Handcuffs used to take a dying 84 year old to the hospital. Twice!

An inquest jury gets told by a Manager of a United Kingdom detention centre that is for profit that there was no allowance for discretion; that it would have had him slowed down from going to the hospital if it had been challenged.

Yesterday, the inquest that is being made into the demise of Alois Dvorzak heard how a Canadian man who was confused, frail, and 84 years old was in handcuffs taken to the hospital twice due to the United Kingdom detention centre’s staff thinking that an escape risk was what he was.

On January 23, 2013 Dvorzak arrived at Gatwick Airport on arrival from Canada where he had gone to Slovenia to see his daughter. Immigration officers of the United Kingdom were worried about his vague travel arrangements and mental health.

Dvorak was sent to East Surrey Hospital by officials and then he was detained at the immigration removal centre at Harmondsworth, awaiting repatriation. On February 10, 2013 he died.

Yesterday, the inquest at the Coroner’s Court of West London heard from Firat Loverisge who was the manager of duty operations charged with the daily operations of Harmondsworth. Geo is a private security outfit which operated Harmondsworth and provided escorts for security for visits to the hospital, and it was where Loveridge worked for.

Loveridge stated that he was the only person in the building who was in a managerial position during the night shift. He stated that it was on the morning of February 10th at around six o’clock was when he heard of Alois Dvorzak for the first time. It was when staff of the healthcare had sent an alert to him that Dvorzak was going to be taken to the hospital by an ambulance that was coming for him.

The jury were informed by him that on several visits to the hospital detainees were expected to be in handcuffs based on a Detention Services Order.

Dvorzak’s paperwork was checked by Loveridge and he discovered that he had once already been handcuffed for a visit to the hospital and that when he was in Canada he had previously escaped from a mental hospital that was secure. His understanding was that any detainee who was regarded an escape risk must be put in handcuffs.

There was no notice from the staff of healthcare with regards to the extremely frail condition of Dvorzak. Loveridge himself had not seen Dvorzak yet.

Discretion was not permitted any chance

Chinyere Inyama the Senior Coroner continuously asked Loveridge who was sitting in the stand for witnesses if Dvorzak was possibly a risk to any person. Loveridge stated that staff of security had included details about the escape in the paperwork.

He agreed that once they had escaped, he did not see any risk to any body.

The jury was informed by Loveridge that he only got to see Dvorzak after he was inside the ambulance already, and sitting upright.

He was asked by the coroner if he did need any handcuffs.

In response, Loveridge stated that in all honesty that he did not. However, whenever he was taking a reading of paperwork and then he saw him there was a slight difference. Information was the basis of their decision making. Discretion was not permitted any chance. His going to the hospital would have been slowed down if he had challenged it.

Two Geo escorts and ambulance staff took Dvorzak to Hillingdon Hospital. Loveridge stated that the use of handcuffs could have been challenged by any one of them.

Also, the jury listened to Manpreet Sidhu who in January 2013 was at the Home office at Harmondsworth as the acting centre manager. She stated that whenever she saw handcuffs on detainees it was just an occurrence that was so routine that she would not even think too much about it and neither would she have the policy of Geo question with regards to it.

The inquest was informed by Sidhu that she was only temporarily in charge. She stated that she could not have been as experienced as she was supposed to have been. The expectation was that a detention centre was what Harmondsworth was and that it could handle most kinds of detainees. The expectation was that they were supposed to simply get along with it.

Sidhu stated that she did not have any understanding of what was involved in a Mental Health Act evaluation and did not have any knowledge about how frequently a doctor of psychiatry visited the centre.

Sidhu was then asked by the coroner who was in charge of the health of Dvorzak.

In response, Sidhu stated that the exercise was a collaborative one and his welfare was the involvement of many parties.

Unfit for detention

On January 30, 2013 Dr Farrah Jarral informed Sidhu that Dvorzak was unfit for detention. She stated that it was unusual and a rarity for her to be directly contacted by a doctor in that ways and the seriousness of the situation was shown by it.

A revelation was made by SIdhu that at the time at Harmondsworth a huge issue was chickenpox. In the healthcare wing where Dvorzak was kept there were two cases of chickenpox in isolation. She stated that there could be serious implications for Mr. Dvorzak being within the same vicinity.

The jury was informed by the healthcare manager at Harmondsworth Dr. Angela Davies that she did not have any background in mental health but had done work in prisons comprising of Wormwood Scrubs.

She had stated that Harmondsworth possessed a hospital system which was of a very basic type, and was managed by Primecare a private healthcare company.

On January 30, 2013 when Dvorzak was first seen by Dr. Davies, she stated that he was in the ward in a corner with his hat on him, very quiet and curled up. She stated that they were all worried about him due to his obvious frailty and his age.

The inquest was informed by Dr. Davies that a gentleman who was elderly and frail was who he was, and one who was vulnerable very clearly. For him, it was simply not the place that was appropriate for him. they had not been established to give that support level. He required a care centre.

Dr. Davies stated that it was obvious that things were not going properly for him. they had serious worries with regards to his health physically. He had not been taking any of the medications for his heart. Dr. Davies stated that she informed the manager of the Home Office Manpreet Sidhu that she thought he was fit for a detention that was very short term. She was going to be worried if at most it was going to take over a week.

Dr. Davies stated that Harmondsworth was to staff a difficult place, and it was not staffed optimally. A revelation was made by her that a doctor of psychiatry only came there for a routine visit once in a fortnight. An assessment that was direct could be more quickly arranged, but it was not going to ever happen on a similar day. To arrange from Hillingdon hospital a doctor of psychiatry on appointment would require several weeks.

A point was made by the coroner that officers of immigration had requested for Dvorzak to be given a Mental Health Act evaluation, and a doctor who had specific knowledge in mental health evaluation or treatment was required for this.

Initially, however, Dvorzak was provided with just a mental health evaluation by a nursing personnel. Dr. Davies stated that the on a Thursday the nurse was the person who was the most appropriate and quickest to deal with him. The doctor of psychiatry was expected on Monday.

The jury was informed by Dr. Davies that she did not possess deep knowledge with regards to psychiatry in the old age. A lot of the individuals that they normally handled were lower than 65 years of age.

“No alternative was available”

The inquest was informed by an Chief Immigration Officer at Gatwick airport Michael Langran that he was the case worker for Dvorzak after his discharge from the Hospital in East Surrey. (The progress of the immigration case of a detainee was the responsibility of case workers.)

The jury was informed by Langran that everybody who had ever handled him considered him not fit to be detained. They all shared the same opinion that he was not fit to be detained but there was no other option.

On February 6, 2013 his goal was to have Dvorzak deported with a medical escort and for him to be met on arrival in Canada by police. A care home was being searched for by authorities in Canada because the previous care home of Dvorzak had been closed. Dvorzak however was not able to get to the flight because he did not agree to work with the medical escort who was evaluating his ability to make a trip on an aero plane.

The jury was informed by Langran that he had not handled a situation before which involved partial dementia which also included problems with the heart which also included lack of cooperation which also included no family or friends. Contact was being attempted to be made with Dvorzak’s daughter by the Home Office. The authorities in Canada were successful in making contact with her a lot of months after the death of Dvorzak.

The Rule 35 Report of Dr. Jarral which stated that on January 30th, Dvorzak was not fit for detention did not get to Langran until on February 4th which was several days after. An insistence was made by Langran that even if he had seen the medical report much sooner, nothing would have changed.

He repeatedly stated that there was no alternative; that this was the particular place that they had in which he could be catered for. It was either on the street on in Harmondsworth was where Mr. Dvorzak was on. In the last week he had two heart attacks.

A statement which was written by a centre manager of Harmondsworth Jatinder Kaur was read by the coroner. Kaur had written that shortages in staff was the reason for the Rule 35 Report of Dr. Jarral being delayed from getting to the caseworker Michael Langran. Kaur claimed that they had always had problems with acquiring administrative staff.

A continuation would be made to the inquest.