A Thamesmead prisoner and heroin addict was killed by a toxic reaction to prescribed drugs despite a life-saving antidote being available just metres away from where he was lying dead on the floor of his cell with a head wound, a court heard.

Darren McConnell died in Thameside Prison on the evening of December 4, 2014, the day after he was jailed, having been prescribed methadone at 4.37pm that day.

The 41-year-old convict had been locked in his cell on the 18-bed in-patient ward, which is monitored 24-hours-a-day, since 5pm – and appeared to have been dead for some time when he was discovered at 9.43pm, the inquest jury was told.

Prison GP Dr Talal Al-Mekhlafi had ordered for the dad-of-two to be put on half-hourly vital sign checks, which would require unlocking his door and taking his pulse and blood pressure, throughout the night –Southwark Coroner’s Court heard yesterday (March 31).

However, between 6.30 and 7.10pm there were no nurses or healthcare assistants on the ward.

Medication

At the time of his arrest on December 2, Mr McConnell was prescribed 110ml of methadone-a-day, and was also taking street benzodiazepines, sometimes known as benzos, and £60 worth of crack cocaine and heroin on a near-daily basis.

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However, after being taken to Thameside via Lewisham Hospital and Camberwell Magistrates’ Court, the Peckham resident went without methadone for up to 56 hours, Coroner Sarah Ormond-Walshe calculated.

In some people, it takes just 24 hours for tolerance to methadone to drop – rendering the 65ml given to Mr McConnell on the day of his death a “potentially fatal” dose, according to Dr Stephen Metcalf, an expert asked to give his opinion in court.

After a post-mortem examination by Dr Simon Poole, Mr McConnell’s medical cause of death was listed as the “acute toxic effects of methadone”.

The evening of his death

By the time prison officers Michael Ellis and Jeff Rowland unlocked Mr McConnell’s cell and found him “obviously dead” he had been lying under his bed, with only half his torso and legs visible, for a number of hours.

Mr McConnell “had blood around his head and on the floor” and “bruising to the tongue”, the coroner said.

Ms Ormond-Walshe added: “But that injury did not cause his death. It (the head wound) could have been caused by a seizure or a fall.”

A more junior prison officer Danielle Prentice, who was working on Mr McConnell’s ward at the time of the death, carried a key which could be used in life-threatening situations.

She said: “Had I been told about the risk of methadone overdose and serious mental health I would have entered the cell” during checks earlier in the evening.

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Healthcare assistant Olawade Sremhum made three “signs of life” checks, as opposed to the vital signs ones ordered, between 7pm and 9pm – the jury heard.

In a prison ombudsman investigation Mr Sremhum originally claimed to have made five checks, but this did not match up with CCTV footage from Thameside.

Mr Sremhum also claimed to be able to see into Mr McConnell’s cell from the healthcare room, although his colleagues disagreed this was possible.

Mr Sorencom saw “a flick of a hand” at 7.18pm – which he took to mean Mr McConnell was alive.

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Dr Metcalf said allowing Mr McConnell to lie undisturbed for so long was in the “bracket of seriously below acceptable practice”.

Dr Metcalf told the jury that methadone is associated with a large number of deaths and “takes one to two hours to reach toxic levels after taking the methadone”.

Life-saving antidote

Naloxone, an antidote to toxic methadone reactions, was kept on the ward.

Ms Ormond-Walshe said: “He (Dr Metcalf) has seen people who are blue who still recover to normal without brain damage after being given the drug. It reverses the effects of methadone.”

Dr Al-Mekhalfi claims to have prescribed Mr McConnell 65ml of methadone on the day of his death.

However, the drug record book for this period of time at Thameside, which is legally required to be kept for at least two years, has disappeared.

The prison’s healthcare used to be run by Care UK, and Oxleas has since taken over.

Toxicologist Rochelle Savage said it was difficult to predict the exact amount of methadone Mr McConnell had taken, but she believes the amount in his blood was more consistent with the dose Mr McConnell was prescribed before his arrest on December 2, 110ml, than a half dose of 55ml.

Tolerance can reduce by 50 per cent in just one day, she added.

The jury has now gone out to consider the verdict.