Communicated on 21 September 2016
FOURTH SECTION
Application no. 39415/15
Elżbieta ARENDARCZUK
against Poland
lodged on 4 August 2015
STATEMENT OF FACTS
The applicant, Ms Elżbieta Arendarczuk, is a Polish national who was born in 1947 and lives in Wrocław. She is represented before the Court by Mr A. Pietryka, a lawyer practising in Warsaw.
The circumstances of the case
The facts of the case, as submitted by the applicant, may be summarised as follows.
The applicant’s son, Piotr Arendarczuk (P.A.), was born in 1980.
1. Events of September-November 2012
On 16 February 2012 P.A. began serving a prison sentence in Wrocław Detention Centre no. 2. At the time of his arrival he informed the authorities that he suffered from rheumatoid arthritis and nephritis. However, at that time he was in remission. In September 2012 he began complaining of pain in his legs and a swollen knee.
On 6 September 2012 he underwent a standard medical check. He was interviewed and examined by a prison doctor, who prescribed him antibiotics and strong painkillers.
On 11 September 2012 P.A. submitted his medical files to the prison doctors.
On 13 September 2012 P.A. was transported to Detention Centre no. 1 in Wrocław and examined by an internal medicine specialist. The doctor recommended that P.A. consult a rheumatologist and a nephrologist
A medical consultation with a rheumatologist was scheduled for 20 November 2012.
Subsequently, P.A. saw the prison doctor on several occasions, complaining of knee pain and fever.
In the evening of 26 October 2012 an ambulance was called out to assist P.A. An emergency doctor examined P.A., diagnosed him with swelling of the lower leg, and noted that he had previously undergone nephrological treatment. P.A. was transported to the prison hospital in Detention Centre no. 1, and was diagnosed with swelling, nephritis and rheumatoid arthritis.
On 31 October 2012 prison medical staff attempted unsuccessfully to obtain a date for a consultation with a nephrologist in 2013.
On 7 November 2012 P.A. had a consultation with a laryngologist.
On 8 November 2012 his condition deteriorated and a lack of diuresis was observed. On the same day P.A. was transferred to a civilian hospital in Wrocław, since the prison hospital could not provide him with adequate care. He was diagnosed with acute renal failure, sepsis and cardiorespiratory failure. Despite medical attention, P.A. died on 12 November 2012.
2. Investigation into the applicant’s son’s death
On 12 November 2012 the Wrocław Psie Pole district prosecutor opened an investigation into the death of the applicant’s son.
During the investigation, an autopsy was carried out and the prosecutor heard evidence from the doctors who had provided care to P.A. in both detention centres and the civilian hospital in Wrocław. He further took evidence from P.A.’s inmates.
On 28 June 2013 the prosecutor stayed the proceedings and decided to obtain a medical opinion from an institute of forensic medicine.
On 21 August 2013 the prosecutor asked experts from the Department of Forensic Medicine at Katowice Medical University to prepare an opinion with regard to the quality of the diagnosis and treatment afforded to P.A. The prosecutor asked the experts to answer the following questions:
“1. What was the cause of P.A.’s death?
2. Were the actions taken by the doctors and medical staff of Detention Centre no. 2, Detention Centre no. 1 and [Wrocław] Specialist Hospital appropriate and in accordance with the principles of medical knowledge and practice?
3. Did the actions or omissions of the doctors and medical staff from the above institutions expose the applicant to a direct risk of death or grievous bodily harm, and if so, what were these actions or omissions and what kind of action should have been taken by a doctor in those circumstances?
4. Is there a direct causal link between the actions (omissions) of doctors and medical staff and P.A.’s death and if so, what kind of a connection?”
On 24 July 2014 the experts submitted their opinion to the prosecutor. They noted that the whole chain reaction of pathological problems had been caused by the recurrence of the rheumatoid arthritis and the aggravation of the nephritis. They were also of the opinion that it would have been more beneficial for the patient if he could have been treated in a rheumatological ward of a specialist hospital. However, they concluded that, while the ambulatory treatment received by P.A. in Detention Centre no. 2 and the treatment he received in the prison hospital of Detention Centre no. 1 had not been optimal, it had been within the standard procedures and had guaranteed correct solutions appropriate to P.A.’s condition.
On 28 July 2014 the prosecutor resumed the investigation.
Subsequently, on 31 July 2014 the Wrocław district prosecutor decided to discontinue the investigation. Referring to the experts’ opinion, the prosecutor considered that the applicant’s son’s death had been a consequence of simultaneous chronic conditions. The doctors who had provided care for him in Detention Centre no. 2, Detention Centre no. 1’s prison hospital and Wrocław Specialist Hospital had not exposed him to a direct risk of death or grievous bodily harm, and had not caused his death. The prosecutor concluded that P.A’s death had been caused by his illness, and not by the doctors’ negligence.
On 18 August 2014 the applicant’s lawyer filed an appeal. He alleged in particular that the prosecutor had failed to examine why P.A. had not had a consultation with a rheumatologist, despite his complaints that he had been suffering from rheumatoid arthritis. He further referred to the fact that on 13 September 2012 the prison doctor had advised that P.A. should have a consultation with a nephrologist, and only on 31 October 2012 had prison medical staff attempted to obtain a date for such an appointment. He further complained of a number of procedural errors on the part of the prosecutor.
On 5 February 2015 the Wrocław District Court dismissed the appeal, reiterating the prosecutor’s findings that there had been no circumstances indicating that an offence of exposing a person to a direct risk of death or grievous bodily harm or unintentional homicide had been committed. The court established that the applicant’s son had received adequate medical care in all three institutions, and concluded that the impugned decision should be upheld.
COMPLAINTS
1. The applicant alleges a breach of Article 2 of the Convention in its substantive aspect. In her view, the authorities failed in their positive duty to provide her son with adequate medical care in detention. Despite the fact that P.A. was suffering from chronic illnesses, only on 26 October 2012 was he placed in a prison hospital and subsequently transferred to a civilian hospital, four days before his death.
2. The applicant complains under the procedural limb of Article 2 of the Convention that the authorities did not carry out an effective and prompt investigation into the death of her son.
QUESTIONS TO THE PARTIES
1. Has the applicant’s son’s right to life, ensured by Article 2 of the Convention, been violated in the present case? Reference is made to the alleged inadequacy of the medical treatment provided to the applicant’s son in Detention Centre no. 2 in Wrocław, and subsequently in the prison hospital of Detention Centre no. 1 in Wrocław.
2. Having regard to the procedural protection of the right to life (see paragraph 104 of Salman v. Turkey [GC], no. 21986/93, ECHR 2000-VII), was the investigation into the present case by the domestic authorities in breach of Article 2 of the Convention, in particular with regard to the requirement of promptness?
Full & Egal Universal Law Academy