Communicated on 17 May 2016

THIRD SECTION

Applications nos 41859/15 and 44068/15 Amazasp Vardani ABRAMYAN against Russia and Yelena Anverovna PALTSEVA against Russia lodged on 14 September 2015 and 26 October 2015 respectively

STATEMENT OF FACTS

The applicants are Russian nationals.

The facts of the cases, as submitted by the applicants, may be summarised as follows.

1 . Application no. 41859/15 was lodged on 20 August 2015 by Amazasp Vardani Abramyan , who was born on 18 January 1966, and lived until his arrest in Perm. He is now detained in a temporary detention facility in the Perm Region. The applicant is represented before the Court by Mr S. Petryakov , a lawyer practicing in Perm.

A. Facts

On 11 February 2015 the applicant was arrested on suspicion of bribery. His detention was regularly extended.

Following a number of medical examinations, including tomographic scans, the applicant was diagnosed with deformation of the left hipbone. Another set of medical tests performed in public medical facilities in June and July 2015 amended the diagnosis with doctors having concluded that the applicant was suffering from cystic dysplasia of the hip with aseptic necrosis of the hipbone. Doctors noted that the applicant ’ s condition called for state-of-the-art surgery, specifically proximal femoral replacement.

According to certificates from the head of the detention facility where the applicant is being held, the surgery cannot be performed in the penitentiary medical facilities given its complexity. The detention facility is also unable to secure the applicant during the lengthy post-surgery rehabilitation period. However, the near-by civil regional hospital is fully equipped to perform the surgery and to hold the applicant for his post-surgical treatment. The head of the detention facility noted that the surgery will be scheduled in the regional hospital following a number of required pre-surgical medical examination and consultations with that facility.

The applicant submitted that he only receives painkillers to deal with the pain. The anaesthetic therapy was amended on a number of occasions because the pain is particularly severe and doctors are unable to choose the correct treatment strategy to decrease the level of pain.

The surgery has not yet been performed.

B. Complaints

The applicant complains under Article 3 of the Convention about a lack of proper medical assistance in detention.

2 . Application no 44068/15 was lodged on 26 October 2015 by Yelena Anverovna Paltseva , who was born on 31 December 1970, and lived before her arrest in Samara. She is now serving her eight-year prison sentence in a correctional colony in the Nizhniy Novgorod Region.

A. Facts

The applicant suffers from a HIV related illness in stage 4B, chronic hepatitis B and C, post thrombophlebitis of the lower limbs, and other concomitant illnesses.

Between December 2011 and May 2012, when the applicant was in a pre-trial detention facility, the applicant ’ s CD4 cell count level dropped from 153 to 136 cells/cubic milimetre . However, antiretroviral therapy was not initiated, nor did she receive a consultation with an infectious disease specialist, despite the applicant ’ s continuous requests for these measures.

In October 2012 the applicant ’ s CD4 cell count level dropped to 57 cells/cubic milimetre . That drop in the CD4 level precluded the applicant from having planned surgery to treat chronic haemorrhoids. A surgeon decided that the progression of the applicant ’ s HIV related condition did not allow surgery to be performed. He however authorised the applicant to be relieved of various detention-related obligations, such as roll calls, morning exercise and work.

The applicant started antiretroviral therapy in March 2013. However, the therapy was interrupted on a number of occasions (mostly during the applicant ’ s transfer between different detention facilities). Each interruption resulted in a significant drop in the level of CD4 cell count, with the latter falling to 96 cells/cubic milimetre in July 2014.

In September 2014 the applicant, who was detained in a prison hospital at the time, again suffered an acute attack of chronic haemorrhoids accompanied by significant bleeding and severe pain. No treatment was provided and the applicant was transferred to a temporary detention facility on 27 September 2014, where she was immediately admitted to a medical unit for in-patient treatment.

On 3 October 2014 the applicant was sent to correctional colony no. 18 in the Nizhniy Novgorod Region. On admission to the colony she was examined by a prison nurse who recommended bed rest given the deterioration of her chronic haemorrhoids. The applicant was only given painkillers to relieve her of serious pain.

The applicant complained to a prosecutor of the colony authorities ’ failure to provide her with effective treatment. She argued that the colony had not employed an infectious disease specialist and that her chronic haemorrhoids had deteriorated rapidly because of the lack of medical assistance.

The applicant stated that, following her complaint to the prosecutor, the colony administration had ended the bed rest regime and ordered her to take part in all colony activities including exercise and work. The applicant argued that she had to endure severe pain when she had to sit for twenty minutes during roll calls, when she was unable to stand up or even to change her position.

Since February 2015 the applicant has not been receiving antiretroviral therapy; prison doctors informed her that the colony had not received the necessary drugs.

In March 2015, following yet another acute attack of haemorrhoids, the applicant was transferred to a prison hospital for surgery. However, the surgery could not be performed given that the applicant ’ s CD4 cell count level was below 150 cells/cubic milimetre . An infectious disease specialist prescribed antiretroviral therapy for the applicant. However, the colony could not guarantee the treatment as they did not have the drugs in question.

It appears that sometime in August 2015 a prison nurse proposed that the applicant take some antiretroviral drugs. However, the applicant refused given that they had not been prescribed to her and given that the nurse was not competent to amend her drug regimen. Moreover, no tests had been performed to see whether the applicant ’ s state of health was compatible with the new medication.

B. Complaints

The applicant complains, under Article 3 of the Convention, of a lack of proper medical assistance in detention and, under Article 13 of the Convention, that she did not have an effective remedy to complain of a violation of her right to adequate medical care.

COMMON QUESTIONS

1. The Government are requested to produce a typed copy of the applicants ’ complete medical record drawn up after his or her arrest, and, if available, copies of medical expert reports and secondary opinions from medical specialists assessing the applicants ’ health, the quality of the treatment afforded to him or her during the detention, and laying out the medical procedures which should have been or should be performed to maintain the applicants ’ health.

2. Taking into account the applicants ’ medical history, have the authorities of the respondent State met their obligation to ensure that that applicants ’ health and well-being are being adequately secured by, among other things, providing him or her 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 each of the applicants dispose of effective domestic remedies – as required by Article 13 of the Convention – for his or her complaint about the lack of effective medical care?