An investigation has found that HMP Altcourse "apparently altered" records concerning whether a prisoner was handcuffed on his way to hospital before he died. Romanian national Vasile Moisa, 51, was on remand at the privately operated category B prison on a burglary charge when he died of a hypoxic brain injury due to a heart attack on January 17 this year.
Conflicting accounts over restraints
The Prisons and Probation Ombudsman (PPO), which investigates all deaths in custody, reported conflicting accounts over whether Moisa was placed in restraints for the journey to hospital. Ombudsman Adrian Usher said the prison "submitted an apparently altered version of the escort risk assessment when challenged about the use of restraints."
The overall security assessment, completed by the duty operations manager, stated "uncuffed at this time due to potential heart attack...to be reviewed as and when he regains consciousness." However, a contradictory account in the authorisation section, completed by the duty director, indicated restraints should be used and could only be removed for treatment and emergencies.
In the reason for decision section, the duty director recorded "cuffs removed for treatment, staff informed to reapply once treatment finished." The escort authority form was annotated specifying the handcuffing arrangements as "escort chain."
Evidence of escort chain
When the ombudsman tried to explore the reasons for the use of restraints, the prison said they had not used them and provided another copy of the security risk assessment. Sections of the form which were previously blank were now marked with a highlighter pen. When challenged about the variation in the form, the prison provided no explanation for the alteration.
The ombudsman report said the duty director, duty operations manager and one of the prison officers insisted Moisa did not have restraints. The duty director suggested the comments on the form "might have been misinterpreted." But a pharmacy technician at the emergency "vividly remembered" an escort chain and recalled the duty operations manager "saying an escort chain would be applied as it was an emergency."
Mr Usher said: "The weight of evidence suggests an escort chain was applied at some point, as the duty director had noted that 'cuffs' had been removed. It is conceivable that they were withdrawn before Mr Moisa left the prison, but this cannot be substantiated.
"At best, there was an initial intention to use restraints despite a cardiac arrest barely an hour before, as well as continuing intravenous treatment. At worst, restraints were used and the modification of the form was a ploy to conceal this. Either way, the judgments were flawed and cast doubt on whether healthcare and wing staff fully understand their responsibilities."
Medical care concerns
When he entered prison, Moisa reported medical conditions as type 2 diabetes and a recent stroke. A health screening recorded he also had heart problems and asthma. A wing officer found there was a language barrier as Moisa "didn't speak good English."
Moisa collapsed at around 5.20pm on January 12. An officer radioed a code blue medical emergency and an ambulance was called. Paramedics arrived at the scene at 5.36pm and resuscitation attempts resulted in his heartbeat being restarted. Moisa died shortly after 9pm on January 17 after a video call was facilitated with his son in Romania.
The postmortem concluded his death was hypoxic brain injury due to a myocardial infarction. An inquest recorded his death as of natural causes.
The ombudsman added: "The clinical reviewer concluded that the clinical care Mr Moisa received at Altcourse was partially equivalent to that which he could have expected to receive in the community.
"She found that healthcare staff had not complied with the requirement in national guidance to identify Mr Moisa's communication needs during his health screens and this had impaired his clinical and medication management."
"We found that despite Mr Moisa's limited English, staff did not use an interpreting service for important discussions, or refer him to the equality and inclusion team, inline with the prison's foreign national strategy.
"Record keeping was poor in many areas, impairing the reception and induction process, family contact and documenting wing staff's involvement in the emergency response when Mr Moisa became unresponsive."
A spokesperson for Altcourse prison told the ECHO: "Our thoughts continue to be with the friends and family of Mr Moisa. We have cooperated fully with the Prisons and Probation Ombudsman's investigation, accepted the findings in full and we have completed the recommended actions by their deadlines."
Moisa was the 17th prisoner to die at Altcourse since 2023. Of the previous deaths, eight were from natural cause, six were self-inflicted and two were drug-related.
