P, Regina (on The Application of) v HM Coroner for The District of Avon: CA 18 Dec 2009

The deceased was found hanging in her prison cell. The jury returned a verdict of accidental death, not being satisfied that she was not merely making a cry for help. The family appealed a finding that the inquest had satisfied the requirement for a fuller investigation of a death in custody, there having been an investigation and report by the Prisons’ Ombudsman. They said that the jury should have been advised that they could attach a narrative to their verdict. The deceased had given several signs of possible suicide, but these had not been put together.
Held: The jury had been given advice on completion of the form including the possibility of a narrative verdict. However, the direction gave the jury the impression that they could only attach a narrative if the verdict of suicide or accident was insufficient. That was, since Middleton, incorrect, a misdirection.
Nevertheless the verdict should not be quashed or a new inquest ordered. The presence of the Prisons ombudsman’s report, and the actions taken on it filled any lacunae in the satisfaction of the State’s article 2 obligations.

Dyson LJ, Maurice Kay LJ, Rimer LJ
[2009] EWCA Civ 1367
European Convention on Human Rights 2, Coroners Act 1988 11(5)(b)(ii)
England and Wales
Appeal fromP, Regina (On the Application of) v HM Coroner for the District Of Avon Admn 5-Mar-2009
The deceased was found suspended by a sheet in her prison cell. The jury found accidental death, not being satisfied that she was not issuing a cry for help. The family appealed saying that the jury had not been directed that they could provide a . .
CitedRegina v North Humberside and Scunthorpe Coroner ex parte Jamieson CA 27-Apr-1994
The deceased prisoner had hanged himself. He had been a known suicide risk, and his brother said that the authorities being so aware, the death resulted from their lack of care. The inquest heard in full the circumstannces leading up to the death, . .
CitedMiddleton, Regina (on the Application of) v Coroner for the Western District of Somerset HL 11-Mar-2004
The deceased had committed suicide in prison. His family felt that the risk should have been known to the prison authorities, and that they had failed to guard against that risk. The coroner had requested an explanatory note from the jury.
CitedRegina (Cash) v County of Northamptonshire Coroner Admn 2007
. .
CitedAmin, Regina (on the Application of) v Secretary of State for the Home Department HL 16-Oct-2003
Prisoner’s death – need for full public enquiry
The deceased had been a young Asian prisoner. He was placed in a cell overnight with a prisoner known to be racist, extremely violent and mentally unstable. He was killed. The family sought an inquiry into the death.
Held: There had been a . .

Lists of cited by and citing cases may be incomplete.

Coroners, Human Rights, Prisons

Updated: 11 November 2021; Ref: scu.384363