Communicated on 15 April 2015
THIRD SECTION
Application no. 56681/14
Andrei Ovidiu CRISTEA
against Romania
lodged on 5 August 2014
STATEMENT OF FACTS
The applicant, Mr Andrei Ovidiu Cristea, is a Romanian national who was born in 1980 and is currently detained in Miercurea Ciuc Prison. He is represented before the Court by Ms T.D. Mariş, his aunt.
A. The circumstances of the case
The facts of the case, as submitted by the applicant, may be summarised as follows.
The applicant was diagnosed with hypothyroidism, hypermetabolic catabolic state (sindrom hipoanabolic) and was admitted on several occasions to the prison hospitals for evaluation: from 25 to 28 February 2013 in Dej Prison Hospital, from 5 to 15 April 2013 and again from 17 to 24 May 2013 in Târgu Ocna Prison Hospital, and from 18 July to 1 August 2013 in Colibaşi Prison Hospital.
The applicant suffered a significant weight loss, he currently weighs 48 kg and is 181 cm tall.
In July 2013 he complained about the medical care in prison before the judge designated to supervise the execution of sentences, under Law no. 275/2006 in Miercurea Ciuc Prison (the post-sentencing judge). He explained that:
“the prison doctor breaches my right to medical assistance ... I do not receive the treatment prescribed and the doctor transferred me to prison hospitals which did not have an endocrinologist and therefore I could not be prescribed adequate treatment for my illnesses; furthermore, ... I do not receive the food regime recommended by the doctors.”
On 10 July 2013 the post-sentencing judge dismissed as unfounded the applicant’s allegations concerning his hospitalisation and the food regime. He noted however that the prison administration had failed to adduce official records which would allow him to discern what treatment had been prescribed to the applicant and how that treatment had been administered. For this reason he ordered the prison administration to:
“... take the necessary measures in order to ensure strict respect for the applicant’s right to medical assistance in case a breach of the existing regulations were to be found, and in case the medical treatment was administered correctly and there was evidence to that end, evidence which the prison administration did not deem useful to adduce before the judge, ... to identify the opportunity of taking measures in order to identify solutions that would optimise the manner in which prisoners are informed about the possibilities they have in order to receive medical treatment adequate for their state of health.”
Consequently, the post-sentencing judge partially allowed the applicant’s complaint.
On 15 July 2013 the Miercurea Ciuc prison administration lodged an objection, arguing that the decision was incomplete, in so far as it did not clarify what aspect of the applicant’s initial complaint had been allowed and as it did not establish the guilt on the part of the prison administration.
In a final decision of 11 February 2014 the Miercurea Ciuc District Court noted, based on the findings of the post-sentencing judge, that the prison administration had failed to produce the requested evidence concerning the treatment prescribed to the applicant and its administration, including evidence that the applicant had received the medication and had signed an official document to that end. The court considered that not even the prison medical record presented before it by the prison administration could clarify those aspects. The court further noted that the new law on the execution of sentences (Law no. 254/2013 applicable since 1 February 2014) also guaranteed, in its Article 71, the right to medical care.
It therefore dismissed the objection and upheld the decision adopted by the post-sentencing judge.
According to the applicant, not even after the adoption of these decisions did the prison administration take any concrete measures in order to ensure adequate medical care.
B. Relevant law
The relevant extracts from the standards concerning medical care in prison issued by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (“the CPT”), CPT/Inf/C (2002) 1 [Rev. 2013] read as follows:
“34. ... A prison’s health care service should at least be able to provide regular out‑patient consultations and emergency treatment (of course, in addition there may often be a hospital-type unit with beds). ... Further, prison doctors should be able to call upon the services of specialists. ...
38. A prison health care service should be able to provide medical treatment and nursing care, as well as appropriate diets, physiotherapy, rehabilitation or any other necessary special facility, in conditions comparable to those enjoyed by patients in the outside community. Provision in terms of medical, nursing and technical staff, as well as premises, installations and equipment, should be geared accordingly.
There should be appropriate supervision of the pharmacy and of the distribution of medicines. Further, the preparation of medicines should always be entrusted to qualified staff (pharmacist/nurse, etc.).
39. A medical file should be compiled for each patient, containing diagnostic information as well as an ongoing record of the patient’s evolution and of any special examinations he has undergone. In the event of a transfer, the file should be forwarded to the doctors in the receiving establishment.
Further, daily registers should be kept by health care teams, in which particular incidents relating to the patients should be mentioned. Such registers are useful in that they provide an overall view of the health care situation in the prison, at the same time as highlighting specific problems which may arise.
40. The smooth operation of a health care service presupposes that doctors and nursing staff are able to meet regularly and to form a working team under the authority of a senior doctor in charge of the service.”
The relevant provisions of Law no. 254/2013 on the execution of sentence and of the measures restricting the liberty ordered by the judiciary during the criminal proceedings read as follows:
Article 71 Right to medical assistance, treatment and care
“(1) The right to medical assistance, treatment and health care is guaranteed to all convicted persons, without discrimination on the ground of their status [situaţia lor juridică]. The right to medical assistance includes medical intervention, general medical assistance, emergency medical assistance and specialised medical assistance. The right to care incudes both medical care and terminal care.
(2) Medical assistance, treatment and health care in prison is ensured by specialised personnel, free of charge, according to the law, at request or whenever it is necessary.
(3) Convicted persons benefit free of charge according to the law from health care, medical treatment and medicine.
(4) The services of medical assistance, treatment, health care, and the medicine are financed from the National Fund for Social Insurance in Health [Fondul national unic de asigurări sociale de sanatate], according to the conditions laid down in the Framework Agreement for the conditions of giving medical assistance within the frame of the system of social insurance in health and according to the Methodological Norms for its application, from the prisons’ funds allocated for this matter and from other sources, according to the law.
(5) Medical assistance, treatment and care of convicted persons are delivered according to the Norms of application of the present law.
(6) The person sentenced to serve time in prison may ask, in exchange for a fee, to examined, in detention, by a physician not belonging to the prison health system. The physician’s observations shall be recorded in the convicted person’s medical file.”
Article 72 Medical examination
“(1) Convicted persons shall undergo a medical examination upon admission to prison and during the execution of sentence, periodically; the provisions of Article 71(4) apply accordingly.
...
(6) Upon admission to prison, if the convicted person suffers from illnesses, the prison shall adopt all necessary measures to ensure medical assistance within the prison hospitals system or through the Ministry of Health system.”
Article 105 The convicted person’s personal file
“(1) The prison administration shall keep ... the medical records in the prisoner’s file ...”
COMPLAINT
The applicant complains under Article 2 of the Convention that the authorities have failed to establish and administer an adequate medical treatment for his condition.
QUESTIONS TO THE PARTIES
1. Has the applicant’s right to life, ensured by Article 2 of the Convention, been violated in the present case, with regard to the medical care received in detention?
2. Have the conditions of the applicant’s detention been in breach of the requirements of Article 3 of the Convention, with respect to the medical care received in detention?
The Government are requested to provide copies of the applicant’s prison medical records.
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