Information Note on the Court’s case-law No. 109
June 2008
Kotsaftis v. Greece - 39780/06
Judgment 12.6.2008 [Section I]
Article 3
Degrading treatment
Inhuman treatment
Conditions of detention of and lack of proper medical care for a prisoner suffering from Hepatitis‑B‑induced cirrhosis: violation
Facts: The applicant complained about the conditions of his detention on account, in particular, of the lack of treatment appropriate to his state of health. He had been placed in pre-trial detention for trafficking in antiques and possessing drugs. He was sentenced on appeal to thirteen years and four months’ imprisonment. After the applicant was admitted to hospital for tests in August 2003, doctors found him to be suffering from cirrhosis of the liver caused by chronic hepatitis B. According to a medical report the applicant’s condition called for continuous monitoring in a centre specialising in hepatology, as well as treatment to prevent possible complications. The domestic courts ordered a stay of execution of the applicant’s sentence to enable him to spend four months in hospital. After being granted prison leave, the applicant absconded. The applicant was arrested again over two years later and returned to prison, where he was placed in a cell measuring 24 square metres which he shared with ten other prisoners. He suffered from bleeding in the oesophagus and was sent to hospital for treatment. After the applicant lodged an application for a stay of execution of his sentence, an expert examination was carried out by two forensic medical experts. According to the two medical reports, an extended hospital stay was not essential at that stage of the disease. In order to prevent the applicant’s condition from worsening, one of the reports recommended rest, a special diet, treatment with the appropriate drugs and regular check-ups. The application for a stay of execution was rejected. Under Rule 39 of the Rules of Court (interim measures), the European Court of Human Rights requested Greece to order the transfer of the applicant to a specialised medical centre so that he could undergo all the necessary tests and remain in hospital until his doctors considered that he could return to prison without his life being endangered. The applicant was transferred to a hospital gastroenterology and hepatology unit, where he remains to date. A medical report found his condition stable and concluded that he no longer needed to be kept in hospital.
Law: Article 3 – The applicant suffered from cirrhosis of the liver caused by the hepatitis B virus, a chronic and irreversible disease which gradually destroyed the structure of the liver. It was a disease which necessitated continuous monitoring and appropriate treatment and frequently, as in the applicant’s case, resulted in complications such as bleeding in the digestive tract and portal hypertension. The applicant claimed that his infection with the hepatitis virus had been caused by his poor conditions of detention, but given the chronic nature of the disease and the way in which the virus was transmitted, the Court could not accept that claim.
The Court then sought to ascertain whether the national authorities had done what could reasonably be expected of them in view of the seriousness of the applicant’s illness. It considered that prior to his absconding and since the interim measure ordering his transfer to a specialised medical centre the authorities had not failed in their duty to safeguard the physical integrity of the applicant, who had received the appropriate treatment and medical supervision during those periods. However, with regard to the period between the applicant’s arrest and the application of Rule 39 of the Rules of Court, contrary to the findings of the expert reports drawn up, the applicant had been kept in detention without being given a special diet or treatment with the appropriate drugs, and had not undergone tests in a specialist medical centre. In particular, with the exception of his hospital treatment for bleeding in the oesophagus, virtually all the applicant’s medical checks had related to other health problems. Moreover, an operation scheduled for a particular date had not been performed until one year later. The Court also deplored the fact that a person suffering from a serious and highly infectious disease had been detained along with ten other prisoners in a cell measuring 24 square metres. Lastly, despite the fact that the competent authorities had been informed that he was suffering from cirrhosis and that his condition necessitated appropriate treatment, it was not until measures had been indicated by the Court that the applicant began to receive regular check-ups. Therefore, during the period in question, the authorities had not fulfilled their obligation to safeguard the applicant’s physical integrity, in particular by providing him with the appropriate medical care.
Conclusion: violation (unanimously).
Article 41 – EUR 7,000 in respect of non-pecuniary damage.
© Council of Europe/European Court of Human Rights
This summary by the Registry does not bind the Court.
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