Information Note on the Court’s case-law No. 116

February 2009

Kaprykowski v. Poland - 23052/05

Judgment 3.2.2009 [Section IV]

Article 3

Degrading treatment

Inhuman treatment

Inadequate medical care of a prisoner suffering from severe epilepsy who was forced to rely for assistance and emergency medical care on his cellmates: violation

Facts : The applicant suffered from severe epilepsy marked by frequent (daily) seizures, encephalopathy and dementia. As a recidivist, he served a number of prison sentences in various detention facilities in Poland. He was first remanded in custody in May 1998. Since then he had been released and remanded in custody again on numerous occasions. In particular, from 5 August 2003 to 30 November 2007, he was in continuous detention either in ordinary detention facilities or prison hospitals. Throughout his incarceration a number of doctors stressed that he needed specialised psychiatric and neurological treatment. Notably, in 2001 medical experts recommended that he should undergo brain surgery and in 2007, on his release from a stay in hospital, doctors clearly stated that he should be placed under 24-hour medical supervision. The Government submitted that the applicant had received adequate medical care and medicine and emphasised that he had been detained with inmates who knew what to do when he had one of his epileptic seizures. The applicant had also been transferred to a remand centre hospital which specialised in neurology to receive better medical care on two occasions. When the applicant was given alternative generic medicines, he was kept under close medical supervision at another remand centre hospital, where he was examined by doctors almost every day.

Law : The Court had no doubts that, during the relevant period, the applicant had been in need of constant medical supervision, without which he faced a major risk to his health. Even though the scope of the applicant’s case was limited to three periods of detention in the Poznań Remand Centre, in order to determine whether or not he had suffered inhuman and degrading treatment during that time it was necessary to examine those periods against the entire background of the case. The applicant had been in continuous detention from 5 August 2003 to 30 November 2007, during which period he had to rely solely on the prison health-care system. It was a matter of concern that, during most of that period, he was detained in ordinary detention facilities or, at best, in a prison hospital. He had been detained at a specialised neurological hospital on only two occasions, despite his specific condition. During that time, he would have been aware that he might need serious emergency medical treatment at any moment and that, apart from his fellow inmates, no immediate medical assistance was available to him. Even if he was examined later by in-house doctors, they had no specialist knowledge of neurology. Given his personality disorder, he had not been able to take autonomous decisions or go about more demanding daily tasks. That had to have caused him considerable anxiety and placed him in a position of inferiority vis-à-vis other prisoners. In particular, the Court was struck by the Government’s argument that the fact that the inmates with whom the applicant shared his cell knew how to react to his seizures could be considered adequate conditions of detention. The Court stressed its disapproval of remand-centre staff who considered that their duty to provide security and care to more vulnerable detainees could be discharged by making their cellmates responsible for providing daily assistance or, if necessary, emergency aid. A further problem was that the applicant had been transferred about 18 times, often over long distances, between different detention facilities. That had to have been unnecessarily detrimental to his already fragile mental health. The lack of adequate medical treatment in Poznań Remand Centre, which had effectively placed him in a position of dependency and inferiority in relation to his healthy cellmates, had undermined his dignity and entailed particularly acute hardship that had caused anxiety and suffering beyond that inevitably associated with any deprivation of liberty. His continued detention without adequate medical treatment and assistance had therefore constituted inhuman and degrading treatment.

Conclusion : violation (unanimously).

Article 41 – EUR 3,000 in respect of non-pecuniary damage.

© Council of Europe/European Court of Human Rights This summary by the Registry does not bind the Court.

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