Officers at a Queensland watch house failed to properly check that a woman was still breathing on at least 11 occasions before she died in custody, an inquest has heard.
An inquest is being held over the next fortnight to examine the deaths of Vlasta Wylucki, in the Southport watch house in 2018, and Shiralee Tilberoo, in the Brisbane city watch house in September 2020.
Both died from natural causes, but questions have been raised about their care and supervision in custody.
On Monday the inquest heard Wylucki had a heart condition, had been vomiting and told her cell mate she was “really sick” in the hours leading up to her death.
Overhead CCTV footage showed Wylucki lying on the floor next to a toilet behind a concrete wall that blocked officers’ view on the night of her death.
Officers physically checked on the 50-year-old several times, but a torch was not used on all occasions.
During one check, an officer briefly entered the cell but did not move close enough to get a proper look at Wylucki, the inquest heard.
Sharon Pickett, an ethical standards investigator with Queensland police, told the inquest that 11 of 13 of the checks were deemed non-complaint with police procedures. The officers involved were referred to the south-eastern region for local managerial resolution, which involves a remedial discussion with a superior.
Pickett said CCTV footage showed Wylucki breathing but as the evening progressed it became more laboured and she was seen sitting up and dry retching.
“I assume there’s bile, she wipes something on the floor. I took that more from the audio,” Pickett told the inquest.
At one point, an officer noticed Wylucki sit up, but he did not enter the cell to ask her if she was OK – which Pickett told the inquest would have been an opportunity for “a different outcome”.
A senior officer at Southport, Daniel Marshall, had booked Wylucki into the watch house that evening. He told the inquest that she had consumed two bottles of wine that day, but she was in good spirits and not intoxicated.
Counsel assisting the inquest, Sarah Lane, asked Marshall how easy it was to check if someone was breathing if they were positioned behind the concrete wall in that particular cell.
“You can’t,” Marshall responded, saying that issue had been brought up “many times”.
Southport watch house supervisor Sgt Lyle Wiss told the inquest officers were required to do CCTV checks on prisoners every 30 minutes and physical checks every hour to make sure their “chests are rising and falling”.
He said the frequency of the checks could be increased to 15 minutes if a prisoner had special needs or was affected by drugs or alcohol.
Wiss said he had chosen to place Wylucki in the female-only cell as there had been a spot available.
But a state custody expert, police inspector Marcus Cryer, said the cell – which is no longer used to hold more than one person – was inappropriate for two prisoners and should not be used for an overnight stay.
Cryer said a number of the inspections were done too quickly and that officers should continuously watch CCTV to ensure detainees are well.
“They should’ve done more,” he said.
Wylucki was born in Croatia but lived in Canberra from the age of two, later moving to Queensland, where she worked as a nurse.
Standing outside the coroner’s court on Monday, Wylucki’s family described her as “kind hearted”.
“Sadly, things got a bit much for mum so her outlet was alcohol to numb the pain from her marriage breakdown and chronic health issues, her daughter Laura said. “I really want to stress how much of a kind, funny and caring woman my mother was.”
She described the evidence before court as “disgusting” and called for watch house staff to do more checks on prisoners.
“It’s just ridiculous – you can’t even see my mum, whether she’s breathing or not,” Laura said.
“We just want to know exactly what they’re going to do to prevent this, how they’re going to actually make the changes.”