Coroner: Cops careless, diabetic man in lockup could live if treated


Source: The Malay Mail Online

Police lock up – file pic taken from The Star

KUALA LUMPUR, Dec 27 — The police had acted negligently and had failed to ensure immediate medical treatment that could have saved a diabetic man from dying in 2015 after just around three days in the Dang Wangi lockup, a coroner ruled today.

Coroner Mohd Zulbahrin Zainuddin noted that R. Thangaraja’s family had testified that he had suffered from diabetes since the age of 21 and had required insulin injections twice a day to avoid feeling dizzy, and that he had in the past been brought to the hospital over his condition.

“Although the cause of death is associated with heart attack and diabetes, it is this court’s finding that the deceased’s life could have been saved if early treatment was given to him while he was in detention, even more so when there were signs of him being ill.

“The failure to give early treatment to the deceased is linked to the carelessness of the lockup management that failed to provide the attention and consideration due to the deceased who was proven to have suffered from health problems since he was first detained in the Dang Wangi lockup,” said Mohd Zulbahrin, who is also a Sessions Court judge.

Mohd Zulbahrin made his remarks in his 28-page written ruling that was made available to Malay Mail.

In delivering the decision of the inquest into Thangaraja’s death, the coroner found that the man had died of coronary artery disease and probable diabetic ketoacidosis due to the “failure to be given immediate full treatment”, with the man believed to have breathed his last in the Dang Wangi lockup between 8.30pm on November 18, 2015 to 12.30am on November 19, 2015.

Mohd Zulbahrin noted it is not within the Coroner’s Court’s jurisdiction to determine if any offence was committed by any individual as that is the public prosecutors’ jurisdiction.

However, he highlighted there was negligence among those managing the police lockup.

“However from the testimony as a whole, the court concludes that there were elements of carelessness and negligence on the part of the IPD Dang Wangi lockup’s management that failed to perfectly manage the welfare of the deceased, particularly in relation to the medical problem and the need for treatment throughout his detention in the lockup until the date of his death,” the coroner said, having earlier concluded that Thangaraja was a “chronic” diabetic patient.

What happened in 2015

According to Thangaraja’s family’s lawyers, he was detained on November 15, 2015 at around 11.40pm by police to assist in investigation of a car theft case, before being brought over to the IPD Cheras criminal investigation division with another man and placed in the IPD Dang Wangi lock up at around 1.30am.

Police then obtained a three-day remand from November 16 to November 18 where Thangaraja was questioned twice and while being kept at the IPD Dang Wangi lockup.

The magistrate subsequently allowed on November 18 only a one-day extension to the remand, also ordering then for Thangaraja to be immediately brought to hospital for treatment.

However, Thangaraja was not brought to the hospital but was sent back to the IPD Dang Wangi lock-up, where he was found five minutes past midnight on November 19 to be unconscious and verified 30 minutes later by a paramedic officer to have died, the lawyers said.

A total of 15 people testified during the inquest, including Hospital Kuala Lumpur’s Forensic Department’s Dr Muhammad Yazid Sahak who had carried out the post-mortem on Thangaraja and found that the primary cause of death was coronary artery disease that was complicated by probable diabetic ketoacidosis.

Diabetic ketoacidosis is a life-threatening complication that can cause death, with symptoms such as excessive thirst, frequent urination, nausea and vomiting, weakness, fast breathing, confusion and breath with fruity odour. This condition occurs when the body has no insulin to use sugar for energy, leading to the body breaking down fats instead for energy in a process that will also produce a harmful chemical called ketones that can build up in the body.

According to the coroner, Dr Muhammad Yazid’s inspection of Thangaraja’s pancreas showed damage typically suffered by Type I diabetes patients, who cannot produce insulin at all and are fully dependent on external injections of insulin.

“Diabetic ketoacidosis is associated with stress experienced by the deceased due to diabetes. The failure of the deceased to obtain insulin injections throughout his detention and the detention environment undeniably caused stressed to the deceased’s body. Therefore, the stress on the body will also cause stress to the heart,” the coroner said.

The coroner said it was unbelievable that Thangaraja had never told the police throughout his detention that he needed insulin, noting that Dr Muhammad Yazid had testified that Thangaraja would suffer complications if he did not take his insulin injections as scheduled each day.

“In our case today, it is unacceptable that not one of those on duty at the lockup during November 16 to November 18, 2015 did not realise the health problem that the deceased had,” the coroner said in his ruling, having cast doubt that Thangaraja was allowed access to his insulin supply during detention.

Casting doubt that Thangaraja had actually eaten on November 18 and was healthy prior to his death, the coroner said a detainee who refuses food should be given attention as soon as possible on humanitarian grounds and as he was yet to be convicted.

“This is in line with the actual purpose he was detained, among others, to go through an investigation process that requires perfect health. Furthermore someone who has breached the law, whether he is still under investigation or has already been found guilty has the right to be guaranteed appropriate health,” the coroner said.

The coroner said the hourly patrols of lockups should be fully utilised to ensure detainees are truly in good health, adding that the police should improve the administration of lockups as death in police lockups would cause heavy public criticism of the police.

M. Visvanathan (pic), one of the lawyers representing Thangaraja’s family, said they would sue over the “needless death” of the man who leaves behind a wife and six young children. — Picture by Choo Choy May

M. Visvanathan (pic), one of the lawyers representing Thangaraja’s family, said they would sue over the “needless death” of the man who leaves behind a wife and six young children. — Picture by Choo Choy May

Could have been alive

M. Visvanathan, one of the lawyers representing Thangaraja’s family, said they would sue over the “needless death” of the man who leaves behind a wife and six young children.

“We thank the Coroner for a fair verdict. It brings some form of justice to the family. A needless death in our book.

“Now for the civil suit. We shall file it soonest possible. Be that as it may, no amount of money can ever truly compensate the family for their loss,” he told Malay Mail when contacted.

Lawyer Chan Yen Hui also appeared for the family.

In the lawyers’ written submission for the inquest, they had told the Coroner’s Court that Thangaraja’s death was due to the police’s carelessness, arguing that there was a huge likelihood that he would still be alive today if he was given his medicine and insulin injections and if the lockup guards had done thorough patrols.

“The police were aware and knew that the deceased is a diabetic patient and that he needed medicine and insulin that was just left hanging at the detainee’s registration board. No one bothered to give the medicine to the deceased because the deceased himself apparently did not inform the lockup personnel that he needed treatment or medicine,” the lawyers said.

Pointing out that there were at least five to six policemen who knew Thangaraja needed immediate treatment and that the police had not sent him to hospital despite the magistrate’s orders then, the lawyers said that his death would have been avoidable if he was sent immediately to the hospital then.

The lawyers noted in their submissions that Thangaraja did not have any criminal records, saying that the police should be held responsible over his death and should act in a more humane way in the future to prevent such deaths from reoccurring.