HMP Thameside (Serco corporate image)

Healthcare staff at Thameside Prison in London were unaware that a young man in their care was detained for immigration purposes, which led to him missing a hospital appointment that might have saved his life, an inquest jury heard yesterday.

Bruno Dos Santos, 25, was detained at HMP Thameside for several months from September 2013 until May 2014, a court sitting in Dorchester was told yesterday. In May he was transferred to the Verne Immigration Removal Centre in Dorset, where he died on 4 June. 

Dos Santos had a complex medical history and was taking medication for epilepsy, depression and shoulder pain. He suffered from severe epileptic fits and had dislocated both shoulders as a result of frequent seizures. In February 2014, while detained at Thameside, Dos Santos was assessed by Dr Giovanni Cocco, a consultant neurologist.

Following the appointment Dr Cocco wrote to a GP working at the prison, whose healthcare provider at the time was private contractor Care UK, explaining that the young man’s fits were a result of trauma after being knocked down by car aged 10. After the car accident Dos Santos was in a coma for two or three days. He then spent several months in hospital re-learning how to walk, talk and carry out basic tasks. Dr Cocco recommended Dos Santos undergo an MRI, EEG and an ECG, and that his anti-epileptic medication be increased gradually. An MRI appointment was booked for 23 February.

The court heard that Rida Kamsilla, a nurse working at Thameside, spoke to Dos Santos the day before his appointment on 23 February. When he told her about it, she told the wing officer that Dos Santos “is not going anywhere tomorrow”. She then passed the same message on to the senior nurse on duty asking for the appointment to be cancelled. Nurse Kamsilla told the court that she was following prison policy at the time, which was that patients should not be given dates regarding external appointments. This was for security reasons, she said.

Nick Brown, the barrister representing the family, suggested that Nurse Kamsilla had been “over officious” in making this decision. “It was not your decision to make,” he said. Instead, he said, she should have passed it on to another member of staff to carry out a proper risk assessment. She replied that she was simply following the policy. Brown asked if the policy was written anywhere and nurse Kamsilla replied that it was not. Brown then questioned the nurse about Dos Santos’s immigration status.

Brown: “Were you aware that he was an immigration detainee?”

Kamsilla: “No, I was not aware.”

Brown: “Were you aware of the policy on immigration detainees at that time?”

Kamsilla: “No.”

Brown then read from the Detention Services Order 2012 which states that: “Every effort must be made to keep and fulfil medical appointments of detainees, both those arranged prior to and during detention.”

The rules also state that external appointments must be considered on a case by case basis, he said. This assessment would consider factors such as the seriousness of the condition of the detainee.

“Bruno would have undergone an MRI if a proper risk assessment had been made?” Brown asked Nurse Kamsilla. “Yes,” she answered.

Earlier, the jury heard that Dr Esther Okumo, a locum doctor working at Thameside, had also been unaware that Dos Santos was an immigration detainee and not a prisoner at the time. Dr Okumo said she was unaware that there are policies governing the treatment of immigration detainees.

Once Dos Santos’s appointment was cancelled there was no follow up to reschedule, the jury heard. Several months after the missed appointment, Dr Cocco wrote to Dr Okumo to ask why he had missed the appointment, and whether another should be booked. Dr Okumo said she was shocked to discover this and immediately rebooked it. Several times during her evidence Dr Okumo mentioned the number of prisoners held at Thameside at the time (approximately 900), and said that errors were sometimes made and missed appointments were a common occurrences.

However, when Brown asked if the prison was “under staffed” and unable to offer “proper continuity of care” for prisoners as a result, she said: “I am not going to admit that. It’s not my place … I’m just telling you what goes on.”

The court also heard from staff at Belmarsh prison, where Dos Santos was held as prisoner between January and May 2013. He was charged and convicted of robbery and served a sentence of one year and four months. He became an immigration detainee in September 2013 when he moved to Thameside, a private prison run by the outsource company Serco.

It was revealed that a GP at Belmarsh, Dr Ekpo said he had referred Dos Santos for an MRI scan in January 2013, several months before his move to Thameside. However, there was no record of the referral on the prison’s internal record system and no appointment was made.

On 6 May 2014, the court heard that Dos Santos told staff at Thameside that he had suffered another fit during the night. A staff nurse made a note on the prison’s electronic system for managing medical records for prisoners and included a comment from Dos Santos. Brown read it aloud to the court: “The last comment that we have from Bruno is ‘stated that his medication does not work’. He was transferred to the Verne the next day.”

The inquest continues.  

Note: At Serco’s request, on Tuesday 31 May at 15.11 the Serco logo was removed from the image above and the headline changed to make clear that it was Care UK staff who cancelled the brain scan. The original headline was: “Private prison run by Serco cancelled detainee’s brain scan”.