A serving prisoner who died after being found unconscious in his cell suffered a ‘massive’ bleed on his brain, an inquest has heard.
Brian William Randall was pronounced dead at West Suffolk Hospital at 6.34pm on February 10, 2013, after being discovered unconscious and unresponsive in his cell at HMP Highpoint (South) in Stradishall at around 9am the same day.
The 60-year-old was sentenced to a three-year prison term for conspiracy to supply a controlled drug in June 1012 and had been transferred to Highpoint prison from HMP Oakwood in November 2012.
Today’s inquest in Bury heard that Randall had had a number of medical problems throughout his life, including a heart attack and a mild stroke previously, and had visited the hospital on a regular basis prior to being imprisoned.
He had also lost about eight stone in weight since having a gastric band fitted in March 2012 and had a history of high blood pressure for which he was eventually prescribed the anticoagulant drug warfarin.
His wife, Jacqueline, told the inquest Randall – with whom she had two children – had missed follow up medical appointments because of his imprisonment and had expressed concern about the lack of healthcare he had been receiving behind bars.
She said: “I wish I had done more to pursue healthcare with the prisons. I made a number of phone calls but that wasn’t enough.
“I fully accept Brian deserved to be in prison for his crime but this did not mean he should not receive appropriate medical treatment.”
Randall was discovered by fellow inmate Roger Oldfield who thought he may have overslept and knew that his wife was due to visit.
He found Randall lying on his back with his tongue partly out of his mouth. His breathing was laboured and he had a ‘slight’ pulse.
Believing he had suffered a stroke, Oldfield alerted the prison officer who reported it as a ‘code blue’ and placed Randall in the recovery position.
In his evidence, Stephen Bennett, Randall’s cell neighbour, said he noticed Randall usually slept naked but was found wearing a shirt and sock, suggesting he had been taken ill while getting dressed.
An ambulance was called at around 9.10am.
Andrew Martin, one of the EMTs who responded, told the inquest he believed Randall was experiencing some form of neurological event and was ‘time critical’.
Randall arrived at the Bury St Edmunds hospital at about 10.20am.
Hospital consultant Dr Catherina Swanevelder said Randall had experienced a spontaneous, catastrophic bleed on his brain for which surgical intervention was not possible.
She said he also had therapeutic levels of warfarin in his system.
Dr Swanevelder explained that medicine was a ‘balance of risks and benefits’ and that without warfarin Randall could have suffered a stroke from a blood clot rather than a bleed.
“The bleeding was probably caused by hypertension but, because he was on warfarin, the bleeding didn’t stop,” she said, adding that a fatal bleed was possible even without the drug.
Randall was surrounded by family when the machines keeping him alive were eventually turned off.
The inquest heard evidence from Detective Inspector Nick Stonehouse who said there was nothing to indicate Randall’s death had been caused by anything other than natural causes.
Dr Sheila Purdy, the pathologist who conducted a post-mortem examination on Randall, said there was no evidence of a skull fracture or bruising on his brain.
Her key findings included a swollen brain containing a large amount of blood and an enlarged heart.
She attributed Randall’s death to a large, acute intracerebral hemorrhage secondary to hypertension, but said she could not exclude the possibility that warfarin had been a contributory factor.
A report from the Prisons and Probation Ombudsman (PPO) noted that an inspection of Highpoint in 2010 found a large number of inmates did not attend healthcare appointments and the Independent Monitoring Board had also expressed ‘serious concerns’ relating to prisoners’ healthcare.
The inquest continues tomorrow.