Abstract

Introduction: The death of an individual in custody garners attention from lawmakers and the administration, and if such a death is sudden, it is often associated with media attention. Methodology: This original study conducted at the Medical College of West Bengal from 2020 to 2023 scrutinizes the causes of death in the custody of correctional homes during this period, obtains the frequency of sudden deaths, which is natural, and recommends ways to reduce it in the future. All custodial deaths coming to autopsy during this study period were considered. After thorough scrutiny of all received documents, a complete autopsy was conducted; including toxicological analysis and histopathology examination, and the cause of death was opined. Results: During the study period, 118 cases of custodial deaths were autopsied in our centre, of which 49 subjects were inmates of the correctional home. There were 28 sudden deaths, of which the manner was natural in 14 cases. In these cases, primary pulmonary causes were seen in five cases; primary cardiac causes were seen in four cases; combined pulmonary and cardiac causes were seen in two cases; and others, including malignancy and gastro-intestinal causes, were seen in three cases. Among the 21 deaths that received hospital care, combined cardiac and pulmonary causes were the most common, followed by primary pulmonary causes. The frequency of sudden deaths among inmates is around 28.5%, which is about 10% in the general population. Conclusion: Poor medical facilities in correctional homes lead not only to the failure of disease diagnosis in the early stages but also to the failure of documentation. As a result, the patient reaches the hospital in critical condition, and death gets labelled as sudden due to the inability to make a diagnosis in a short period of time. A mere commitment to the adoption of Nelson Mandela rules cannot make a change; rather, a specialty medicine subject like custody medicine should be considered to have a positive impact on the health of inmates.

• 1.   Prison Statistics India–2020. Available from: https://ncrb. gov.in/sites/default/files/ Executive-Summary-2020. pdf. [Internet] Accessed on 2024, February 11th.
• 2.   Prison Statistics India–2021. Available from: https://ncrb. gov.in/sites/default/files/ Executive-Summary-2021. pdf. [Internet] Accessed on 2024, February 11th.
• 3.   Prison Statistics India–2022. Available from: https://ncrb. gov.in/sites/default/files/ Executive-Summary-2022. pdf. [Internet] Accessed on 2024, February 12th.
• 4.   Frater A. Deaths in custody. BMJ. 2008 Apr 17;336 (7649):845-6.
• 5.   Okoye M et al. An Analysis and Report of Custodial Deaths in Nebraska, USA. J Clin Forensic Med. 1999 June; 6(2): 77-84.
• 6.   WHO ICD-11 for Mortality and Morbidity Statistics. Available from: https://icd. who.int/browse11/lm/en#/ http%3A%2F%2Fid.whoint%2 Ficd%2Fentity%2F426429380. [Internet] Accessed on 2024, February 24th.
• 7.   https://nhrc.nic.in/sites/ d e f a u l t / f i l e s / s e c - 1 . p d f. [Internet] Accessed on 2024, February 12th.
• 8.   https://indiankanoon.org/ doc/1199182. [Internet] Accessed on 2024, March 04th.
• 9.   Devraj NA, Chaudhari KM, Pathak AG, Gadhari RK. Analysis of Custodial Death – 4 yrs Retrospective Study. Medico-legal Update. 2016 June; 16(1): 24-28. DOI: 10.5958/0974- 1283.2016.00005.0.
• 10.   Bansal YS, Murali G, Singh D. Custodial Deaths - An Overview of the Prevailing Healthcare Scenario. J Indian Acad Forensic Med. 2010 December; 32(4): 315-317.
• 11.   Solanki A, Dutta S, Goel S, Sharma P. Study of Natural Deaths in Custody at Tertiary Care Hospital in Rajasthan. J Indian Acad Forensic Med. 2023 April-June; 45(2): 116-120. DOI:10.48165/ jiafm.2023.45.2.4.
• 12.   Salive ME, Smith GS, Brewer TF. Death in prison: changingmortality patterns among male prisoners in Maryland, 1979-87. Am J Public Health.1990;80(12):1479-80.
• 13.   Jedidi M, Mlayeh S, Mahjoub M, Mezgar Z, Masmoudi T, Dhiab MB et al. Death in detention in Sousse,Tunisia: a 10-year autopsy study. Egypt J Forensic Sci. 2018 Dec;8(1):1-4.
• 14.   Bardale R, Dixit P. Natural Deaths in Custody: A 10 YearMortality Study. J Indian Acad Forensic Med. 2011;33(4):326- 329.
• 15.   Pathak AG, Gadhari RK, Chaudhari KM, Devraj NA, Jadhav VT, Gavale PS. Analysis of custody deaths of the year 2015 and 2016. Int J Res Med. 2017; 6(2): 79-85.
• 16.   Kulkarni CV, Panchonia A, Dadu SK, Tiwari NP. Histopathological Study of Prisoners Autopsy Viscera:A 3 Year Study.J. evid. based med. healthc. 2015;51(2):8594-8595.
• 17.   Sharma MK, Sharma A, Jain P. Autopsy analysis of custodialdeaths in RNT Medical College, Udaipur. J Ind AcadForensic Med. 2019;41(4):262-264.
• 18.   Fazel S, Benning R. Natural deaths in male prisoners: a 20-yearmortality study. Eur J Public Health. 2006 Aug;16(4):441-444.
• 19.   Saukko P, Knight B. Knight’s Forensic Pathology. 4th ed. Florida: Taylor & Francis Group, LLC; 2016. p. 516.
• 20.   Aggrawal A. Textbook of Forensic Medicine and Toxicology. 1st ed. New Delhi: Avichal Publishing Company; 2014. p. 170.
• 21.   https://www.unodc.org/ documents/justice -andp r i s o n - r e f o r m / N e l s o n _ Mandela_Rules-E-ebook.pdf. p. 1. [Internet] Accessed on 2024, February 16th.
• 22.   h t t p s : / / w w w. u n o d c. o rg / d o c u m e n t s / j u s t i c e - a n d - p r i s o n - r e f o r m / N e l s o n _ Mandela_Rules-E-ebook.pdf. p. 8. [Internet] Accessed on 2024, February 19th.
• 23.   h t t p s : / / w w w. u n o d c . o r g / d o c u m e n t s / j u s t i c e - a n d - p r i s o n - r e f o r m / N e l s o n _ Mandela_Rules-E-ebook.pdf. p. 9. [Internet] Accessed on 2024, February 19th.
• 24.   https://main.mohfw.gov. in/?q=Major-Programmes/ basicpage-22. [Internet] Accessed on 2024, March 15th.

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