Investigation report into the death in custody of Joseph Abraham

Published on May 21 2013

The Prisoner Ombudsman for Northern Ireland, Pauline McCabe, today published her report into the death of 56-year-old Joseph Abraham, who died of a heart attack while in the custody of Magilligan Prison on Saturday 21 April 2012.

Mr Abraham had a medical history which included a past heart attack in 1997 and a diagnosis of stable angina in 2006. Prior to his committal, Mr Abraham had regular cardiac outpatient reviews but had declined invasive investigations and disregarded medical advice as how to best manage his condition.

On 19 February 2008, Mr Abraham was committed to Maghaberry Prison and later transferred to Magilligan Prison on 10 July 2008. Mr Abraham did not tell staff about his ongoing outpatient reviews nor was there any evidence in his prison medical records that his community medical records were requested. A review of Mr Abraham’s prison medical records did, however, show that there was regular monitoring of his blood pressure, blood tests, cholesterol level and doctor’s reviews for his angina. It was also noted that Mr Abraham remained a heavy smoker during his time in prison.

The report points to two matters of concern requiring action by the Northern Ireland Prison Service and South Eastern Health and Social Care Trust. These relate to: the failure to request Mr Abraham’s community medical records at the time of his committal to Maghaberry Prison, or when he was subsequently transferred to Magilligan Prison; and the inadequate support of staff after Mr Abraham’s death.

Releasing the report, Mrs McCabe said:

“The evidence examined in connection with the investigation into the circumstances of Mr Abraham’s death suggests that, overall, he was well cared for at Magilligan and staff were very responsive when he was found collapsed in his cell. The autopsy report concluded Mr Abraham’s death was from natural causes relating to a ‘coronary atheroma’, in other words, a heart attack and the investigation supported this finding.”

Mrs McCabe added: “I have however, identified two issues of concern. Firstly, and of utmost importance, is the necessity to ensure that community records are requested for prisoners at the time of committal so that important decisions made about medical and medication care needs are properly informed. I have referred to this many times and I welcome the fact that the South eastern Health and Social care Trust are now fully addressing this matter. Secondly, it is my experience that deaths in custody can be very distressing for staff who have known and cared for prisoners or who have to attend following the death. I have, therefore, emphasised the need for the arrangements in place to provide support for staff are adequately and consistently applied.”