James Colton

“The doctors and nurses at the prison failed to properly diagonose, treat and care for Mr [name redacted] in that they assumed that the diagonosis of mechanical back pain was accurate and took no steps to revisit the diagonosis or to escalate his treatment despite his obvious continuing decline. The failure to consider alternate diagnosis led to them missing his developing cancer and which may, therefore, have contributed to his early death”

“The procedure and processes for providing Mr [name redacted] with adequate anelgeasia were defective and there were occassions when Mr [name redacted] did not receive Tramadol to control his pain. This meant that his last days in prison were distressing and increasingly painful for him to the extent that he was at times unable to get off his bed to receive medication”

“There appeared to be no continuity of care for Mr [name redacted], little or no adequate communication as between Healthcare nursesand doctors, and no coherent plan for his care. There appeared to be no appropriate review of Mr [name redacted] care or treatment.”

“The evidence given was that there was an extremley heavy workload which meant {to quote one of the GP's who gave evidence) that he was unable to get on top of the work that was required-of him and that reviewing prisoners in Healthcare was not a priority.”