A prisoner had a cocktail of drugs in his system after being found dead in his cell at HMP Durham.
Convicted burglar Joseph Andrew Price died in his cell on September 20, 2020 - just 10 days after arriving there on remand - and post-mortem toxicology tests revealed that the 28-year-old had used methadone, cannabis, diazepam and pregabalin before his death. However, a pathologist was unable to establish the cause of his death.
On September 10, 2020, Mr Price had been recalled and remanded at the County Durham prison for breaching his licence conditions and had been charged with intent to steal, possession of cannabis, assaulting a police officer and damaging a police cell. He had served a number of previous prison sentences for burglary and the possession of offensive weapons.
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A report by the Prison & Probation Ombudsman (PPO) raised a number of concerns over the death of Mr Price, including how he was apparently able to access drugs. Kimberley Bingham, Acting Prisons and Probation Ombudsman, states in the report, which was recently published: "The availability of illicit drugs has been an ongoing issue at Durham. While I am concerned that Mr Price was apparently able to access drugs, I recognise the challenges facing Durham, a busy local prison. I note that Durham has a comprehensive drug strategy and that measures introduced to tackle drug supply appear to be having an impact. However, Durham will need to keep its drug strategy under regular review."
Suicide risk factors that Mr Price presented were also highlighted, with concerns that staff did not monitor him under suicide and self-harm procedures, known as ACCT, when he arrived at Durham. When ACCT procedures were started, monitoring only lasted for one day and ended the day before his death. The report considered that ACCT procedures "ended prematurely".
There were also concerns about waiting times for medical appointments and health screens, and about the poor quality of CCTV images at night which meant that investigators could not determine whether the roll check was properly conducted on the morning that Mr Price was discovered dead in his cell.
The report states that Mr Price arrived at HMP Durham with a suicide and self-harm warning form after telling the police that he "would set fire to and hang himself in prison". He had a history of self-harm, attempted suicide, mental health issues, attention deficit hyperactivity disorder (ADHD), emotionally unstable personality disorder (EUPD) and substance misuse.
During his 10 days at the prison, he was prescribed medication to relieve his drug withdrawal symptoms as well as methadone. Two days before his death, staff raised concerns about his wellbeing and mental health and began monitoring him under suicide and self-harm procedures, known as ACCT.
Staff stopped ACCT monitoring the next day when it was assessed that Mr Price felt better. But tragically, on September 20, an officer found Mr Price unresponsive in his cell during a routine roll check. The officer radioed a medical emergency code blue and staff responded quickly. The report added that staff did not try to resuscitate Mr Price as rigor mortis was present. When paramedics arrived, they pronounced him dead.
An inquest was held on January 16 2023 at Crook Coroner's Court where a coroner recorded the cause of death as 'sudden cardiac death' and concluded that Mr Price died of natural causes.
Although Mr Price had a history of substance misuse, staff saw no evidence that he was using drugs at Durham but the report considers that the stopping of ACCT procedures after 24 hours "was premature and meant that staff could not assess Mr Price’s risk adequately". The report added: "The CCTV footage at night on Mr Price’s wing is very poor quality. This meant that we could not determine whether a roll check had been completed correctly about an hour before Mr Price was found dead in his cell."
Mr Price was the fifteenth prisoner to die at HMP Durham since September 2018 - four of the previous deaths were from natural causes, eight were self-inflicted and two were drug-related. The most recent inspection of HMP Durham was in September and October 2018 and inspectors were concerned that Durham was unsafe. They reported the high prevalence of illicit drugs and noted that there had been five deaths in the space of eight months where it was suspected that illicit drugs might have played a role.
They also noted that there had been seven self-inflicted deaths since their last inspection in October 2016. They were disappointed that Durham - which holds up to 996 prisoners - had not addressed the PPO’s recommendations with "sufficient vigour and urgency".
An Independent Review of Progress was carried out in July 2019 to review the progress made in achieving the key recommendations from the 2018 inspection. The report said that inspectors found that "reasonable progress had been made in assessing newly arrived prisoners on arrival, but that staff were working under considerable pressure due to the volume of prisoners, which meant that the process was often rushed".
Following Mr Price's death, post-mortem toxicology tests detected methadone, cannabis, diazepam and pregabalin in his system, meaning he had used these drugs before he died. Only methadone had been prescribed to him.
The post-mortem examination found no natural disease and no injuries that might account for or have contributed to Mr Price’s death. The pathologist said that the methadone was not present at a level that would normally have been expected to have caused death.
The pathologist commented that it was possible that the combined effects of methadone and diazepam could have caused the death as both have the effect of depressing respiration, but that there was no evidence that this was the case. The toxicology results indicated that Mr Price had been a frequent user of cannabis and the toxicologist noted that although deaths as a direct result of cannabis use are rare, there is some evidence that the drug may have an adverse effect on the heart.
In response to the report, a HMP Durham prison service spokesperson said: "Our thoughts are with the family and friends of Joseph Price.
“We have already implemented all recommendations made by the Ombudsman to bolster the safety of prisoners, including improved training for staff to better understand and spot suicide and self-harm and extra CCTV across the prison.”
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