Farleys were instructed to represent the mother of Mr Olatunji Apena of London in connection with the Inquest into his death whilst an inmate at HMP Parkhurst, Isle of Wight.
On 6th January 2010 Mr Apena suffered a series of epileptic seizures in his cell. Expert evidence commissioned by the Coroner revealed a number of failings in his care by the healthcare professionals responsible for him.
Mr Apena was convicted on 25th January 2007 for a number of offences. He was returned to custody at HMP Brixton and was thereafter transferred to HMP Isle of Wight on 8th July 2009.
Whilst at HMP Brixton Mr Apena had been treated by the King’s College Hospital after being found in an unconscious state in his Prison cell. Over the following days Mr Apena was observed by healthcare staff as confused, withdrawn and disorientated. Such symptoms being potential evidence of a postictal state.
When Mr Apena was transported to HMP Albany no specific medical issues were highlighted. At this stage Mr Apena did not highlight any medical issues as no diagnosis had been made. Healthcare staff at HMP Albany did not make any enquiries into his medical history.
On 21st September 2009 Mr Apena had a seizure and was taken to St Mary’s Hospital. Doctors were unable to determine the cause of this seizure and he was returned to Prison later that day. Several days later Mr Apena was seen by the Prison doctor and was referred to a Consultant Neurologist. The referral letter was received by the hospital but no appointment was subsequently made. This was due to a long waiting list at the hospital and limited resources to escort prisoners to appointments.
On 4th November 2009 Mr Apena suffered another seizure. An urgent CT scan was requested which took place on 10th November 2009. The results were received by the doctor at HMP Parkhurst the same day and showed that Mr Apena had abnormalities of the frontal lobes requiring specialist care. The doctor referred Mr Apena to a Neurologist however in the meantime no medication was prescribed to manage his condition.
A recall was arranged for Mr Apena to take place on 2nd December 2010 however this never occurred and no follow up was carried out.
Unfortunately the neurology appointment never took place despite the Prison chasing the appointment up a number of times with the hospital. The hospital were unable to facilitate an appointment before Mr Apena’s breach date of 12th January 2010.
In the early hours of 10th January 2010 Mr Apena’s cell mate raised the cell alarm and reported that Mr Apena appeared to be having a fit. A Prison Officer attended the cell and offered healthcare advice to Mr Apena’s cell mate through the cell door. Prison Officers then liaised with healthcare. Advice was given by the Nurse to monitor Mr Apena and seek a clinic appointment in the morning.
Approximately one hour later Mr Apena suffered a second fit. The same advice was reiterated by the Nurse.
A short time after Mr Apena suffered a third fit. An Officer called for outside assistance and a doctor agreed to attend the Prison. The doctor however attended without any medication and did not call an ambulance despite him having the knowledge that Mr Apena had already had three fits.
Mr Apena suffered a further fit. An ambulance was called approximately 25 minutes later and the nature of the request was for the ambulance to attend within an hour.
Just over one hour later Mr Apena suffered his fifth and final fit. CPR was commenced and a blue light 999 call was made immediately. Two Paramedics arrived at the cell within 10 minutes.
Sadly Mr Apena was pronounced dead at the scene.
The Coroner commissioned expert evidence from a Professor in Neurology and Neuro Surgery to comment on the care and management of Mr Apena’s condition.
A number of failings were found.
The expert was of the opinion that despite Mr Apena displaying clear signs of epilepsy a diagnosis was never provided. In addition, Mr Apena was never prescribed any appropriate medication for the treatment of epilepsy and the expert’s opinion was that had Mr Apena been prescribed medication promptly there was a 70% chance that he would have been seizure free once a therapeutic level had been reached after approximately 2 to 3 weeks of taking the medication.
The Inquest found that there was a failure of healthcare staff to treat Mr Apena’s condition seriously and a failure to fully appreciate the extent of Mr Apena’s brain damage upon consideration of the CT scan.
In the hours leading up to Mr Apena’s death there was a clear failure of the Prison GP to attend the Prison with sufficient medication in the knowledge of the deceased having had three violent fits and there was a failure to explore the use of anti seizure medication to prevent further seizures.
There was a further failing in calling a blue light 999 as a matter of urgency.
The jury hearing Mr Apena’s Inquest and having heard all of the evidence concluded that Mr Apena had sustained a substantial head injury at a time and date that could not be determined and in circumstances which could not be determined but which caused serious brain injury and which in turn caused him to suffer from seizures which were capable of being diagnosed as epilepsy. There had been a failure to diagnose this condition and a failure to medicate the deceased with anti seizure medication historically and especially from September 24th 2009. They further found that in the early hours of 6th January 2010 the deceased had suffered five seizures which resulted in him dying of status epilepticus after the final seizure despite attempts being made to resuscitate him by Prison Officers, a GP and First Response Paramedics. The medical cause of death was recorded as:-
(1a) Status epilepticus.
(1c) Or blunt force brain injury