Staff training conducted at Kent prison healthcare unit where prisoner died eight hours after arriving

It was “probable” a nurse inserted an airway incorrectly, meaning Josh Tarrant didn’t get oxygen for more than 16 minutes, an inquest found

More training for staff at a Kent prison’s healthcare unit on assessing and managing prisoners who are under the influence of drugs has been given after the death of an inmate eight hours after he arrived.

Raising the standards of staff knowledge and response followed the death of Josh Tarrant, 34, at 2.13am on November 1, 2023, at HMP Elmley on the Isle of Sheppey, having being brought there the day before at around 6.20pm.

Hours after his arrival, father-of-five Mr Tarrant, a Black British man, was exhibiting signs of adverse affects of cocaine intoxication and he was restrained by prison officers.

An inquest in November heard how one prison officer, who had kicked and swore at him, said she thought Mr Tarrant was “playing dead” when he collapsed.

And it was “probable” a mistake in attempts to resuscitate Mr Tarrant led to him not getting oxygen for 16 minutes, said the just-published report of the Prisons and Probation Ombudsman into his death. Recommendations had been actioned at the prison, and the prison had taken disciplinary action against two officers, said the report.

Mr Tarrant died of cocaine toxicity, with cardiac hypertrophy, a disease of the heart muscle, and exertion during restraint, being contributory factors, said the report.

It also said: “Although Mr Tarrant was searched and went through a body scanner on reception, it is likely that he brought cocaine into the prison.”

Two recommendations to HMP Elmley were included in the report, made to Oxleas NHS Foundation Trust:

• More training for healthcare staff on assessing and managing prisoners who are under the influence of drugs.
• More frequent Immediate Life Support refresher training for healthcare staff at HMP Elmley.

The hospital trust said it had reviewed and updated all staff training needs, and introduced Level 3 First Responder Training which includes modules on caring for patients under the influence of substances. It is also introducing Royal College of General Practitioners Part B1 training for staff in reception areas to enhance their ability to manage substance intoxication cases effectively.

There is also now monthly training sessions which incorporates emergency response and simulation training of emergency response, said the trust.

The Ombudsman report said two hours before his death, Mr Tarrant was moved under restraint to the healthcare unit due to concerns about his mental health. He was “non-compliant and staff had to use force to move him”.

The clinical reviewer, an independent healthcare professional commissioned by NHS England to carry out a review of healthcare given to a person who died in custody, found healthcare staff had presumed Mr Tarrant’s presentation was due to his mental health without establishing whether there was a physiological cause, such as drug intoxication, said the report.

Mr Tarrant was then moved from one cell to another, again by force, after he damaged the first cell. He became unresponsive straight after the second move. Mr Usher said the decision to move Mr Tarrant was a “reasonable one” in the circumstances.

“However, some of the officers involved in the restraint used inappropriate techniques, including kicking, and used bad language towards Mr Tarrant. The prison carried out an investigation and took disciplinary action against the officers,” said Mr Usher.

Mr Usher also said the clinical reviewer found it “probable” that a nurse at the prison inserted an airway incorrectly during the attempt to resuscitate Mr Tarrant which resulted in him not getting oxygen for more than 16 minutes.

An inquest in November last year at Medway Coroners Court in Maidstone heard he had an “unreal” tolerance of pain during the incident, and was calling for his mum.

Mr Tarrant had been charged with robbery, actual bodily harm and criminal damage after crashing a Nissan Qashqai in Sittingbourne on October 28.

The Ombudsman report said CCTV footage from the van taking Mr Tarrant’s from the court to prison, viewed after his death, “showed him putting his hands down the back of his trousers and, at one time, squatting down while his hands were behind him. Police suspect that he might have been retrieving secreted drugs”.

As KentLive reported in November, a prison officer laughed outside his cell shortly before his death. She had shouted at Mr Tarrant, punched him in the leg, and had laughed when his fingers was caught in the door. She had also believed he was “playing dead” when he collapsed, the inquest heard.

Mr Tarrant was a Black British man: in November 2021, another Black prisoner died following restraint by staff, said the report. It also said Mr Tarrant was the 18th prisoner to die at HMP Elmley since November 2020. Twelve of these deaths were due to natural causes, three were self-inflicted and two were drug related.

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