Inquest into Amphon’s death

The inquest into the death of 'Uncle SMS' Amphon Tangnoppakul began on 17 December at the Criminal Court on Ratchadaphisek Rd, seven months after his death at the Correctional Hospital, starting with two witnesses, a head nurse and the duty doctor.

Ratchanee Harnsomsakul, 59, a senior nurse from Bangkwang Prison Hospital, told the court that Amphon, a lèse majesté convict detained at Bangkok Remand Prison, was sent to the Correctional Hospital on 4 May 2012, when she was head nurse in charge of the hospital's 5th floor.

The hospital usually treated 65-70 patients on five of the eight floors of the building, with 50 nurses and a dozen doctors on duty, Ratchanee said.

The nurse said when she arrived on Tuesday after a three-day official holiday, she was told by her nursing team at around 9.10 am that Mr Amphon was already dead.

The nurse initially told the court that the lèse majesté inmate was still alive when she arrived at the hospital but later corrected her statement to the court during cross-examination. The nurse said she did not come to work during that long holiday, but there was a male nurse on duty taking care of all five floors in the building and a doctor on duty.

The nurse tried to explain to the court that the nursing team has humanely cared for inmate patients.

The head nurse said Mr Amphon was given suction (as he vomited) and oxygen when his condition worsened.

Amphon was pronounced dead at 9.10 am. She said she communicated with the doctor all information needed about the inmate situation as the doctor was not in the 5th floor ward at that time.

The nurse said the 5th floor normally housed 30-40 patients but approximately 10 with more severe conditions would be placed in the corner, nearer to the nursing area than normal patients.

She said Amphon was sent to the hospital for abdominal pain and when she went onto the sealed area (of the inmate patients) she saw in the vomit traces of the porridge that the patient had taken that morning.

She added that the hospital did not have facilities to treat cancer patients; no chemotherapy equipment or technicians, and no radiation treatment facilities.

Dr Kittibun Techaporn-anan, 39, who has worked at the Correctional Hospital for 13 years, met Mr Amphon on 4 May. Before that he was assigned to a station inside the prison hospital unit and had met Amphon in 17 April 2011.

"On that Friday, Amphon was still in a normal condition as he could walk towards my desk. He told me that he had pains in the stomach. I asked him to lie down on the bed and touched his stomach, finding that it was swollen and it looked like the liver was also bigger," Dr Kittibun said.

He told the court that the patient file was not sent along but he was told by the patient himself that he had previously had an operation for oral cancer which had been treated by radiotherapy.

The doctor conceded that the admission of Amphon to the hospital was partly because the Bangkok Remand Prison management had previously phoned his boss to accept the case.

Asked by the lawyer if the treatment given to the late inmate who was a cancer patient was of a normal standards, the doctor said since there was no file attached to him, he prepared a treatment plan by ordering a blood test and perhaps later on an x-ray.

"But normally the blood test is conducted outside the prison and they will collect the blood in the morning only. That day when Amphon saw me it was around 10.30-11.00 am already," said the doctor.

He prescribed some pain-killing tablets and a diuretic to help release water in the abdomen that was swollen.

The doctor met Amphon in the morning every day during the three-day holiday, though it was not his duty; he said he had to check his other patients including one who had just had an appendix operation so he also checked Amphon’s condition.

He said on Saturday Amphon was able to walk towards him (near the bars), on Sunday and Monday he did not walk to see him, but sat on his own bed, three beds away from the bars.

Asked by the lawyer if he was surprised or puzzled why Amphon was still sitting on the bed and not walking towards him like on Saturday, the doctor said "This is the patient's own decision or condition. I did not bother as he could communicate via an inmate colleague inside the (fenced) ward."

When asked about the diagnosis and previous treatment of other doctors, the doctor said he could not comment on previous diagnoses or treatment and he did not want to.

"I did plan the treatment, which was why I asked the patient and his relatives to get his old files from Ratchavithi Hospital (where he had had an operation for cancer) so we could get all the information," said Dr Kittibun.

Asked if he saw Amphon again when the hospital resumed normal work on Tuesday 8 May, the doctor said the routine was for nurses to check and transfer duties in the morning, so there was a routine of breakfast and so on.

"I was with the hospital director and I'd not yet gone to the ward. But I got a phone call after 9.00 am from the ward that his pulse had stopped, so I told them to proceed with life-saving procedures and after some minutes when I was about to go down there, I was asked by the (hospital) director to receive the Corrections Department Director-General who happened to be at the hospital that morning," he said.

He told the court that after 15-20 minutes of life-saving procedures, the nurse still could not get a pulse from Amphon.

Amphon had no other bruises, marks or scars of any signs of being assaulted, he told the Court.

Rosmalin, Amphon’s wife, was at the court but waited outside the courtroom as she will be a witness testifying at future hearings.  She said that personally she did not hold any grudges, as her husband could never be brought back.  However, she wanted the inquest in order to reveal the flaws that still exist in the medical care system for inmates, and the case of her husband should be used as a precedent to improve it.

‘When prisoners get sick, they should be taken care of.  It’s a real struggle to get them transferred to the hospital.  They are already deprived of their freedom.  Don’t deprive them of their lives too,’ she said.

The next hearings will take place on 24-25 April next year, and Rosmalin will testify on the 25th.

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