Communicated on 19 February 2015
FIRST SECTION
Application no. 30125/06
Aleksandr Anatolyevich NIKULIN against Russia
and 20 other applications
(see list appended)
STATEMENT OF FACTS
The applicants, save for Mr Valeriy Vitalyevich Bulin (application no. 41785/13), Mr Shelest (application no. 47875/13), Mr Karyy (application no. 20888/14) and Mr Ramishvili (application no. 60277/14), are Russian nationals.
The facts of the cases, as submitted by the applicants, may be summarised as follows.
1. Application no. 30125/06 lodged on 5 June 2006 by Aleksandr Anatolyevich Nikulin who was born on 27 July 1972 and lived until his arrest in the village of Aleksikovskiy in the Volgograd Region.
A. Facts
1. Criminal proceedings against the applicant and his arrest
On 23 September 2004 the applicant was arrested on suspicion of armed robbery. On a number of occasions the applicant’s detention was extended with a view to the gravity of the charges, his previous conviction of a violent crime and the ensuing ability to reoffend or obstruct justice. The applicant’s complaints of poor health and his having been unfit for detention were dismissed by the courts as irrelevant. The appeal court regularly upheld the detention orders.
As appears from the file, the most recent extension of the detention occurred on 22 November 2006 when the Novonikolayevskiy District Court of the Volgograd Region authorised the applicant’s detention until 23 February 2007, having relied on the gravity of the charges and his previous conviction. The District Court interpreted those two facts as a sign of the applicant’s potential to abscond, reoffend and obstruct justice. At the same time, the court dismissed the applicant’s argument of rapidly deteriorating health. Having heard a tuberculosis specialist who had confirmed the applicant suffering from a serious form of infiltrative tuberculosis and absence of the necessary treatment in detention, the District Court, nevertheless, found that that consideration could not outweigh the necessity to keep the applicant detained. According to the applicant, that decision was unsuccessfully appealed against.
On 16 May 2007 the Novonikolayevskiy District Court found the applicant guilty of armed robbery and unlawful possession of firearms and sentenced him to seven years of imprisonment. It appears that the judgment was upheld on appeal on 4 September 2007.
2. Health issues
The applicant suffers from tuberculosis since 1999. In 2004 the applicant was declared to be suffering from a third-degree disability. According to a letter sent to the applicant’s lawyer on 26 September 2005 by a tuberculosis specialist from the Novonikolayevskiy Central Hospital, the applicant suffered from progressing infiltrative tuberculosis of the upper limb of the right lung in the disintegration and dissemination stage complicated by the pulmonary heart disease of the second degree. Doctors recommended the applicant’s in-patient treatment in intensive care.
According to another certificate issued by a deputy head of the medical correctional facility (LIU-23) the applicant had been admitted to the facility and had received intensive treatment with antibacterial drugs. As follows from yet another certificate, in March 2006 the applicant’s disability progressed with it having been registered as second-degree type.
The applicant provided the Court with an extract from his medical record drawn up in August 2006. It appears that at that time he was detained in an ordinary detention facility. He complained to the warders about a further deterioration of his health. An X-ray examination performed on 21 August 2006 showed the pronounced negative dynamic of the tuberculosis process with the infiltration disseminating further and also affecting the left side. He was immediately recommended transfer to a hospital for inpatient treatment.
At the same time, relying on statements made by the tuberculosis specialist in the court hearing concerning the extension of his detention, as well as on medical certificates showing a further progress of his infection, the applicant argued that he had not received necessary treatment in detention.
On 13 April 2007 the applicant was transferred to the medical correctional facility LIU-23 where he remained at least until 18 March 2008. A letter sent to the applicant in response to the complaints about the quality of medical services indicated that his health continued deteriorating with his having developed multi-drug resistant tuberculosis in open form. The applicant’s condition was considered moderately grave.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention and under Article 5 § 3 of the Convention about the unreasonably long detention on remand.
2. Application no 7805/07 lodged on 9 November 2006 by Sergey Vladimirovich MAKSIMOV who was born on 11 November 1969 and lived until his arrest in the village of Duldurga, Zabaykalye Region. He is serving his sentence of imprisonment in the medical correctional colony in the town of Chita.
A. Facts
In February 2001 the applicant was sent to serve his sentence at correctional colony no. 7 in the Chita Region. Upon his admission he was diagnosed with remaining changes following his having had tuberculosis. In 2003 he was transferred to the medical correctional colony in Chita with diagnosis of infiltrative tuberculosis of the upper lobe of the right lung in the dissolution stage. The applicant received antibacterial treatment for almost a year which was not successful as after the treatment had been completed the applicant tested as having open form of the illness.
In September 2004 the applicant complained to a prison doctor about a serious pain in the back and during urination. He was prescribed treatment which did not produce any result. In November 2004 he was sent for an examination to the Regional prison hospital where he was diagnosed with vesical [cystic] diverticulum, secondary cystitis and pyelonephritis. A surgery was scheduled but was not performed as the hospital did not have a radiologist to prepare the applicant for the surgery. In the end of December 2004 the applicant was sent back to the medical colony. Supervision by prison doctors was recommended.
The applicant continued complaining about a severe pain in the back (kidney area and bladder) and pain during urination. Drugs prescribed by a prison doctor did not have any effect.
In February 2005 the applicant was sent to the prison hospital for a surgery. Having confirmed his previous diagnosis, the doctors again scheduled a surgery which was not performed as the hospital did not have necessary equipment and materials, as well as an anaesthesiologist. The absence of necessary drugs also served as the reason for the hospital’s failure to provide the applicant with specific therapeutic procedures. The applicant was returned to the colony. He provided the Court with a copy of a letter sent to him in October 2005 by a deputy head of the Chita Regional Penitentiary Service. In that letter the deputy head acknowledged that the failure to perform the surgery to the applicant resulted from the poor staffing and equipment of the hospital.
In March 2005 the applicant’s illness reached the stage when he could no longer urinate unaided. He had to use a catheter to relieve urine. Several months later he was sent to a medical colony. Between July and October 2005 the applicant was detained in a medical department of the colony where he continued using catheter and was only given Furacilin (a bactericidal compound used as an antibiotic) and Vaseline. Doctors did not assist him with using the catheter and did not provide him with disposal catheters. The applicant merely cleaned the one catheter he had with water before and after using him. The applicant followed that procedure several times a day, each time feeling pain and humiliation as he had to do it in the presence of other inmates. His complaints to various authorities, including prosecutors, were to no avail.
In September 2005 the applicant was examined by a surgeon who recommended surgery. The applicant stated that following his examination by the surgeon, prison doctors attempted to force him to sign a document withdrawing his complaints about the quality of medical assistance. In response to the applicant’s refusal to do so, they refused to transfer him to the prison hospital for treatment and had included a record in his medical history stating that the applicant had himself refused transfer to the hospital, although he had been explained the consequences of the refusal. The applicant submitted that he had not signed the record.
In the end of October 2005 the applicant was admitted to prison hospital in colony no. 5 where he was finally given another disposal catheter.
In December 2005 the applicant was taken to Chita town hospital where he was consulted by an urologist. The latter scheduled a number of specific urinary system examinations and tests to diagnose the applicant. The tests, however, were never performed and the applicant was diagnosed on the basis of the old urological scans. The urologist recommended surgery and prescribed antibacterial therapy to the applicant to prepare him for the surgery. The treatment was only initiated in March 2006 when the hospital received necessary drugs.
On 12 May 2006 the applicant underwent a suprapubic cystostomy, cystoscopy, dissection of intravesical septum and incision of Petuev’s catheter.
The applicant was again admitted to the prison hospital on 29 July 2006 and stayed there until the end of August for specific chemotherapy. Following the surgery the applicant was given an empty shampoo bottle (which he still uses) to use as a medical urinal bag.
Following the surgery in June 2006 doctors recommended to perform a plastic surgery of the bladder. In February 2007 that recommendation was repeated by a surgeon from the regional prison hospital. The surgeon also noted that the surgery was to be performed in a special urological medical facility.
Despite the recommendation from the surgeon, in May 2007 the deputy head of the penitentiary service informed the applicant that the prison doctors who examined him in April 2007 had not established any necessity to perform that additional surgery.
The applicant insisted, that in the absence of a further surgery, he became in fact a disabled person walking around with a catheter and a shampoo bottle glued to it to remove the urine. The applicant’s complaints to various authorities did not find any response.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention.
3. Application no. 51252/09 lodged on 2 September 2009 by Vladimir Sergeyevich BARSUKOV who was born on 15 February 1956 and lived before his arrest in St. Petersburg. He is serving his sentence of imprisonment. The applicant was represented by Mr K. Kuzminykh and Mr S. Afanasyev.
A. Facts
1. Criminal proceedings against the applicant
On 23 August 2007 the applicant was arrested and two days later his arrest was authorised on the charge of an attempt to organise murder. The applicant’s detention was regularly extended with new charges having been put forward against him and the courts having relied on the gravity of the charges and increased risks of his absconding, reoffending and tampering with witnesses, as well as obstructing justice by other means. The charges against the applicant were subsequently amended to include organisation of a stable criminal group, aggravated fraud, illegal corporate raiding, extortion, fraud and attempted murder. On 9 November 2009 the Kuybyshevskiy District Court of St. Petersburg found the applicant guilty of aggravated fraud and money laundering committed within an organised criminal group and sentenced him to fourteen years of imprisonment. That judgment was upheld on appeal by the St. Petersburg City Court and became final on 30 March 2010. By another judgment of 6 March 2012 the Kuybyshevskiy District Court, in another set of criminal proceedings, found the applicant guilty of two counts of aggravated extortion committed within an organised criminal group and imposed a cumulative sentence of fifteen years of imprisonment. The judgment became final on 12 July 2012 when endorsed by the St. Petersburg City Court. It appears that a new set of criminal proceedings against the applicant is still pending.
2. The applicant’s state of health
On 1 June 1994 the applicant’s car was shot at. His bodyguard was killed and the applicant lost his right arm in the attack. The applicant spent about a month in a coma.
The applicant’s medical history listing his diagnoses is more than a page long and includes, among other illnesses, ischemic disease, exertional angina of the second functional group, atherosclerotic and postinfarction cardiosclerosis (in 2000 and 2007 the applicant had suffered an acute myocardial infarction), hypertension in the third stage; a high risk of vascular complications; cardiac failure of the second functional group; chronic posttraumatic pericarditis with effusion (foreign objects in the pericardium after gunshot wounds); condition after the nephrectomy related to cancer of the left kidney: tumor; remote metastases requiring the permanent supervision; kidney stones; concretion of the right kidney; chronic pyelonephritis; chronic kidney failure of the first degree; adenocarcinoma of the prostate gland: tumor requiring permanent medical supervision; chronic prostatitis; chronic cystitis; constantly recurrent infection of the urinary tract; bronchiectasic illness in the relapse with the permanent presence of the blue pus bacillus in the sputum; condition after numerous gunshot wounds to the chest, back, upper and lower extremities leading to the extremity avulsion (right arm at the level of the upper third part of the shoulder).
Given the seriousness of the condition, until his arrest in 2007 the applicant received the daily complex drug regimen comprising up to ten medicaments and underwent frequent, once in two months, in-depth medical examinations in the specialised clinical hospital where he was subjected to a number of craniological and urological tests and analysis, as well as received necessary treatment in respect of his oncological illnesses. When the applicant suffered the relapse of his urinary infections, his drug regimen was amended to include additional drugs administered intravenously. At the time of his arrest the applicant was receiving chemotherapy in respect of his oncological problems. The chemotherapy was interrupted and was not reinitiated after the applicant’s arrest.
The applicant argued that he did not receive medical assistance adequate to his condition which is life-threatening. Despite the continuous deterioration of his health, in particular the relapse of urinary illnesses, the only assistance provided to him in this respect in detention included his having been catheterised, approximately 250 times during the first twenty months of his detention. The detention facility where the applicant stayed did not have license, and as follows equipment and specialists, to perform oncological, craniological and urinary medical assistance. He could only obtain services of a general specialist, a prison physician. The applicant noted that on a number of occasions ambulance had been called to trial hearings to take care of his problems, in particular those related to hisurinary illnesses. The applicant stressed that, despite his very fragile health and his being prone to infections, including due to his being constantly catheterised, he was kept in unsterile conditions of an ordinary cell with the risk of infections having been exacerbated even further.
On 27 August 2009 the Kuybyshevskiy District Court of St. Petersburg dismissed the applicant’s request for his forensic medical examination. Having relied on the medical records provided by the detention facility, the court concluded that the applicant received necessary medical treatment in detention and that therefore there was no need to authorise his expert examination. A similar decision was taken by the court on 13 October 2009.
On 28 December 2009 the applicant was examined in the Scientific Institute of Urology. According to the applicant, doctors recommended his urgent hospitalisation. The recommendation was not acted upon and the applicant was not provided with any treatment.
As follows from a certificate issued by the acting head of the medical unit of the detention facility, in 2009 the applicant was examined, on a number of occasions, by a urologist, an oncologist and a cardiologist. On two occasions, on 22 October and 16 November 2009 he was seen by an oncologist in an oncological hospital in Moscow. The acting head also noted that during his visit to the Urology Institute necessary examinations had been performed and the applicant’s treatment had been adjusted to take account of the recommendations given by the doctors from the Institute.
In March 2010 specialists of the Urology Institute, responding to prosecutors’ request for information, again insisted on the applicant’s admission to a hospital for treatment. The specialists made necessary recommendations in respect of the chemotherapy regimen that the applicant should have been provided with and issued a list of analysis to perform prior to his placement in a hospital. He continued being kept in the conditions of an ordinary detention cell.
The applicant’s requests for examinations by various retained medical specialists were persistently dismissed.
As follows from an expert opinion issued by three forensic medical experts on 12 October 2009, the applicant needed “systematic treatment with corrections of the chemotherapy regimen and periodic admissions to a specialised cardiology hospital for instrumental examinations and necessary amendments to drug regimen”. Given the absence of proper medical supervision, the experts also warned against a possible deterioration of the applicant’s urinary and oncological problems and a risk of those illnesses having advanced to a stage requiring radical treatment without any prospect of the applicant’s being cured or even his life saved. The experts stressed a high risk of a number of the applicant’s illnesses relapsing and made a list of procedures and examinations which were necessary to support his health. They also observed that the medical unit of the detention facility where the applicant was kept was not equipped for treating a patient in his condition.
During the criminal proceedings, at a number of hearings, the trial court heard medical specialists who had treated the applicant prior to his arrest. These specialists testified that the applicant’s condition was deteriorating. In particular, at the hearing on 5 August 2009 the court interviewed the head of the clinical hospital where the applicant had undergone examinations in 2007 and the applicant’s attending doctor from that hospital. Having confirmed the gravity of the applicant’s condition, the doctor testified that the former needed permanent supervision of an urologist, oncologist and cardiologist and that there was clear evidence that his condition was deteriorating, particularly so that assistance provided to him in detention did not satisfy the required level of medical care established for such patients in Russia.
In December 2009 doctors from the clinical hospital which had treated the applicant prior to his arrest wrote a letter to the head of the detention facility where the applicant was kept. The doctors noted serious negative changes in the applicant’s condition, in particular the relapse of urinary illnesses, made a list of recommendations for his examinations and treatment and proposed to perform necessary analysis in the hospital, as well as to examine the applicant by specialists from the hospital and prescribe necessary chemotherapy regimen. It appears that the proposal went unanswered.
The applicant provided the Court with a long list of heart attacks, exhibitions of urinary complications he suffered, as well as other health problems he experienced from the first day of his arrest until the beginning of 2010. He also noted that his heart problems, including heart attacks which, during certain periods, he had at least once a week, had been addressed by a mere provision of nitroglycerine. His urinary problems were, as usual, solved by the introduction of a catheter. He continued complaining to the authorities of a severe pain in the back, in the kidney, or his having urinated up to 30 times per day. However, his complaints were left without any response.
On 29 January 2010 an investigator dismissed the lawyers’ request for an authorisation of a forensic medical examination of the applicant. The investigator stressed that the applicant’s condition was satisfactory and that he received necessary medical assistance in detention and that therefore there was no need to authorise a forensic medical examination.
On 19 March 2010 an investigator issued a decision, dismissing the lawyers’ complaints pertaining to the applicant’s health and their request for provision of the applicant’s complete medical record. The investigator noted that the applicant was under a dynamic medical supervision from the prison doctors of the medical unit of the detention facility, that he was also examined by specialists from other facilities and therefore he received necessary out-patient medical care.
On 25 March 2010 the lawyers’ request for a medical examination of the applicant was dismissed because the investigator considered that the applicant was provided with the necessary medical care in the detention facility.
From 28 to 30 April 2011 the applicant was surgically treated in the Urology Institute. He was sent back to the medical unit of the detention facility for post-surgical treatment of the complications related to the surgery. On 13 May 2011 doctors assessed his condition as moderately grave. Another medical examination in the Urology Institute was scheduled for 26 May 2011.
The applicant also provided the Court with a copy of an expert opinion issued on 29 October 2011. Having assessed the applicant’s medical records, the expert concluded that the applicant experienced serious pains related to his underlying conditions and that additional examinations were necessary to determine the morphology of the syndrome.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention.
4. Application no. 2460/10 lodged on 4 December 2009 by Sergey Vladimirovich SILANTYEV who was born on 2 July 1970 and lived until his arrest in the town of Samara. He is serving his prison sentence in the medical colony in the Khabarovsk Region.
A. Facts
1. Applicant’s health and the quality of medical assistance in detention
The applicant was arrested in April 2009. Medical examinations, including an X-ray exam, did not reveal any pathology.
On 6 May 2011 a regular X-ray examination showed changes in the applicant’s lungs. Less than two weeks later the applicant was sent to the medical colony for treatment, where he remains ever since.
On 27 May 2011, following a number of examinations and tests, doctors diagnosed the applicant with infiltrative tuberculosis of the upper lobe of the left lung in the disintegration and insemination stage. He was placed on intensive regimen of chemotherapy with the first-line drugs. Given the negative dynamic in the treatment, the applicant was subjected to drug susceptibility testing which showed that his tuberculosis acquired multi-drug resistant form. The applicant was transferred onto another chemotherapy regime, comprising second-line drugs. In February 2012 doctors recorded a further deterioration of the applicant’s condition. The applicant, as follows from medical certificates provided by him, fully complied with the prescribed treatment. In April 2012 doctors again recorded an extremely negative development of the illness with the applicant having started exhibiting symptoms of intoxication. An extract from the medical history submitted by the applicant indicated that his treatment had been amended to take account of those negative developments. The applicant continued complaining of fatigue, dizziness, serious cough accompanied by sputum discharge. An X-ray examination performed in September 2012 showed a significant reduction of the applicant’s lung and its shadowing due to the infiltrative process and fibrosis. A medical certificate issued by the head of the medical colony indicated that the applicant’s condition was moderately grave in view of a further rapid development of the tuberculosis process. The applicant was in need of a lengthy, for no less than two years, treatment in a specialised tuberculosis hospital.
The applicant also has only three teeth. He complains that he is unable to eat properly and that the authorities refuse to provide him with dentures.
2. Conditions of detention in the medical colony
In May 2011 the applicant was transferred to medical colony no. 2 in the Khabarovsk Region. The applicant argues that he is detained in extremely poor conditions having been forced to share a room of less than 20 square metres with 8 to 10 inmates. He complains about unsanitary conditions, poor lighting and ventilation and extremely poor quality of food. He stresses that those factors are particularly aggravating for an inmate in his condition, suffering from a serious form of pulmonary illness.
B. Complaint(s)
The applicant complained, among other matters, under Articles 3 and 13 of the Convention about a lack of proper medical assistance in detention, conditions of detention in the medical colony and lack of an effective remedy for his complaints.
5. Application no. 47236/11 lodged on 19 July 2011 by Eduard Arkadyevich NOVSELOV who was born on 14 November 1964 and lived before his arrest in the town of Oryol.
A. Facts
1. Criminal proceedings
On 6 June 2008 the applicant was arrested on suspicion of aggravated fraud. On 7 August 2008 his measure of restraint was amended and he was released under his own recognisance.
By the judgment of 8 November 2010 of the Zavodskoy District Court of Oryol the applicant was convicted as charged and sentenced to three years of imprisonment. The applicant was remanded on the same day pending the appeal proceedings. On 21 January 2011 the Oryol Regional Court upheld the judgment on appeal.
2. Applicant’s state of health
The applicant had thyroid carcinoma. Prior to his detention he underwent radio-surgical treatment in the Federal Medical Radiological Scientific Health Institute.
A letter sent to the applicant’s lawyer by the Director of the Institute on 12 January 2011 read, in so far as relevant:
“The patient’s right lobe of thyroid gland was surgically removed in respect of papillary carcinoma up to 2 centimeters in diameter. A histological examination ... showed that [the patient had] encapsulated follicular type of papillary carcinoma of the thyroid gland with indications of invasive growth into its own capsule.
[The applicant’s] life depends on daily, permanent intake of thyroxin in suppressive dosage, life-long supervision by an oncologist and endocrinologist which is possible in specialised medical facilities with necessary equipment to perform examinations of the level of thyroid hormones, thyroglobulin ... and thyroglobulin antibodies, to perform ultrasound examinations with expert level equipment, with a gamma-camera to examine the entire body with isotopes.
This disease is grave. It is life-threatening for [the applicant].
[The applicant’s] state of health is aggravated by ischemic heart condition, hypertonic illness, osteoarthritis of knee, elbow and hand joints, and skin dermatitis.
Interruptions in the intake of thyroxin and other drugs, conditions of detention, absence of dietary food, absence of prompt highly-qualified medical care in November-December 2010 has already led to the deterioration of [the applicant’s] health which can have irreversible effect.
[The applicant] needs assessment and treatment in [the Institute] or any other medical facility which has analogical equipment.”
In response to the applicant’s lawyer’s letters the head of the penitentiary service of the Oryol Region stated that neither of the detention facilities in the region could provide necessary treatment to the applicant as they did not have necessary equipment. He also informed the lawyer that the treatment which the applicant received was determined by the requirements of domestic law. The head of the Oryol Regional Health Department notified the lawyer that the necessary equipment was available in two regional hospitals.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention.
6. Application no. 3933/12 lodged on 23 December 2011 by Nikolay Petrovich PISKUNOV who was born on 2 August 1955 and lived before his arrest in Krasnoyarsk. He is serving his sentence of imprisonment in a correctional colony in the Krasnoyarsk Region.
A. Facts
1. The state of the applicant’s health
On 10 December 2010 the applicant was arrested on suspicion of having incited an attempted murder. On admission to the detention facility a prison doctor noted that the applicant suffered from third-degree hypertension with the illness having the critical nature and with blood pressure readings of 200/120 mmHg or higher. The history of the applicant’s condition went back to 2008 when he had had an ischemic stroke. The medical records also indicated that the applicant was under an increased risk of acute impairment of cerebral blood flow. He was placed under dynamic supervision. The applicant submitted that no medical care, save for infrequent visits from the prison doctor, had been provided to him in the detention facility.
On 12 April 2011 the applicant received a letter from the acting head of the medical unit of the detention facility noting that the applicant’s condition called for the permanent control of his blood pressure and his being assigned specific drug therapy, including courses of vascular medicaments and nootropics twice a year. The applicant was also in need of in-patient examination and treatment.
Two days later the applicant was sent to a tuberculosis prison hospital to receive treatment in respect of his pneumonia. The doctors also noted the applicant’s diagnosis of hypertension in an advanced stage and the first degree myopathy of both eyes. The applicant was released from the hospital on 19 May 2011 after his having been considered cured from pneumonia.
On 19 May 2011 an expert medical commission issued a report noting that the applicant did not suffer from any medical condition warranting his release. The applicant submitted that the experts had never performed his examination in person and had only issued that conclusion upon a request from the investigating authorities to prevent his release from detention.
In June 2011 the applicant’s condition deteriorated with his having suffered a hypertension attack. The prison doctor prescribed the applicant bed rest from 10 June to 19 July 2011.
Another medical certificate issued in the detention facility on 20 October 2011 indicated that the applicant required dynamic supervision and treatment in respect of his hypertension.
In the meantime, the applicant lodged a complaint with a court challenging the conclusions made by the experts in the report of 19 May 2011 as inaccurate and unsubstantiated.
By the final judgment of 1 August 2012, the Krasnoyarsk Regional Court accepted the applicant’s complaint and declared null and void the expert report of 19 May 2011 because it was not based on any relevant medical evidence, including any proper medical examinations of the applicant. The court also noted that the applicant should be sent for another expert medical examination to determine whether he was fit to remain in custody.
In the end of August 2012 the applicant’s lawyer complained to the head of the detention facility that his client was left without any medical assistance and that prison doctors had even refused to authorise bed rest to the applicant, despite his deteriorating health.
In May 2013 the applicant complained to the director of the correctional colony that he had suffered from serious pains in the back and legs and that he started experiencing difficulties while walking or moving his legs. It appears that the applicant’s complaints went unanswered until January 2014 when he was sent for an MRI examination of the lumbosacral section of the spine and hip joints. As a result of the examination he was diagnosed with cancer of the prostate gland. The applicant submitted that despite the new life-threating diagnosis he continued being detained without any medical assistance.
On 6 February 2014, in response to the applicant’s request for the application of interim measures under Rule 39 of the Rules of Court, the Court decided not to indicate to the Russian Government the interim measure sought and asked the parties, under Rule 54 § 4 (a) of the Rules of Court, to submit factual information regarding the applicant’s state of health and the quality of the medical care he received.
Having relied on the expert report of 19 May 2011 the Government argued that the applicant did not suffer from any serious illness warranting his release and that he received complex and comprehensive medical care in respect of his diagnosis in detention. They stated that the detention facility and prison hospitals had necessary equipment and well-trained medical personnel. The Government also alleged that the applicant, in writing, refused admission to the oncology department of the prison hospital. They provided the Court with a handwritten copy of the applicant’s medical record with the majority of the entries barely legible. It appears that the record did not contain the applicant’s written refusal to undergo inpatient treatment in an oncology hospital.
The applicant disputed the Government’s submissions having argued that he had not been offered treatment in relation to his oncological problems. He stressed that his placement in a tuberculosis hospital would not produce any positive effect as the hospital was not equipped to deal with an oncology patient or a patient suffering from a serious hypertension condition. He insisted that his relatives had provided him with the majority of necessary medicaments because the detention facilities had not had them, including painkillers without which he could not spend a day as he suffered from severe pains.
The applicant also submitted a medical certificate issued by an oncologist who had examined him in the beginning of February 2014. The doctor, having confirmed the diagnosis of prostatic cancer, recommended the applicant’s outpatient symptomatic treatment and stage-related analgesic therapy. He also noted that the applicant may require prescription of narcotic analgesic with the unavoidable progress of the illness.
2. Conditions of detention in the temporary detention facility
After his arrest on 10 December 2010 until his transfer to a correctional colony on 8 October 2012, save for short periods of his stay in hospitals for in-patient treatment, the applicant was detained in detention facility no.1 in Krasnoyarsk. He provided the following description of the conditions of his detention:
Cell no.
Date: from
Date: to
Cell surface, m2
Number of sleeping places
Number of inmates
55
10 December 2010
31 December 2010
18
7
7
174
1 January 2011
1 February 2011
24
10
11
190
1 February 2011
10 July 2011
16
6
6
185
10 July 2011
18 August 2011
24
10
10
86
18 August 2011
8 October 2012
16
4
4
The applicant insisted that he had been detained in extremely cramped conditions, with very limited personal space. He also submitted that he had had no privacy as a lavatory pan in a cell had been installed no more than two meters away from a sleeping place with only a small partition separating it from the remaining part of the cell. Inmates were allowed to take a shower once a week with the entire cell having been afforded no more than ten minutes. On a number of occasions there was no hot water in the facility and detainees had to take a shower with the freezing water. He also complained about short and infrequent outside walks in small recreation yards. The entire cell population was taken to a recreation yard measuring between 6 and 20 meters which also meant that inmates were left in overcrowded conditions even during those walks. Cells were dirty and in unsatisfactory sanitary condition. The applicant supported his description of the conditions with handwritten statements by two inmates who had shared a cell with him.
3. Detention on remand
On 10 December 2010 the Tsentralniy District Court of Krasnoyarsk authorised the applicant’s remand in custody in view of the gravity of the charges against him and the risk that the applicant could go on with his plan to commit murder if released. That decision was upheld on appeal on 21 December 2010.
On a number of further occasions the Tsentralniy District Court and Zheleznodorozhniy District Court extended the applicant’s detention on remand, having each time linked the gravity of the charge against the applicant to his liability to abscond and obstruct justice. They also attributed particular weight to the fact that criminal proceedings had been instituted against the applicant on another occasion, having noted it as evidence for the applicant’s potential to re-offend. The courts did not find that his stable family situation, his having permanent place of work and residence and his poor health could outweigh the reasons calling for the applicant’s continued detention. Those detention orders were upheld on appeal with the Regional Court having each time endorsed the District courts’ reasoning.
On 5 May 2012 The Tsentralniy District Court found the applicant guilty as charged and sentenced him to five years of imprisonment to be served in a correctional colony. On 4 September 2012 the Krasnoyarsk Regional Court upheld the conviction but decreased the sentence by two months.
On an unspecified date the judgment of 5 May 2012 was amended with the applicant having been sent to serve his sentence in a colony settlement.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention and poor conditions of his detention on remand, under Article 5 § 3 of the Convention about the unreasonably lengthy detention on remand and under Article 13 of the Convention about the lack of domestic remedies to complain about a violation of his right to adequate medical care.
7. Application no. 11823/12 lodged on 24 February 2012 by Anatoly Markovich ZAK who was born on 25 June 1973 and lived before his arrest in Perm. He is detained following conviction and sentence to imprisonment in the medical unit of a correctional colony in the Perm Region. The applicant is represented by Ms O. Sulimova and Mr P. Arsentyevich, lawyers practicing in Perm.
A. Facts
The applicant was a co-owner of a nightclub in Perm, “Khromaya Loshad” (‘Lame Horse’) where a fire in December 2009 killed over 150 people and left dozens injured. Criminal proceedings were instituted on the same day on suspicion of a violation of fire safety regulations. The applicant was arrested on the following day. He remained in detention ever since, having been convicted, on 22 April 2013, and sentenced to almost ten years of imprisonment.
The following account of the events is based on the information submitted by the parties in respect of the Court’s request under Rule 54 § 2 (a) of the Rules of Court.
On admission to the temporary detention facility, the applicant was examined by a prison doctor. He did not make any health-related complaints. The facility administration received the applicant’s medical records which included, in particular:
- certificate no. 24044 issued by the admission department of Perm Clinical Hospital no. 4 of 7 December 2009, diagnosing the applicant with second-stage hypertension of third degree; chronic pancreatitis; asthenic syndrome. The certificate also indicated that there was no evidence of the applicant suffering from any acute cardiac pathology or being in need of in‑patient treatment;
- an examination record issued on 8 December 2009 by the deputy chief of the Regional Hospital and diagnosing the applicant with second-stage hypertension of third degree; critical course of hyperkinetic syndrome; chronic pancreatitis. The deputy chief confirmed that the applicant was fit to remain in detention;
- an examination record issued on 8 December 2009 by a neurologist and stating that the applicant did not have any acute neurologic disorder;
- four electrocardiograms performed on 7 December 2009.
On 14 December 2009 the applicant was examined by a prison doctor, who having again listed all the illnesses detected on previous examinations, amended them with 3-rd-degree obesity, noted the absence of any complaints on the applicant’s part and registered him for a dynamic medical supervision in the medical unit of the detention facility.
On 24 December 2009 the applicant was transferred to detention facility no. IZ-99/1 in Moscow. On his return back to detention facility in Perm on 27 February 2010 he was examined by a prison physician who found his condition satisfactory. Subsequent regular medical examinations, performed at least once in few days, did not reveal any deviations. The applicant received treatment for his hypertension.
On 2 June 2010 the applicant was consulted by a neurologist of the Regional prison hospital and was diagnosed with chronic headaches; neurotic condition resulting from the circumstantial situation; and apnoea of the compressive obstructive type. The doctor concluded that there was no ground to subject the applicant to apnoea treatment with a device normalising the breathing.
Another examination performed by a cardiologist from the Regional prison hospital on the same day showed that the applicant suffered from second-stage hypertension of third degree; neurosis; psychogenic angina spuria; tension headaches, and dissomniya.
The applicant remained under regular dynamic monitoring by prison doctors with no deterioration of his health having been recorded.
According to the applicant, in November 2010 his condition sharply deteriorated. He started experiencing increasing pains in the stomach. The applicant submitted that he had not received proper treatment in respect of that episode due to an incorrect diagnosis.
As follows from hospital records and the applicant’s medical history, on 16 December 2010 he complained of frequent and painful urination; he was taken under dynamic supervision of a prison physician with diagnosis of cystitis and exacerbation. A regimen of antibiotics was prescribed. He underwent general clinical blood and urine tests. The final diagnosis was prostatitis and exacerbation. An additional course of treatment was administered.
In the afternoon on 23 December 2010 (according to the applicant on 23 November 2010) the applicant complained of an increasing abdominal pain. He was immediately seen by a prison physician who suspected that the applicant had appendicitis. An hour later an ambulance was called and, following a visual examination, the applicant was transferred to the Perm Regional Clinical Hospital for consultations by a surgeon, urologist and gastroenterologist.
At approximately 8.00 p.m. on the same day the applicant was seen by a medical commission comprising the head of the general surgery department, the head of the urology department, a gastroenterologist and a resuscitation specialist – anaesthesiologist who recommended the applicant’s admission to the surgical department of the Clinical Regional hospital for further diagnosis and treatment.
The applicant underwent a surgery related to the perforation of the straight intestine of unknown aetiology. He stayed in the Clinical Regional hospital until 31 December 2010, when he was transferred, in a grave condition according to him, to the surgical department of the prison hospital. The hospital doctors listed the following additional diagnosis: abscess of the abdominal cavity; severe abdominal sepsis; hypoventilation of the lower segments of the lungs; reactive pleurisy on the left; impaired glucose tolerance; obesity.
Until 17 January 2011 the applicant underwent inpatient treatment in the prison hospital and was discharged in a satisfactory condition to detention facility no. 1. On arrival at the facility he was taken under the regular medical supervision by a prison surgeon who examined the applicant each two or three days and continued with the treatment prescribed by the doctors from the Clinical hospital. Merely a week later, in response to complaints, the applicant was taken to the Clinical hospital. An examination did not reveal any acute surgical pathology. Between January and June 2011 he was seen by a number of specialists and underwent clinical testing and ultrasound scanning in relation to his main and accompanying illnesses. On 18 March 2011 a medical expert commission did not find that the applicant suffered from a disability.
From 6 to 20 June 2011 the applicant stayed in the Clinical hospital for scheduled in-patient in-depth examinations and treatment. He underwent a second surgery, a laparotomy of the external large bowel fistula. The Government submitted that the applicant had quickly recovered after the surgery, having been closely monitored by specialists and subjected to necessary examinations and testing. The applicant argued that during the entire period after the surgery he had suffered from a severe stomach pain, frequent fevers, high blood pressure and generally poor condition.
The Government submitted that the applicant’s examinations in the following months had become a matter of routine with his having been daily seen by a paramedic, a surgeon or a prison physician. He was also seen, on a number of occasions, by specialists from the main prison hospital and was subjected to a number of clinical tests and X-ray examinations.
The applicant submitted that between September 2011 and March 2012 he had been urgently admitted to the surgical or craniological departments of the Clinical hospital or the prison hospital in response to the acute attacks that he had suffered. The Government described the applicant’s admissions to the hospitals as a measure advised by the applicant’s attending doctors to ensure in-depth examinations and required treatment of the applicant. In particular, they argued that for two days in September 2011 the applicant had been kept in the Clinical hospital upon a recommendation of the prison doctor who wanted to consult the specialists regarding the applicant’s chemotherapy regimen. Another admission on 27 September 2011 followed an examination by a surgeon and the necessity to confirm the diagnosis of peritoneal commissures of the abdominal cavity. The applicant stayed in the hospital until 3 October 2011 and received necessary treatment which continued after his release to the detention facility.
From 12 to 18 October 2011 the applicant again stayed in the Clinical hospital for the purpose of an expert medical examination which was to determine whether he suffered from a condition warranting his release from detention. On 17 October 2010 the medical commission issued a report, concluding that the applicant suffered from a serious illness included in the List of Illnesses preventing his detention on remand, as established by a Governmental decree.
In response to the expert report, on 20 October 2011, the administration of the detention facility where the applicant stayed at the time asked the Lininskiy District Court to authorise his release from detention on health grounds. The Director of the detention facility, in his letter to the court, argued that the facility could not provide the applicant with the requisite level of medical care (including the prescribed drug regimen). He also indicated that the facility did not employ specialists qualified to treat the applicant. The request for the applicant’s release was dismissed by the court four days later.
From 26 to 31 October, 27 November to 1 December 2011, 27 December 2011 to 10 January 2012 and from 25 January to 4 February 2012 the applicant received treatment in the Clinical hospital. In-between of his stays in the hospital he was regularly seen by a number of specialists, including a gastroenterologist, an endocrinologist, an ophthalmologist and a surgeon, underwent a variety of clinical tests and examinations. The Government submitted that on each occasion his diagnosis had been clarified or amended, the treatment had been adjusted to take account of his complaints and new medical procedures had been prescribed. On 2 December 2011 a medical commission declared that the applicant suffered from a third-degree disability. Twenty-four days later another medical commission considered that decision erroneous and removed the disability assignment.
On the applicant’s release from the Clinical hospital on 2 February 2012, his diagnosis read as follows: “underlying disease: diverticular illness; diverticulosis of the colon; remission of the peritoneal commissures of the abdominal cavity; axial hernia of the oesophageal opening. Rival illnesses: third-stage hypertension of third degree, risk 4; ischemic illness; exertional angina of the second functional class. Concomitant illnesses: gastroesophageal reflux disease (GERD) of the first degree; chronic gastritis; duodenal ulcer in the incomplete remission stage; chronic acalculous cholecystitis without signs of acute condition; chronic biliary pancreatitis without the signs of an acute condition; fatty hepatosis; second-type diabetes of the moderately grave stage; second-degree obesity; a medium-size postsurgical ventral hernia”.
On 16 February 2012 the applicant was urgently driven by an ambulance from a courtroom to the surgical department of the Clinical hospital to undergo treatment in respect of his deteriorating state of health. On 27 February 2012 he was transferred to the intensive care wing of the cardiology department of the hospital where he remained until 11 March 2012.
On 27 February 2012 the applicant was subjected to a coronary angiography and thoracic aortography. On the basis of the results of those tests and following the examination of the applicant, the attending doctor, professor S., recommended an urgent coronary artery bypass surgery “due to the high risk of the sudden death and myocardial infarction”. The Government argued that the applicant “was abstaining from the surgery”.
On 11 March 2012 the applicant was transferred back to the detention facility with a recommendation of the urgent re-admission to the hospital in case of increase of a chest pain to perform an urgent surgery, if the applicant agreed to it.
In their last submission, the Government noted that on 15 March 2012, the applicant, following his request, was sent for an expert examination to determine whether his release on health grounds could be authorised.
Relying on a medical certificate issued by the Russian Heart Institute on 5 March 2012, the applicant argued that his condition, a serious arterial involvement, could at any given moment lead to his death. The course of his illness was burdened by a number of concomitant illnesses. The specialists of the Heart Institute noted that the applicant needed an optimal complex chemotherapy treatment, comprising at least five groups of drugs. The therapy should be permanent and uninterrupted.
From 15 to 20 March 2012 the applicant stayed in the cardiology department of the Clinical hospital with another month-long stay in the surgical department following. After his return from the hospital to the detention facility he, however, was left without proper assistance as the facility did not have the specialists (a cardio-surgeon, cardiologist, gastroenterologist, endocrinologist, urologist, neurologist, etc.) and equipment to ensure the requisite level of medical services.
The applicant provided the Court with a list of the diagnosis comprising thirty-one serious illnesses. He complained to various authorities about the absence of comprehensive, thorough and regular medical assistance. In response to one of those complaints, the Prosecutor General’s office found that the detention facility did not entirely fulfil the recommendations of the medical specialists who had treated the applicant.
In his most recent letter to the Court of 1 September 2014, the applicant complained that his condition continued deteriorating. He suffered an attack and was transferred to prison hospital no. 2 where he has remained ever since.
On 14 November 2013 the applicant underwent yet another surgery, a herniotomy, in the Clinical hospital in Perm. His diagnosis, in addition to the usual set, was as follows: recurrent incarcerated post-surgical ventral hernia with the strangulation tendency; pain syndrome. It appears that during the subsequent period, the applicant continued being transferred between the surgical and cardiology departments of the hospital. The latest diagnostic conclusions assessing the applicant’s health include the list of the old illnesses (listed above), some of which had progressed to the next stage, as well as a number of new medical conditions. There is still a pending recommendation to urgently perform a coronary artery bypass surgery in view of a serious threat to his life and limb.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention, and lack of an effective remedy for his complaints.
8. Application no. 33690/12 lodged on 19 June 2012 by Aleksandr Ivanovich BALKOV who was born on 11 June 1965 and lived before his arrest in the town of Vyborg in the Leningrad Region. He is serving his sentence in a correctional colony in the Leningrad Region.
A. Facts
Following the conviction on 27 March 2009, as upheld on appeal on 11 June 2009, the applicant was sent to a correctional colony to serve his fourteen years’ prison sentence. His sentence was subsequently reduced by six months to take account of mitigating circumstances.
On 18 January 2010 the applicant arrived at colony no. 4. Having been examined by a prison doctor on admission to the colony, the applicant did not make any complaints.
In September 2010 the applicant complained to the head of the colony medical unit about the deterioration of the eyesight. His request for an examination by an oculist was left without any response.
In May 2011 several medical specialists visited the colony and the applicant was able to consult an oculist. As a result of the examination, the applicant was diagnosed with mature cataract of the right eye and the initiating cataract in the left eye.
A month and a half later the applicant was sent to prison hospital MSCH-78 where he was again examined by an oculist. He confirmed the diagnosis made in May 2011 and recommended a planned surgery in an ophthalmological hospital after yet another examination within six to eight months.
A year later the applicant was seen by the head of the medical unit in the correctional colony and, as a result, was included in the list of patients to undergo an in-depth inpatient examination and surgery in an ophthalmological hospital.
As follows from the applicant’s most recent letter received in the end of 2012, he was still not subjected to the recommended observation and surgical treatment. The applicant claimed that his condition continued deteriorating, with his having almost lost eyesight.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention.
9. Application no. 20988/13 lodged on 1 February 2013 by Mikhail Valentinovich KIRYUKHIN who was born on 22 January 1972 and lived before his arrest in the town of Saratov. He is serving his sentence in a correctional colony in the Saratov Region.
A. Facts
The applicant has suffered from hepatitis B and C since 1996. It appears that in 1998 he was arrested and since then has remained in detention. In 2002 he was convicted and sentenced to twenty-one years of imprisonment.
In 2001 the applicant was diagnosed with HIV. In 2006 he was placed in a prison hospital where he started receiving antiretroviral therapy. Having been dismissed from a prison hospital sometime later, the applicant was transferred to a colony. On admission to the colony the applicant refused to continue the therapy, having stressed that he had not been properly diagnosed and that the therapy could not therefore be correctly formulated and managed. In 2009 the therapy was resumed and continued ever since with slight amendments.
Once a year the applicant was transferred to a prison hospital for the assessment of the development of his illnesses and the amendment of the therapy, if necessary.
In May 2010 the applicant was admitted to the infectious diseases department of the prison tuberculosis hospital in Saratov where he remained until July 2011. In December 2010 his chemotherapy regimen was amended to include treatment for hepatitis. The applicant submitted that no comprehensive health evaluation and no diagnostic procedures were performed either prior to the initiation of highly intrusive medical treatment or in the course of such treatment to determine whether he responded well to it. The applicant received the hepatitis treatment for approximately six months. He complained to prison doctors that his condition had significantly deteriorated following the initiation of the treatment. However, the attending doctors refused to amend the regimen. According to the applicant, his condition became so poor that a medical expert commission declared him permanently disabled. In view of the absence of any response on the doctors’ part and given the continuous deterioration of his condition, the applicant refused to continue with the treatment and was dismissed from the hospital as a result.
Following a complaint to a prosecutor’s office, on 14 October 2010 the Saratov investigating committee issued an order to the prison medical authorities to eliminate a number of defects in the applicant’s treatment. In particular, the investigators made a long list of diagnostic procedures which the medical authorities had failed to perform. Among those included in the lists were CD4 cell count testing indispensable for HIV-patients, as well as laboratory tests necessary to take a decision prior to the initiation of the hepatitis therapy. The investigators also noted that the applicant did not receive the antiretroviral therapy in compliance with the established medical standards.
At the same time, on 28 October 2011 the investigator refused to institute criminal proceedings against the medical personnel, having found no criminal conduct in their actions.
The applicant’s current diagnosis is: the HIV infection in the stage of secondary illnesses, 4A stage, chronic viral hepatitis C, chronic mycosis, 2nd degree varices. The applicant complains that he still has not received adequate treatment in respect of his condition, including varices. He argues that the colony where he is detained does not employ an infectious disease specialist or an immunologist. It also does not have medical license to provide the treatment the applicant requires. His condition continues deteriorating. The treatment against hepatitis was not yet re-initiated.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention and under Article 13 of the Convention about the absence of an effective domestic remedy for his complaint under Article 3.
10. Application no. 41785/13 lodged on 19 May 2013 by Valeriy Vitalyevich BULIN, a Ukrainian national, who was born on 9 September 1977 and lived before his arrest in Moscow, Russia. He is serving his sentence of imprisonment in a correctional colony.
A. Facts
1. Criminal proceedings
In October 2007 criminal proceedings were instituted against the applicant on suspicion of murder. A federal search warrant for him was issued. It was not until October 2011 when his whereabouts were established and he was arrested on 12 October 2011.
On 14 October 2011 the Podolsk Town Court of the Moscow Region authorised the applicant’s placement in custody on suspicion of murder. His detention was regularly extended by the courts in view of the gravity of the charges against him, including the fact that the charges were subsequently amended to include robbery and drug trafficking. The courts also considered the increased risk of his absconding given his previous behavior and his liability to obstruct justice, including tampering with witnesses. On 28 November 2013 the Trpitskiy District Court of Moscow found the applicant guilty and sentenced him to thirteen years of imprisonment. The judgment became final on 23 June 2014 when examined on appeal by the Moscow City Court. The City Court upheld the applicant’s conviction of murder and aggravated theft and discontinued the proceedings on the remaining charges due to the expiration of the limitation period. The sentence was not amended.
2. State of health
According to the applicant, in 2006 in Ukraine he was diagnosed with multiple sclerosis.
In August 2010 the applicant was diagnosed with the optic neuritis and recommended an MRI examination of the brain and spinal cord. These examinations performed in September 2010 showed that the applicant had a demyelinating illness of the brain and spinal cord. The applicant was admitted to the Neurology Centre for several days in September 2010 to undergo additional examinations and tests for the correct diagnosis. The final medical conclusion was as follows: the applicant suffered from the acute condition of multiple sclerosis of the cerebrospinal form and with the monopolar course. At that stage, the doctors recorded the applicant’s complaints of poor eyesight, frail legs, urinary retentions, and so on and noted that he already exhibited signs of slight pyramidal paraparesis.
Following the applicant’s arrest, on 13 October 2010 he was examined in the neurological department of the Podolsk Town Clinical hospital. The doctor confirmed the diagnosis of multiple sclerosis and frail legs (pyramidal paraparesis) and noted that the condition was not acute and therefore the applicant could be detained in the conditions of a detention facility.
On 21 October 2011 the applicant was examined by a medical commission which determined that he did not suffer from an illness included in the List of Illnesses precluding detention of suspects, as established by a Governmental Decree.
On 17 November 2011 the applicant underwent an examination by a medical commission from the Serbskiy State Scientific Centre of Social and Forensic Psychiatry. The doctors’ diagnosis was: multiple sclerosis against the consequences of the central nervous system impairment of the complex genesis and optic neuritis of the left eye.
For the purposes of yet another examination in the Serbskiy Centre, the applicant was examined on 7 February 2012 by a neurologist who, having confirmed the previous diagnosis, amended it with pyramidal paraparesis and ataxia.
On 22 May 2012 the applicant was sent to the neurological department of the Central Republican Hospital in the Moscow Region for an expert forensic examination. The experts were to determine whether the applicant suffered from a condition precluding his detention, according to the Governmental Decree of 14 January 2011. Having listed the applicant’s diagnosis of multiple sclerosis and pyramidal paraparesis in the incomplete remission and having noted the applicant’s complaints, the experts concluded that his condition was included in the List of Illnesses (hereinafter – the List), precluding his detention on remand.
However, a week later another expert commission from the Kashira Central District hospital issued report no. 347 concluding that the applicant did not suffer from any illness, included in the List.
The applicant’s lawyers, having disagreed with the latter report, submitted the applicant’s medical history and the two expert reports to the Russian Centre of Forensic Medical Examinations in Moscow. They asked the experts to assess the applicant’s state of health and to determine whether he suffered from an illness included in the List and thus preventing his detention. The relevant part of the report prepared by these experts on 29 August 2012, in so far as relevant, reads as follows:
“The [applicant’s] diagnosed illness [multiple sclerosis] is a chronic progressing illness of the nervous system, characterised by multiple focal impairments ... of the central and peripheral nervous system. The clinical course of the present illness is accompanied by periods of acute attacks and remissions; [it] progresses with time.
The dynamic medical supervision of [the applicant] (according to medical records and extracts from the medical history) from 25 August 2010 to 22 May 2012 confirms the progress of the multiple sclerosis which is reflected in the deterioration of the eyesight and the growing number of neurological impairments (dysarthria – articulation impairments, appearance of palpebral fissures of various sizes, appearance of the sensory impairments, increase of pathological reflexes ... and so on), which is the negative prognostic feature of the development of the pathology (illness) process.
[The applicant’s] multiple sclerosis, of the cerebrospinal form and with the monopolar course, is a serious degenerative illness of the nervous system which according to paragraph 5.2.8 of the List of Illnesses, established by Joined Order no. 311/242 by the Russian ministry of Health and Ministry of Justice adopted on 9 August 2001 ‘On Release from Serving Sentences of Imprisonment by Convicts in view of a Serious Illness” ... may serve as a ground to authorising [the applicant’s] release from imprisonment.
It should be noted that the above mentioned List of illnesses containing the description of particular nosological forms corresponds to the List of Serious Illnesses Preventing Detention of Suspects and Accused Individuals, adopted by Government’s Decree no. 3 on 14 January 2011.”
In September 2012 the investigating authorities authorised another forensic medical examination of the applicant to settle the differences of opinion arising from the previous expert reports.
On 17 September 2012 three experts from the Moscow Bureau of Forensic Medical Examinations of the Health Department issued report no. 561-12 based on the applicant’s entire medical file, including all previous expert opinions and reports. The experts concluded that although the applicant suffered from a chronic autoimmune illness of the central nervous system, that is the multiple sclerosis, his condition was satisfactory, did not prevent his participation in the investigating actions and court hearings and was not included in the List of Serious Illnesses preventing detention on remand. The experts noted that the applicant’s condition was not accompanied by the significant impairment of the vital activities and did not require lengthy treatment in the conditions of a specialised medical facility.
The applicant’s lawyers solicited another expert examination from the same experts of the Russian Centre of Forensic Medical Examinations in Moscow, having also asked them to assess the expert report of 17 September 2012.
On 16 October 2013 the two experts of the Centre issued a report, having again confirmed their findings made in the report on 29 August 2012. While having failed to explicitly answer the question whether the applicant’s condition was covered by the List, they again confirmed that the applicant’s illness was grave and could have served as a ground for his release. At the same time, they again confirmed the similarities between the description of pathologies in the List and another List established by the Joined Order (cited in the quoted part). The experts refused to assess the gravity of the applicant’s condition according to the List of Serious Illnesses considering that his medical examination in person was necessary and the experts did not have an opportunity to perform it. Having relied on the applicant’s medical records, the experts further stressed that his condition was progressively deteriorating given that the appearance of new impairments, including residual ophthalmogyric, movement and coordination, as well as impairments of the pelvic functions and partial atrophy of visual nerve of the right eye. The experts concluded by criticising the validity of the conclusions made by the experts in the report on 17 September 2012.
The applicant argued that his condition continued deteriorating. After his arrest his treatment of multiple sclerosis, including the imperative drug regimen, was interrupted and no medical care was provided. His illness continued progressing and no steps were taken to support his health. He will soon be completely blind and paralysed. Moreover, his condition is accompanied by a severe painful syndrome which the authorities also failed to address. A large number of the applicant’s complaints to a variety of the Russian authorities went unanswered.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention and under Article 13 of the Convention about the absence of an effective domestic remedy for his complaint under Article 3.
11. Application no. 42270/13 lodged on 18 May 2013 by Aleksey Aleksandrovich BEREZIN who was born on 7 January 1973 and lived in the Saratov Region prior to his arrest.
A. Facts
1. Criminal proceedings against the applicant and his detention
On 29 November 2010 the applicant was arrested on suspicion of having participated in an aggravated fraud committed by a group of persons. In particular, the prosecution argued that he and several other defendants fraudulently took possession of a flat following the death of its lawful owner. On the following day the Podolsk Town Court authorised the applicant’s placement in custody, having concluded that the gravity of the crime and the applicant’s liability to abscond, obstruct justice and re-offend warranted his remand. The court particularly noted that the applicant had been on the run, had been placed on the wanted persons’ list and had been arrested during his attempt to leave Moscow. The court further stressed that the investigation had yet to determine all parties to the crime and that there was therefore a risk that the applicant could influence other suspects or tamper with victims and witnesses.
Further extensions of the applicant’s detention on 27 January, 28 February and 22 March 2011 were authorised by the Town Court with a similar reasoning.
On 12 May 2011 the Town Court again authorised the applicant’s detention, having noted, in addition to the previous grounds of the gravity of the charge and the risks of absconding, re-offending and obstructing justice, the lack of permanent place of residence in Moscow and the Moscow Region.
The applicant’s detention was again extended on 10 June, 19 July and 30 August 2011 with the court citing the usual reasons. At the same time, the court each time dismissed as unconvincing the applicant’s arguments of poor health, difficult family situation and absence of any intentions to interfere with justice or to escape. In particular, the court noted that there were no medical documents supporting the applicant’s complaint that he was not fit for remaining in the conditions of the detention facility.
On 13 December 2011 the Moscow Regional Court extended the applicant’s detention for two months, having stressed a particularly active role of the applicant in the criminal group which had committed fraud, and his previous attempt to escape the investigation. The court noted that there were no reasons to believe that the applicant would not decide to go on a run and therefore interfere with the investigation if released. It also stressed that the applicant’s attempt to run when he had failed to pay alimony to his child and thus was placed on the wanted persons’ list showed that he would be even more inclined to run when charged with a particularly serious offense. The court also stressed that there was no evidence supporting the applicant’s argument that he could not stay in detention due to health issues.
Further extensions on 17 May and 14 August 2012 were authorised given the court’s belief in the applicant’s liability to re-offend, escape or obstruct justice. The decisions were very similar in wording.
On 1 November 2012 the Podolsk Town Court extended the applicant’s detention until 3 February 2013, having cited the gravity of the charges and the risks of the applicant’s absconding and obstructing. That detention order was upheld on appeal on 22 November 2012 by the Moscow Regional Court with the appeal court having endorsed the Town Court’s reasoning.
2. The state of the applicant’s health and quality of medical assistance
According to a number of medical certificates submitted by the applicant, he suffers from a long list of medical conditions comprising duodenal ulcer, kidney stones, arthrosis, insulin dependent diabetes, and chronic pancreatitis.
The applicant insisted that he suffers from frequent attacks of his kidney stones illness (urolithiasis). On a number of occasions he complained about a severe pain and deterioration of his conditions to the detention authorities, however, no examinations or testing was performed. On 17 May 2012, following yet another attack, an ambulance brought the applicant from the detention facility to the Prodolsk Town Hospital where an urologist diagnosed him with double-sided urolithiasis. The applicant received painkillers. No other treatment was provided.
On 31 July 2012 the applicant lost consciousness and an ambulance was called to the detention facility. He was transported to the town hospital where he was diagnosed the 1st-degree diabetes. The applicant insisted that following his release from the hospital he was not subjected to the glycemic control and the dose of insulin to be provided to him had not been set by a doctor. On a number of occasions the applicant did not receive a daily dose of insulin. He needs 110 units of insulin per day. His condition is included in the List of Illnesses, established by a Governmental decree, warranting his release on health grounds. However, the authorities constantly disregard his complaints and refuse to acknowledge that his condition is grave and calls for adequate assessment and treatment.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention. The applicant also complained under Article 5 § 3 of the Convention that his detention was extremely lengthy.
12. Application no. 45705/13 lodged on 27 June 2013 by Aleksandr Vladimirovich BELOV, who was born on 7 August 1982, lived before his arrest in Kranosyarsk and serves his sentence of imprisonment in a medical colony in the Khakasiya Republic.
A. Facts
By the final judgment of 8 December 2009 the applicant was found guilty of aggravated drug trafficking and robbery and sentenced to nine years of imprisonment.
An X-ray examination performed on the applicant’s admission to a detention facility after his arrest on 12 May 2008 revealed changes in the applicant’s lungs and he was subsequently diagnosed with tuberculosis. Prison doctors also recorded the following concomitant illnesses: urolithiasis, stones in the left kidney, chronic pyelonephritis without signs of an acute condition.
On a number of occasions the applicant received treatment in various penitentiary medical facilities, including tuberculosis hospitals. His condition deteriorated with the illness having progressed to the stage of infiltrative tuberculosis in the dissemination phase and multi-resistant form. The applicant was assigned a third-degree disability.
At the same time he continued suffering from kidney problems. In 2011 the applicant was recommended kidney stone surgical treatment. As follows from a letter received by the applicant in February 2012 from the head of the medical department of the Krasnoyarsk Regional Penitentiary System, the surgical treatment could only be provided after the applicant had completed his anti-tuberculosis chemotherapy regimen and had been considered fit for the surgery.
In the meantime, the applicant lodged a tort action against the penitentiary authorities having complained about the poor quality of medical services and his deteriorating health.
On 27 February 2012 the Sovetskiy District Court of Kranosyarsk accepted the applicant’s action in part, having found that the authorities had not fully complied with the standards of medical care related to the treatment of kidney illnesses. In particular, they had not placed the applicant under the dynamic medical supervision by a specialist, had only provided him with painkillers without assigning any specific chemotherapy regimen and had failed to perform necessary clinical tests. The District Court awarded the applicant 5,000 Russian roubles (approximately 120 euros) in this respect. At the same time, it also stressed that the applicant’s claim for the surgical treatment of his kidney disease could not be accepted as that type of treatment was “contraindicated” (противопаказно) to him.
As regards the remaining claims, the court dismissed them in full, having found that the applicant’s treatment of tuberculosis was thorough and adequate.
On 14 January 2013 the Krasnoyarsk Regional Court upheld the judgment on appeal, having fully endorsed the District Court’s reasoning. On 5 April 2013 a judge of the Regional Court refused to iinitiate cassation proceedings.
The applicant argued that despite recommendations of the doctors and the District Court’s conclusion that the assistance provided to him in respect of his kidney illnesses was inadequate, he still was left without proper medical care, and in particular, the recommended surgery. He frequently suffered from serious attacks of kidney stone illness when he experienced an excruciating pain. However, the authorities did not take any steps to relieve him of his sufferings. He supported his claims with the following evidence:
- a letter sent to the applicant’s mother by the director of the Krasnoyarsk Regional Health Department, noting that on 9 April 2012 an urologist again recommended surgical treatment of the kidney stone illness to the applicant. Following a consultation with the main tuberculosis specialist of Krasnoyarsk Medical Institute, the doctors came to the conclusion that the development of the tuberculosis process did not prevent the applicant from being subjected to a surgery. However, the director also noted that on 18 April 2012 the applicant had refused the surgery.
The applicant disputed the latter statement having argued that there was no reason for him to do it, as well as there was no evidence of his refusal.
- an extract from the applicant’s record issued on 23 April 2012 again confirming the recommendation for the surgical treatment and noting the absence of contraindications for it.
- decision of 6 June 2012 by the head of the medical colony where the applicant was detained at the time, authorising his placement in a prison hospital for a purpose of a medical forensic examination to determine whether he was eligible for an early release on health grounds. The decision indicated that the question was raised in respect of the applicant’s kidney illnesses. The results of that expert examination are unknown to the Court.
- a letter sent on 8 November 2012 to the applicant’s mother by a deputy head of the tuberculosis hospital noting that the applicant had refused surgical treatment of kidney problems and that his tuberculosis was clinically cured, although there were large residual changes in the lungs in the form of fibrosis and intensive foci. He also suffered from cardiac failure and the first-degree mitral insufficiency.
The applicant insisted on his unequivocal willingness to receive surgical treatment. He stressed that the prison doctors refused to provide him with the required treatment because they are afraid of the negative prognosis given that he suffers from a very serious conditions affected by tuberculosis and inability to combat it.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention.
13. Application no. 47875/13 lodged on 19 June 2013 by Aleskey Vladimirovich SHELEST, a Ukrainian national, who was born on 7 January 1979 and serves his sentence of imprisonment in a correctional colony in the Bashkortostan Republic.
A. Facts
By final judgment of 7 November 2013 the applicant was found guilty of aggravated drug trafficking and was sentenced to twelve and a half years of imprisonment.
Since 1998 the applicant has suffered from chronic lymphoid leucosis of 2nd degree. He is in need of regular in-patient in-depth testing and treatment in a specialised hospital. On 2 June 2011, prior to his arrest, the applicant was recommended treatment in an oncology hospital to receive the scheduled course of chemotherapy. On 18 August 2011 he was transferred from a detention facility to the oncology department of the Bashkartostan Republican Clinical Hospital where, following a complex examination, an expert declared that the applicant suffered from an illness included in the List of Illnesses, as provided for by the Government’s Decree, warranting his release from detention on health grounds.
In November 2011 the applicant sent a request to the Clinical Hospital asking to provide him with necessary treatment given the lack of the requisite care in detention and his deteriorating health. His request was forwarded to the Republican Service for Execution of Sentences (hereinafter – the Service). The applicant was examined in the Clinical Hospital on 19 November 2011. The report issued by the experts on same day stated that the applicant was in need of additional examinations to be performed in specialised medical facilities, including immunology testing, etc. In January 2012 the applicant received a letter from the head of the medical division of the Service confirming his previous diagnosis as well as the fact that the applicant’s condition warranted his release on health grounds.
Despite the fact that the administration of the detention facility where the applicant was kept sent the necessary documents to a court examining the issues of the applicant’s continued detention, his requests for release on health grounds were consistently dismissed.
The applicant argues that during the entire period after his arrest he was not provided with any treatment related to his condition although the necessity to provide him with chemotherapy regimen had already been acknowledged by doctors in 2011. His condition continues deteriorating rapidly. He suffers from frequent loss of consciousness, nose bleeds, and a severe pain. His tumor is growing. He is constantly tired and sleepy.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention.
14. Application no. 53937/13 lodged on 19 July 2013 by Eduard Vyacheslavovich GUBACHEV who was born on 1 January 1984 and lived, before his arrest, in the village of Novonikolayevka, Tatarstan Republic. Having been convicted of aggravated rape and deliberate transmission of HIV-infection, he is serving his sentence of imprisonment in the correctional colony in the town of Nizhnekamsk, Tatarstan Republic.
A. Facts
1. The applicant’s state of health
The applicant is HIV-positive. Prior to his arrest on 1 August 2012 and his placement in detention facility no. 2 in Kazarn, since 2008 he had received antiretroviral treatment in the AIDS Centre in Kazan. On the applicant’s admission to the detention facility his blood was tested for the presence of HIV-infection. The applicant submitted that ever since he did not receive any treatment in respect of the HIV-infection. He lost a lot of weight, he started suffering from psoriasis, his teeth fell out; he experienced serious pain, loss of appetite, nausea, and insomnia.
2. Conditions of detention
From 1 August 2012 to 23 June 2013 the applicant was detained in facility no. 2 in Kazan. He stayed in the overcrowded conditions, having been forced to share cell no. 33 with twelve inmates. The cell was only equipped with eight bunks and it was damp and dirty. It did not have a ventilation system.
B. Complaint(s)
The applicant complained, among other matters, about a lack of proper medical assistance in detention and poor conditions of detention from 1 August 2012 to 23 June 2013.
15. Application no. 63378/13 lodged on 19 September 2013 by Yelena Anatolyevna BOGDANOVA who was born on 18 June 1976 and lived, before her arrest, in the town of Komsomolsk-on-Amur. She is serving her prison sentence in a correctional colony in the Krasnoyarsk Region.
A. Facts
The applicant is a transsexual woman. She had a gender reassignment male-to-female surgery in 2011. For a number of years prior to the surgery as well as after the surgery before the arrest she received hormone replacement therapy.
On 9 June 2012 the applicant was arrested on suspicion of an attempted drug trafficking. She was placed in a temporary detention facility in the town of Komsomolsk-na-Amure, Khabarovsk Region.
A month later the Leninskiy District Court of Komsomolsk-na-Amure found the applicant guilty as charged and sentenced her to two years of imprisonment. The judgment became final on 4 September 2012 and the applicant was sent to serve her sentence in correctional colony no. 10 in the village of Gornyy, Primorye Region, where she stayed until 15 March 2013, when she was transferred to a tuberculosis hospital in the town of Minusinsk. It appears that the applicant remained there until her release.
After the arrest the authorities refused to provide the applicant with the hormone replacement medicaments despite her numerous complaints and the fact that such life-long therapy was an indefensible requirement after the surgery. The applicant argued that the failure to obtain such therapy led to the development of “gender dystrophy”, that is the return of the secondary sexual (male) characteristics. Her mental condition also allegedly deteriorated significantly. She also did not receive treatment for her hepatitis B with which she had been diagnosed after her arrest. In response to the applicant’s complaints, the authorities informed her that she had to pay for the hormone replacement therapy herself. The applicant, an inmate, did not have the necessary resources.
In April 2013 the applicant was transferred to a Krasnoyarsk hospital to see an endocrinologist for the first time since her arrest. A doctor prescribed the applicant the hormone replacement therapy the costs of which she had to bear herself. The applicant did not have the means to pay for it.
Relying on handwritten statements by two inmates, the applicant also stated that following her arrival to the tuberculosis hospital the administration of the facility informed the entire prison population that the applicant was a transsexual. As a result she became the subject of threats and prison violence, was segregated from other inmates and placed in a medical unit as a “safe place”.
In July 2013 the applicant asked a court to authorise her provisional release given her poor state of health and inability to receive the hormone replacement therapy. Having concluded that the applicant’s condition was not included in the list of illnesses calling for a release, on 17 October 2013 the Krasnoyarsk Regional Court, in the final instance dismissed the request.
B. Complaint(s)
The applicant complained, among other matters, under Articles 3 and 13 of the Convention about the absence of necessary medical treatment, including the hormone replacement therapy, and the lack of an effective remedy to complain about that violation. The applicant also complained about the conditions of her detention as a result of the authorities having disclosed the information about her gender reassignment surgery.
16. Application no. 64127/13 lodged on 15 January 2013 by Andrey Anatolyevich ZIMIN who was born on 16 February 1977 and lived, until his arrest, in the Komi Republic. He was represented by Mr E. Mezak, a lawyer practicing in the Komi Republic. The applicant is serving his sentence in a medical colony in the town of Ukhta, Komi Republic.
A. Facts
The applicant, an inmate, has been detained since 2000.
On 13 April 2005 the applicant was diagnosed with HIV infection. After the diagnosis and until 11 May 2008 the applicant was only twice subjected to a CD4 cell count test: on 31 May and 3 December 2007. An HIV viral load test was not at all performed during that period.
On 11 May 2008 the applicant was transferred to a correctional colony in the Komi Republic to serve his sentence. It was not until 10 March 2011 that he was given a CD4 cell count test. On 31 January 2011, for the first time, he was subjected to an HIV viral load test which reported 307,157 RNA copies/ml. The applicant should have immediately started receiving the antiretroviral therapy. However, it was delayed until November 2011, when the applicant had obtained a judgment order.
In May 2011 the applicant lodged a complaint with the Syktyvkar Town Court against the penitentiary authorities, having argued their failure to provide him, timeously, with adequate medical treatment.
On 29 June 2011 the Town Court partly accepted the applicant’s complaint. Having refused to acknowledge that the authorities’ failure to provide the applicant with comprehensive, adequate and timely medical care violated his right guaranteed by Article 3 of the Convention and having also refused to order that the authorities should initiate the antiretroviral therapy, the Town Court, nevertheless, confirmed that the penitentiary authorities had unlawfully failed to subject the applicant to CD4 cell count and HIV viral load tests for more than three years. The Town Court also noted that the applicant had not yet been placed on the antiretroviral therapy.
On 7 November 2011 the Supreme Court of the Komi Republic, acting on appeal, upheld the Town Court’s finding regarding the refusal to acknowledge a violation of Article 3 of the Convention, confirmed the authorities’ unlawful failure to subject the applicant to the necessary tests, quashed the remaining part of the judgment and ruled that the applicant should be regularly subjected to all necessary HIV-related tests and should be, within a month after the final judgment, placed on antiretroviral chemotherapy regimen.
In June 2012 the applicant, having relied on the findings of the Supreme Court of the Komi Republic of 7 November 2011, lodged an action against the penitentiary authorities and the Russian Ministry of Finance, claiming compensation for damage caused by the authorities’ failure to provide him with adequate medical care.
On 11 January 2013 the Syktyvkar Town Court accepted the applicant’s action in part, having awarded him 10,000 Russian roubles (approximately 250 euros). The Town Court concluded that despite the evidence that the applicant’s HIV infection had rapidly progressed in the period of his detention and that the tests, when he had been finally subjected to them, had shown that he had required urgently the antiretroviral therapy, in the absence of the applicant’s proper testing in the years of his detention it was impossible to determine for how long the antiretroviral therapy had been delayed and how the applicant’s health had been affected as a result of that delay.
That judgment was upheld on appeal on 14 May 2013 by the Supreme Court of the Komi Republic.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention.
17. Application no. 70371/13 lodged on 24 October 2013 by Sergey Nikolayevich KOROTEYEV who was born on 2 December 1978 and lived before his arrest in St. Petersburg. He is serving his prison sentence in a correctional colony in the Leningrad Region. The applicant is represented by Ms O. Stasyuk, a lawyer practicing in St. Petersburg.
A. Facts
1. Conditions of detention
On 1 November 2008 the applicant was arrested in St. Petersburg and placed in a temporary detention facility. On 29 January 2009 he was transferred to detention facility no. 1 in Ufa, Bashkortostan Republic, where he remained until 20 May 2013.
The applicant provided the following description of the conditions of his detention:
- from 29 January 2009 to the beginning of 2010 he stayed in cells nos. 3, 8, 10, 11 and 149. The first four cells measured 18 sq. m. and housed five to nine inmates. Cell no. 149 measured approximately 20 sq. m. Nine to ten inmates were kept in that cell;
- from March 2010 to 20 May 2013 the applicant was kept in cell no. 6 which measured 18 sq. m. and accommodated six to ten inmates.
On two occasions in 2009, one occasion in 2010 and one occasion in 2013 the applicant stayed in a prison hospital for in-patient treatment. Usually the stay lasted no more than twenty days. The longest period of his stay in 2013 lasted 27 days. Following the treatment the applicant was immediately brought back to the detention facility.
The applicant provided a similar description in respect of every cell where he stayed. They were severely overcrowded. The cells did not have an artificial ventilation system. Windows were covered by several tows of thick metal bars forming a tight net which blocked access of day light and fresh air. It was stuffy, dark and dirty in the cells. Cells were equipped with four or six double-tier bunks which left no free space for inmates to move around. A lavatory pan was positioned very close to the bunks and a dining table and was not separated by a partition from the remaining part of the cell. On certain occasions inmates did not have an individual sleeping place and had to take turns to sleep due to overcrowding. Inmates were allowed to smoke inside the cells which for the applicant, a non-smoker, was unbearable. Inmates were allowed to take a shower once a week for 10-15 minutes. They could take an hour-long walk outside in the small prison yard. The yards were surrounded by three-meter-high brick walls and covered by a metal plate which did not let any fresh air or light in. No equipment, including a bench, was installed in the yard.
2. Applicant’s health and quality of medical treatment
In March 2001 the applicant underwent a kidney transplantation surgery. Since then he has been placed on permanent immunosuppression therapy. As follows from medical certificates provided by the applicant, he has to undergo frequent clinical examinations and testing every two weeks and remain under constant supervision of a nephrologist. Until his arrest the applicant received necessary chemotherapy regimen and complied with the recommendations regarding the examinations and medical supervision. In 2009 the applicant was assigned third-degree disability related to his condition.
A medical certificate issued on 3 September 2009 by the deputy head of the medical unit of the temporary detention facility stated that the applicant was placed under dynamic supervision by a prison physician. He received “a very expensive drug regimen” with the medicines having been provided by his parents. The deputy head also noted that the applicant did not need any surgical treatment and that his condition was satisfactory.
Following yet another scheduled admission to a prison hospital for in-depth examinations and treatment, doctors issued a certificate having noted that the applicant required permanent supervision and immunosuppressant therapy.
Another medical certificate issued on 12 September 2012 by the deputy head of the medical unit of the temporary detention facility indicated that the applicant, free of charge, received immunosuppressant therapy vital for a patient in his condition. The doses of the drugs had been identified and prescribed by specialists who had treated the applicant at the time of his surgery. The medical personnel of the detention facility had no competence to control or adjust the drug regimen. The deputy head acknowledged that there was a possibility of a deterioration of the patient’s health when there was no due control over the immunosuppressant therapy. However, the applicant did not disclose any negative dynamic. Therefore, there was no reason to schedule an examination by an immunologist or to adjust the drug regimen.
Following his conviction, on 20 June 2013 the applicant was sent to serve his sentence to a correctional colony in the Leningrad Region.
As follows from a letter sent to the applicant by the head of the colony medical unit, the colony did not employ a nephrologist and did not have a possibility to provide the applicant with immunosuppressants.
The applicant submitted that following his transfer to the correctional colony his life is in danger as he does not receive vital immunosuppressant therapy. He was not even once examined by a nephrologist and he was not subjected to necessary clinical testing to determine the progress of his illness.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention and inhuman conditions of his detention from 29 January 2009 to 20 May 2013. He also complained under Article 13 of the Convention that he did not have an effective remedy for the alleged violations of his rights.
18. Application no. 19972/14 lodged on 27 February 2014 by Konstantin Eduardovich SITARSKIY who was born on 24 December 1966 and lived before his arrest in Kazan, Tatarstan Republic. He is now in a temporary detention facility in Kazan. The applicant is represented by Ms I. Khrunova, a lawyer practicing in Kazan.
A. Facts
1. Criminal proceedings against the applicant
On 2 November 2012 criminal proceedings were instituted against the applicant on suspicion of assisted bribery. On the following day the applicant was arrested and interrogated by an investigator.
On 4 November 2012 the Sovetskiy District Court of Kazan authorised the applicant’s placement in custody until 3 January 2013, having relied on the gravity of the charges against him and the flowing risk of his absconding, re-offending or obstructing justice. The District Court was not convinced by the defence arguments that the applicant had strong family ties and was a caretaker for minor children, that he had permanent places of employment and residence and that he was seriously ill. The applicant was taken to temporary detention facility no. 1 in Kazan.
The Sovetskiy District Court extended the applicant’s detention for another month on 28 December 2012. In very concise wording, the court found that the gravity of the charges against the applicant posed a risk of his absconding, re-offending and obstructing justice. It also noted that the applicant did not suffer from any condition precluding his detention.
Another extension followed on 29 January 2013 when the District Court found as follows:
“Taking into consideration the gravity, character and the circumstances of the crimes with which [the applicant] is charged, the established information about the [applicant’s] personality, the court considers well-founded the investigator’s argument that, if released, he may tamper with witnesses and therefore obstruct justice.
The arguments of [the applicant] and his lawyer that the former does not intend to interfere with the investigation, that he is the caretaker for two minor children and elderly mother suffering from a number of illnesses, should be assessed in conjunction with the above-mentioned circumstances of the case and cannot serve, on their own, as the unconditional ground for a change of the measure of restraint.”
On 22 February 2013 the District Court again extended the applicant’s detention, having mentioned that the gravity of the charges and the sentence that the applicant was facing served as the grounds for the conclusion that he was liable to abscond. The court also noted the applicant’s medical condition but concluded that he could receive the necessary treatment in detention. That detention order was upheld on appeal on 7 March 2013.
In April 2013 the District Court examined the applicant’s request for release on health grounds and dismissed it as unfounded. In particular, the applicant argued that he was seriously ill and that he needed medical care which could not be provided in the detention facility, as for instance, the facility did not employ a vascular surgeon and could not subject the applicant to necessary X-ray examinations. Having studied the applicant’s medical record, the District Court concluded that the applicant had received the prescribed treatment in full and that there was no evidence that should the applicant require additional treatment, it could not be provided in the detention facility.
Two more extensions of the applicant’s detention were authorised by the District Court on 10 July and 5 August 2013. In identical wording, on both occasions the District Court found that there were no changes in the applicant’s situation warranting his release and dismissed his lawyer’s requests to place him on house arrest in view of the poor state of his health. The District Court’s detention order of 5 August 2013 was upheld on appeal by the Supreme Court of the Tatarstan Republic on 13 September 2013. The Supreme Court endorsed the District Court’s finding that the applicant was liable to abscond, re-offend and obstruct justice in view of the gravity of the charges against him.
On 4 October and 26 December 2013 the District Court, by a one-page decision, extended the applicant’s stay in custody. Each time the District Court noted the lack of any changes among the grounds which had initially called for the applicant’s placement in custody. The detention order of 26 December 2013 was endorsed by the Supreme Court on appeal on 17 January 2014.
The applicant’s detention was again extended on 5 February 2014 until 11 May 2014. There is no information on the further developments in the applicant’s case.
2. The applicant;s state of health
The applicant suffers from trophic ulcer of the left leg. On 7 February 2013 he asked the director of the detention facility to transfer him to a prison hospital for treatment given that he suffered from a severe pain in the legs, that the lesion on the left leg was spreading and that he was afraid that his movements could be seriously impaired. He also complained about the nausea and fatigue.
On 18 February 2013 a vascular surgeon retained by the applicant’s relatives examined him in the detention facility. He diagnosed the applicant with “post-thrombophlebitic illness of the lower extremities, mixed form, mico-dermathosis of the both shins, trophic ulcer of the right shin, third degree chronic venous insufficiency of the both lower extremities”. The doctor prescribed treatment with medicaments, prohibited any heavy physical exercise and ordered that the applicant should be regularly subjected to ultra-scanning examinations of the veins in the legs.
On 1 March 2013 the applicant received a letter from the director of the detention facility refusing his comprehensive medical expert examination in the absence of any evidence that the applicant suffered from a serious illness calling for his release.
A month and a half later the applicant was again examined by the vascular surgeon invited by his relatives. The surgeon confirmed his previous diagnosis, having noted the progress of the illness.
On 16 April 2014 the director of the detention facility informed the applicant’s lawyer that the facility did not employ a vascular surgeon and was not equipped with a scanner to examine the applicant’s legs. However, the director noted that the applicant would be subjected to necessary tests as planned. A similar letter was sent to the applicant’s lawyer in June 2013.
On 3 July 2013 a vascular surgeon again visited the applicant upon his relatives’ request. Having confirmed his previous diagnosis and again recorded the progress of the illness, the surgeon prescribed chemotherapy regimen and a surgery of the vascular system of both legs preceded by an additional complex scanning examination. He also noted that the applicant should be admitted for inpatient treatment to a specialised hospital.
Two days later the director of the applicant’s detention facility refused to transport the applicant to the courthouse in view of his poor state of health.
On 19 July 2013 the applicant was sent to a prison hospital in correctional colony no. 2 to comply with the surgeon’s recommendations. He remained there until 7 August 2013.
Another examination of the applicant by a vascular surgeon occurred on 19 November 2013. The surgeon’s services were once again paid for by the applicant’s relatives. The surgeon’s diagnosis and recommendations were similar to those given on previous examinations. However, he also diagnosed the applicant with right-sided oblique inguinal hernia which also required surgical treatment. The surgeon again stressed that the applicant’s state of health demonstrated a clear negative dynamic with his condition deteriorating.
In December 2013 the applicant’s lawyer received a letter from the director of the detention facility. The latter, while having acknowledged the importance of a surgery, pointed out that it could not be performed in the penitentiary hospitals.
On 29 January 2014 the applicant was admitted to a prison hospital where, as he argued, his treatment only consisted of analgesics. His health continued deteriorating to the point that he lost ability to move his right leg.
On 10 February 2014 a surgeon who had seen the applicant on previous occasions stated that his condition was critical and that bed rest was imperative for him. He also stated that a further development of the illness would lead to the applicant’s death.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention and under Article 5 § 3 of the Convention that his pre-trial detention was excessively long.
19. Application no. 20888/14 lodged on 5 September 2014 by Nikolay Aleksandrovich KARYY, a Moldovan national, who was born on 4 December 1956 and lived before his arrest in the town of Dubossary, Moldova. He is serving his sentence of imprisonment in correctional colony no. 17 in the Nizhniy Novgorod Region.
A. Facts
On 7 February 2013 the applicant’s jaw was broken in a correctional colony. He was diagnosed with the segmental fracture of the lower jaw when taken to a local hospital for an X-ray. A surgeon who examined the applicant recommended an immediate transfer to the Semashko regional hospital to fix the jaw with a medical cast (tire).
Despite the doctor’s recommendations, the applicant was taken back to the detention facility without any medical assistance being provided. The applicant continued complaining about the pain and insisted on his transfer to a hospital which only occurred on 28 February 2013. He was taken to the prison hospital where he was diagnosed with consolidated fracture of the lower jaw. A surgeon admitted that it was too late to place the cast and that a surgical intervention was needed to fix the jaw. The applicant was promised that he would be taken to the Gaaza prison hospital in St. Petersburg for treatment.
The applicant lodged a number of complaints with prosecutors and the Regional Ombudsman complaining about the lack of any assistance. On 24 April 2013 he received a letter from the Ombudsman informing him that his complaint had been redirected to the head of the Regional Penitentiary Service to identify a reason for the authorities’ failure to provide the applicant with adequate medical assistance. The Ombudsman also noted that the local hospital did not employ a specialist in the oral and maxillofacial surgery and that he therefore had been recommended treatment in the Semashko hospital.
A similar letter was sent to the applicant by a deputy director of the Regional Penitentiary System in May 2013. The applicant was notified of a request sent to the St. Petersburg Gaaza prison hospital to accept him for treatment.
In August 2013 the Deputy Director of the Service informed the applicant that the Gaaza hospital had refused to admit him for treatment and that a surgery had to be performed in clinical hospital no. 39 sometime in August 2013.
On 19 September 2013 the applicant underwent a surgery in clinical hospital no. 39. He submitted that the surgery had been a difficult one and had lasted for more than seven hours given that the lack of medical treatment had led to the injury becoming rotten. The applicant provided the following description of the results of the surgery: two teeth had been removed, as well as a part of the gum at the front of the jaw. A part of the jaw bone had also been removed and had been replaced with an implant. The jaw had been wired with screws having been placed at the chin. The applicant’s face had convulsed features and a part of a bone was sticking out from the place where the teeth and gum had been removed.
Soon an inflammation occurred around the implant and the applicant was admitted to the surgical department of the prison hospital where he stayed from 19 December 2013 to 14 March 2014. His diagnosis was as follows: chronic traumatic osteomyelitis of the right side of the lower jaw. On 31 January 2014 he was seen by a surgeon from clinical hospital no. 39. The applicant submitted that during the consultation the surgeon and another doctor had unsuccessfully tried to remove the sticking part of the bone from his mouth. The applicant was prescribed a surgery in the oral and maxillofacial surgical department. The surgery was not considered urgent and the colony administration sent a request to the St. Petersburg prison hospital to admit the applicant for surgical treatment. No response was yet received.
The applicant submitted that his condition was getting worse. His injury became inflamed again with a wound discharging pus having appeared on the jaw. The applicant suspected that the decaying bone in his jaw was the reason for the inflammation. The applicant cannot eat properly as he experiences a severe pain and his wound is bleeding. The lower jaw is almost hanging unattached.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention.
20. Application no. 60277/14 lodged on 10 August 2014 by Sandro Giorgiyevich RAMISHVILI, a stateless person, who was born on 1 February 1974. He is now detained in the temporary detention facility in the town of Aleksandrov, Vladimir Region.
A. Facts
On 19 March 2014 the applicant was extradited from Ukraine to Russia. On 29 April 2014 he was placed in the detention facility in Aleksandrov. On admission to the facility he was examined by the head of the facility medical unit and was diagnosed with the high degree myopathy, initial cataract of the two eyes, and old retinal detachment of the left eye.
The administration of the detention facility sent a request to the Aleksandrov Central Republican Hospital inviting an oculist to consult the applicant.
During an examination on 19 May 2014 the invited oculist confirmed the diagnosis, having noted the lengthy history of the applicant’s medical problems.
Another request for an additional examination of the applicant in the prison hospital was sent on 23 May 2014. That request was accepted and the applicant was seen by the oculist of the prison hospital. The doctor confirmed the diagnosis, having noted that a surgery was possible but there were no guarantees of improvement.
On 27 June 2014 the applicant was seen by the Main Ophthalmologist of the Vladimir Region, who having confirmed the seriousness of the diagnosis, recommended surgical treatment of the left eye in a specialised hospital to be performed in the shortest time possible. At the same time, the doctor noted that it was impossible to guarantee that the applicant’s eyesight could be significantly improved by the surgery.
As follows from a letter sent to the applicant by the head of the prison hospital, the Vladimir Regional Clinical Hospital was not equipped to perform the recommended surgery. He also noted that a procedure to determine whether the applicant could be released on health grounds was to be initiated.
The applicant lodged an extremely large number of complaints with various authorities. However, he still was not subjected to the surgery.
The applicant is losing eyesight and he is afraid that he will become blind in the absence of the surgery.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention and under Article 13 of the Convention about the absence of an effective remedy to complain about the lack of proper medical care.
21. Application no. 70164/14 lodged on 5 June 2013 by Aleksandr Borisovich BELEVITIN who was born on 22 November 1959 and lived before his arrest in St. Petersburg. He is serving his sentence in a correctional colony in the Leningrad Region.
A. Facts
Before arrest on 1 June 2011, the applicant’s medical history included the following illnesses: cholelithiasis, chronic calculous cholecystitis, chronic pancreatitis, third-degree hepatic stenosis, ischemic illness, exertional angina, second-degree essential hypertension; bronchial asthma of the mixed type; initial cataract of the two eyes.
The applicant alleged that his condition significantly deteriorated during his detention both in the temporary detention facility in Moscow and in the correctional colony in the Leningrad Region. In particular, a number of his illnesses progressed to a more advanced stage with his having started suffering from: atherosclerosis of aorta and coronary arteries, chronic heart failure, critical course of the essential hypertension, third-degree arterial hypertension of extremely elevated risk; insufficient blood circulation; atomic infectious-depended hormone-dependent bronchial asthma of the moderate degree in the phase of unstable remission; pulmonary emphysema; diffusive pneumosclerosis; fourth-stage cholelithiasis, chronic calculous cholecystitis in the acute stage with an increased risk of destructive complications; multiple gallstones, cholesterosis; cholesterol polypus of the gallbladder; frequent relapse of chronic pancreatitis in the acute stage and painful form with the moderate exocrinous failure of the pancreatic gland characterized by a high risk of destructive complications; hypertonic retinal angiopathy; immature cataract of the right eye; initial cataract of the left eye; significant lenticular opacity of both eyes; developed and progressing cataract of the lens of both eyes (the doctors noted significant progress of the lenticular opacity in comparison with 2011 characterised by further deterioration of the eyesight by ten percent); frequently relapsing chronic lumbosacral radiculitis; condition after a mine explosive wound (two times in 1986 and once in 1987) and consequences of brain injuries.
Those diagnoses were included in the applicant’s medical history by the head of the medical unit of the correctional colony. In particular, in the certificate issued in May 2013 the head of the medical unit noted a serious worsening of the applicant’s health, the progress of the chronic illnesses to the grave stage, pathological changes and deterioration of “the quality of his life”. He made a three-page list of various health-related problems experienced by the applicant, among which were serious pains requiring urgent medical interference. The unit head noted that the applicant had been examined by relevant specialists and his treatment, including surgical treatment, in a hospital had been recommended. He stated, in particular, that the applicant was in need of very strict supervision by cardiologists, urologists and ophthalmologist and their assistance to provide the applicant with coronary angiogram, a surgery to solve the problem with calculous cholecystitis and replacement of crystalline lenses with artificial lenses. The head of the medical unit stressed that the applicant could only receive urgent treatment in the colony to resolve an acute attack of any of the illnesses. However, the colony had no opportunity to provide him with lengthy and intensive medical care, including a number of surgeries, he was in need of. The head of the medical unit concluded that the absence of the necessary medical treatment could lead to further complications of the applicant’s condition, development of the critical stages of the illnesses with their progress to even more grave stages and a further negative prognosis for the applicant’s life and limb. In the doctor’s opinion, a delay in the provision of the medical care would necessarily strip any further medical services of any prospects of curing the applicant.
The applicant also provided the Court with copies of opinions by civil experts noting the necessity to subject him to a number of medical procedures and tests and examinations to determine the gravity of his condition and to set the proper course of the treatment. The experts stressed that those in-depth examinations and treatment could only be performed in a hospital.
The applicant insisted that he remained without any medical assistance, save for when it was necessary to provide urgent and rapid relief following yet another attack of his illnesses.
B. Complaint(s)
The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention and under Article 13 of the Convention about the absence of an effective remedy to complain about the lack of proper medical care.
COMMON QUESTIONS
1. The Government are requested to produce a typed copy of the applicant’s complete medical record drawn up after his/her arrest, and, if available, copies of expert reports and secondary opinions from medical specialists assessing the applicant’s health, the quality of the treatment afforded to him/her during the detention and laying down medical procedures which should have been or should be performed to maintain the applicant’s health.
2. Taking into account the applicant’s medical history, have the authorities of the respondent State met their obligation to ensure that that applicant’s health and well-being are being adequately secured by, among other things, providing him with the requisite medical assistance (see McGlinchey and Others v. the United Kingdom, no. 50390/99, § 46, ECHR 2003‑V), as required by Article 3 of the Convention, in the present case.
3. Did the applicant (save for application no. 64127/13) dispose of effective domestic remedies – as required by Article 13 of the Convention – for his/her complaint about the lack of effective medical care?
CASE SPECIFIC QUESTIONS
Applications nos. 30125/06, 3933/12, 42270/13 and 19972/14
Was the length of the applicant’s pre-trial detention in breach of the “reasonable time” requirement of Article 5 § 3 of the Convention?
Application no. 2460/10
Were the conditions of the applicant’s detention in medical colony no. 2 in the Khabarovsk Region compatible with Article 3 of the Convention?
Did the applicant have at his disposal an effective domestic remedy for his complaint about the poor conditions of his detention, as required by Article 13 of the Convention?
Application no. 3933/12
Were the conditions of the applicant’s detention in facility no. 1 in Krasnoyarsk compatible with Article 3 of the Convention?
Did the applicant have at his disposal an effective domestic remedy for his complaint about the poor conditions of his detention, as required by Article 13 of the Convention?
Application no. 53937/13
Were the conditions of the applicant’s detention from 1 August 2012 to 23 June 2013 in facility no. 2 in Kazan compatible with Article 3 of the Convention?
Did the applicant have at his disposal an effective domestic remedy for his complaint about the poor conditions of his detention, as required by Article 13 of the Convention?
Application no. 63378/13
Was the information about the applicant’s sex-reassignment surgery disclosed to the inmate population by the colony administration? If so, was the applicant segregated from the remaining inmate population? Has she, as a result, been subjected to a treatment in breach of Article 3 of the Convention?
Given the authorities’ refusal to provide the applicant with the hormone replacement therapy and/or the disclosure of the information about her sex-reassignment surgery to the inmate population, has there been a violation of the applicant’s right to respect for her private life, contrary to Article 8 of the Convention?
Application no. 70371/13
Were the conditions of the applicant’s detention in facility no. 1 in Ufa from 29 January 2009 to 20 May 2013 compatible with Article 3 of the Convention?
Did the applicant have at his disposal an effective domestic remedy for his complaint about the poor conditions of his detention, as required by Article 13 of the Convention?
APPENDIX
No.
Application
no.
Lodged on
Applicant name
date of birth
30125/06
05/06/2006
Aleksandr Anatolyevich NIKULIN
27/07/1972
7805/07
09/11/2006
Sergey Vladimirovich MAKSIMOV
11/11/1969
51252/09
02/09/2009
Vladimir Sergeyevich BARSUKOV
15/02/1956
2460/10
04/12/2009
Sergey Vladimirovich SILANTYEV
02/07/1970
47236/11
19/07/2011
Eduard Arkadyevich NOVOSELOV
14/11/1964
3933/12
23/12/2011
Nikolay Petrovich PISKUNOV
02/08/1955
11823/12
24/02/2012
Anatoliy Markovich ZAK
25/06/1973
33690/12
19/06/2012
Aleksandr Ivanovich BALKOV
11/06/1965
20988/13
01/02/2013
Mikhail Valentinovich KIRYUKHIN
22/01/1972
41785/13
19/05/2013
Valeriy Vitalyevich BULIN
09/09/1977
42270/13
18/05/2013
Aleksey Aleksandrovich BEREZIN
07/01/1973
45705/13
27/06/2013
Aleksandr Vladimirovich BELOV
07/08/1982
47875/13
19/06/2013
Aleksey Vladimirovich SHELEST
07/01/1979
53937/13
19/07/2013
Eduard Vyacheslavovich GUBACHEV
01/01/1984
63378/13
19/09/2013
Yelena Anatolyevna BOGDANOVA
18/06/1976
64127/13
15/01/2013
Andrey Anatolyevich ZIMIN
16/02/1977
70371/13
24/10/2013
Sergey Nikolayevich KOROTEYEV
02/12/1978
19972/14
27/02/2014
Konstantin Eduardovich SITARSKIY
24/12/1966
20888/14
05/09/2014
Nikolay Aleksandrovich KARYY
04/12/1956
60277/14
10/08/2014
Sandro Georgiyevich RAMISHVILI
01/02/1974
70164/14
05/06/2013
Aleksandr Borisovich BELEVITIN
22/11/1959
Full & Egal Universal Law Academy