Healthcare staff at a North East prison did not consistently monitor the medical conditions of a burglar who died while behind bars, an independent report has revealed.
Darren Davidson was put in the recovery position by other prisoners when he collapsed on a wing suffering a subarachnoid haemorrhage stroke at HMP Northumberland on June 25 last year. Prison Custody Officers (PCOs) called for help from healthcare staff and an ambulance was contacted straight away. Paramedics reached the 46-year-old but, despite resuscitation efforts, he died in the Category C jail.
A report, produced by Prisons & Probation Ombudsman, has identified how he had several pre-existing health conditions including epilepsy, high blood pressure, opiate dependency, a brain aneurysm (a bulge in a blood vessel in the brain) and post-traumatic stress disorder (PTSD).
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ChronicleLive previously reported how agoraphobic and anxious Davidson had been handed the five year jail term in May 2020 for a string of burglaries which had left victims traumatised. He was only one year into the sentence at the prison in Acklington, Northumberland, when he passed away.
The report outlined how Davidson was previously remanded in custody in February 2017. He was sentenced to three years and 11 months in prison for burglary in May that year and transferred to HMP Northumberland the following month. Davidson was released into the community on March 21, 2019 but recalled to prison in November and charged with the further offences.
The report said: "Following his recall to prison, healthcare staff did not consistently monitor Mr Davidson’s long-term medical conditions."
The clinical reviewer concluded that the clinical care Mr Davidson received at Northumberland was of a good standard and generally equivalent to the care he could have expected to receive in the community. However he did identify some areas of concern.
There was found to be a lapse in the monitoring of his high blood pressure due to the restrictions introduced to mitigate the coronavirus pandemic. The clinical reviewer said management of his brain aneurysm, epilepsy and thrombosis was also "poor".
The Prisons & Probation Ombudsman reported how the Head of Healthcare told them the prison healthcare services experienced resource pressures due to sick absences related to Covid-19. They said that this, coupled with guidance from Public Health England to stand down non-priority activity, meant resource was prioritised for urgent and emergency care.
The report said: "The clinical reviewer acknowledged that the prioritising of urgent and emergency care was an approach which was also operating in the community. However, the clinical reviewer considered that there was no consideration given to making use of medical technology to enable remote assessment and monitoring of Mr Davidson’s blood pressure."
They found there was no evidence that healthcare staff reviewed Davidson's cerebral aneurysm following his recall to prison in November 2019. They also identified how Davidson was receiving medication for his epilepsy but not for his thrombosis. The report said: "There is no evidence that these conditions were followed up, monitored or reviewed or that a care plan was created and implemented for these conditions."
The report added: "The clinical reviewer found that it was not possible to say if Mr Davidson’s death could have been prevented due to the nature of a subarachnoid haemorrhage."
Recommendations have been made by the Prisons & Probation Ombudsman following Davidson's death. In the report, they recommend that the Head of Healthcare should review the arrangements in place for monitoring long-term conditions. These include:
- making use of medical technology that enables remote assessment and monitoring
- the care and treatment of prisoners with a diagnosis of epilepsy and the risks associated with sudden unexpected death in epilepsy and the need for neurological review and monitoring of the condition
- the care and treatment of prisoners with a history, or at risk, of thrombosis.
In May last year, ChronicleLive reported how Davidson has only been out of jail a matter of months when he struck again, stealing valuables from traumatised victims in Heaton and Jesmond, Newcastle.
Newcastle Crown Court heard how he had mental health problems following a difficult childhood and had suffered trauma. By his own admission, the "institutionalised" defendant had been "unable to succeed" on the outside and believed it was best for him to be in custody.
Davidson, of no fixed address, was jailed after pleading guilty to two burglaries, having a bladed article and two counts of handling stolen goods. He also asked for another burglary to be taken into consideration. He already had nine convictions for house burglaries on his record since 1999 and more than 60 for dishonesty.
The healthcare at the prison, which is run by Sodexo Justice Services, is provided by Spectrum Community Health CIC.
A spokesperson for Spectrum Community Health CIC said: "We offer our heartfelt condolences to the prisoner’s family and those who knew him. The PPO report concluded that the clinical care Mr Davidson received at HMP Northumberland was of a good standard and generally equivalent to the care he could have expected to receive in the community. We work closely with Sodexo and NHS England to ensure that all recommendations, including staff training and improving our processes, are taken on board and fully implemented."
A HMP Northumberland spokesperson added: "Our thoughts are very much with the family of Mr Davidson, who sadly passed away in June 2021. Alongside our Healthcare partners, Spectrum, we cooperated fully with the Prisons and Probation Ombudsman’s investigation, accepted the recommendations made and are working together to implement the agreed actions."
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