they existed, records included noting Prince Fosu’s “non-compliant” behaviour and that he “declined” food, fresh air, showers and to see doctors.

 

The scale of the collapse of all ‘safeguards’ cannot be overstated. It happened at every turn, within Harmondsworth, the Home Office, healthcare, and the Independent Monitoring Board who acknowledge that Prince Fosu died “in plain sight”. None took purposeful steps to prevent Prince Fosu dying “in plain sight”. During the inquest many were unable to explain why they acted as they did; others gave explanations that were difficult to fathom.  3 doctors working for Harmondsworth have been reported to the General Medical Council for review.

 

Had proper assessment been undertaken and appropriate treatment provided, Prince Fosu may have lived.

 

Verdict / Cause of death :

Record of death : Sudden death following hypothermia, dehydration and malnourishment in a man with psychotic illness”

Further findings : “The failure of Primecare staff to effectively see, assess and provide healthcare to Mr Fosu is inexplicable … Doctors contracted by the Jersey Practice showed insufficient professional curiosity throughout Mr Fosu’s detention.  This lacking in professional curiosity resulted in an absence of any kind of medical intervention which in turn contributed to Mr Fosu’s deterioration … GP  record keeping was inconsistent where notes did appear, there was a failure to record anything meaningful … there was gross failure across all agencies to recognise the need for an provide appropriate care in a person who was unable to look after himself or change his circumstances … this was in part due to the failure to address, recognise, monitor and respond to Mr Fosu’s deteriorating condition.  Neglect contributed to the cause of death.”


 

Emma Ginn, Director of Medical Justice said :

“Prince Fosu was dehumanised. The failure of individual professional responsibility in this case was staggering. IRC doctors, Home Office officials and guards treated Prince Fosu’s life with casual contempt and effectively watched him die right in front of them.  There is nothing to prevent it happening again tomorrow.

 

Policies were clearly not protective enough, and the training and supervision of staff was wholly ineffective.  On top of this the culture of disbelief pervading immigration detention had a fatal consequence.

 

One IRC doctor said they did not regard detainees in segregation as patients and that they were only there to ‘fulfil a Home Office legal obligation’. It seemed they stopped acting like doctors when they stepped into the IRC.

 

7 years on from Prince Fosu’s death, lessons have not been learned ; our independent volunteer doctors still see mentally ill detainees held in segregation who have become psychotic, suicidal, stopped eating and drinking, and lost mental capacity.  Furthermore, the Home Office argued to the end of the inquest that Prince Fosu may have died of natural causes.

 

Many detainees experience a potentially lethal cocktail of medical mistreatment, severe deterioration of their already vulnerable health, and dangerous conditions. Since Prince Fosu’s death, some Home Office policy changes have made detention more harmful and 30 immigration detainees have died, including 4 at Harmondsworth.   

 

 Immigration removal centres should be closed before another detainee dies.” 

 

Mr V (detained in 2019 and previously held in segregation in Harmonsworth IRC) said :

 

“The inquest into Prince’s death just brings back the feelings of neglect, lack of empathy, lack of care and the sheer practice of brutality in the most open form with no repercussions. Having experienced this myself first hand I feel like Fosu’s death could easily have been my death. “

 

Quotes from Prince Fosu’s father, Mr Obeng, and his solicitor as well as INQUEST and more details of the case can be found in INQUEST’s press release here.

 

Available for interview : Mr V, and Medical Justice staff – Emma Ginn, Kris Harris and Dr Mary Kamara.

 

Contact : emma.ginn@medicaljustice.org.uk

 

Notes

  1. Prince Fosu was a 31 year old Ghanaian. He is survived by his wife, child and parents.
  2. Prince Fosu’s father had a valid passport and an airline ticket for his son. He asked that he be allowed to send his son to Ghana and was willing to be escorted to the airport. But the Home Office refused.
  3. The Home Office seems incapable of learning lessons – they have not learned from previous deaths, including that of Brian Dalrymple who died in Colnbrook IRC having been transferred there from Harmondsworth IRC just a few days earlier. His death involved many of the same staff, and the inquest uncovered strikingly similar failures in recognising and responding to signs of mental ill health and distress, clinical record keeping, effective checks in segregation, and doctor unaware of the existence of the Detention Centre Rules.
  4. A key Home Office witness in both inquests seemed to not remember the Brian Dalrymple case. When the barrister for Prince Fosu’s father put it to her, she said that Prince Fosu’s was her first and last case of death in custody.
  5. The General Medical Council must investigate at why none of the doctors, despite saying they were in an unfamiliar environment, not knowing about the rules, took any steps to fulfil their obligations to recognise and work within the limits of their competence. Their failures included basics such as writing proper notes (or any notes) and recognising detainees as potential patients.
  6. Harmondsworth staff deemed Prince Fosu to be on a ‘dirty protest’. The Home Office and IRCs continue to fail to recognise that some ‘dirty protests’ and food & fluid refusal are rooted in mental illness. Many detainees who are mentally ill and/or at risk of self-harm or suicide are inappropriately put in segregation.
  7. Medical Justice has flagged up fatal system failures in healthcare to the Home Office since 2005 but rather than welcome our evidence, it is all too often disregarded or rejected.
  8. It is contemptible that it took until the day the inquest opened for the Home Office to publish amendments to its Segregation policy limiting the removal of bedding from cells – we estimate that over 6,000 detainees will have been exposed to that risk since Prince Fosu died.
  9. Medical Justice doubts any policy improvements will prevent another death ; immigration detention in and of itself can be severely damaging, plus the prevalence of medical mistreatment, combined with two decades of consistent, proven Home Office failure to learn lessons.
  10. The doctors involved in Prince Fosu’s case worked at Harmondsworth for several months. They did not know of the existence of key policies protecting detainees that they alone could operate – so none of those fundamental protections against unlawful detention could be operated at the very least for those months. This calls into question how many cases where the Home Office said detentions were lawful because there were protections in place.
  11. The only way to end immigration detainee deaths is to end immigration detention. Medical Justice agrees with the British Medical Association that immigration removal centres should be phased out.
  12. The inquest – A long awaited decision to bring criminal charges against the private companies responsible for Prince Fosu’s care was reversed in October 2018.
  13. The family of Prince Fosu was represented by INQUEST Lawyers Group members Kate Maynard of Hickman and Rose solicitors and Nick Armstrong of Matrix Chambers.
  14. Other Interested persons represented are GEO, The Home Office, The Chief Constable of Northamptonshire Police, the Independent Monitoring Board, Jersey Practice, Dr Wesley Joseph, Dr Sharif, Dr Singh, Dr Navqi, Central and North West London NHS Foundation Trust, Mitie.
  15. About immigration detention : Previous inquests have concluded that neglect contributed to detainees’ deaths and the courts have made a number of findings that detention amounted to “inhuman and degrading treatment”. It is now widely accepted that immigration detention can exacerbate existing medical conditions and can be the cause of mental illness. 
  16. Immigration detention is arbitrary and indefinite. It is not the consequence of any criminal activity nor is it judicially sanctioned yet 25,000 people are detained every year.
  17. About Medical Justice : Medical Justice is a charity that sends volunteer doctors into IRCs to assist detainees, documenting their scars of torture, medical conditions, and injuries sustained during removal attempts, and to challenge instances of medical mistreatment. With our medical evidence, we quantify the endemic extent and severity of harm suffered by immigration detainees.  We identify systemic healthcare failures to the Home Office and NHS England and where discussion fails, we may undertake strategic litigation.
  18. Some Medical Justice clients were eventually sectioned to a secure psychiatric unit – some were released into the community after many months, others were sent back to an IRC. We have seen an increasing number of clients who have eventually been released due to their mental illness but later detained again.
  19. Data on deaths of immigration detainees – There have been deaths in every single year since Prince Fosu died. There were 11 in 2017 alone. Since 2000 there have been XXX deaths of immigration detainees in IRCs, prisons, during deportation, or within four days of leaving detention.
  20. Recent inquests into deaths of immigration detainees identified: Carlington Spencer, 38, who died as a consequence of a stroke – a series of failings which possibly contributed. Bai Bai Ahmed Kabia, 49, who died as a result of a brain haemorrhage – missed opportunities that could possibly have prevented his death. Marcin Gwozdzinski, 28 – serious failings which contributed to his death. Amir Siman-Tov, 41, who died as a result of ‘misadventure’ – a critical narrative conclusion. Tarek Chowdhury, 64, was killed by another detainee experiencing serious mental ill health who had been inappropriately placed in immigration detention – numerous other critical failings. Michal Netyks, 35, died a self-inflicted death – serious criticisms of the immigration deportation process. Branko Zdravkovic, 43, died a self-inflicted death – serious failings, with the coroner writing a critical report to prevent future deaths.
  21. INQUEST information on Deaths of immigration detainees
  22. Medical Justice report : Death in immigration detention
  23. Medical Justice report : “A Secret Punishment ; The Misuse of Segregation in Immigration Detention

 

‘Gross failures’ contributed to man’s death in immigration centre…The Guardian 02/03/2020

Record Of Inquest For Prince Fosu