Inmate who died of drug overdose declined medical attention

SINGAPORE - She was only 27 when she died of a medical drug overdose while serving her sentence behind bars.

Ironically, Lian Huizuan had been sent to Changi Women's Prison in May 6, 2010, for abusing drugs.

A Coroner's Inquiry into her death on March 2, 2011, revealed that shortly before she died, the former factory operator was holding her legs in pain during a drill session with the other inmates in the yard.

Assistant Superintendent of Prisons (ASP) Claire Koo Qi Hui, who was on the witness stand in court on Wednesday, said that Lian, when asked, had declined to see a medical officer.

ASP Koo added that the mother of two also said "no" when asked if she wanted to take a rest from the drills.

The housing unit officer at the prison told State Coroner Janet Wang that there were previous occasions when Lian stumbled during the drills and "tripped over herself".

She could not recall if Lian required medical attention after those incidents.

Lawyer Raphael Louis, who represents the dead woman's father, cabby Lian Hock Kwee, then read a statement from her cellmate.

Quoting the cellmate, Mr Louis said that Lian had a history of fainting and would require medical attention.

The cellmate added that she did not know why Lian always fainted and noted that she was not always healthy.

When asked about this, ASP Koo replied that she had only seen Lian stumble and fall.

She told Coroner Wang that she had never seen Lian faint.

However, ASP Koo said that she was not present during the drill sessions.

The court had earlier heard that Lian was suffering from depression.

As a result, she had been prescribed medication such as amitriptyline, chlorpromazine and valproate.

A post-mortem revealed that the level of amitriptyline in her blood was 19 times the upper limit of the expected therapeutic range.

The overdose damaged her heart, causing it to beat abnormally.

The cause of her death was determined on Jan 25 last year to be consistent with damage to the heart due to toxicity from the three drugs in the presence of chronic hepatitis C infection.

An independent expert and psychiatrist at the Institute of Mental Health, Dr Tejpal Singh, had said the simultaneous use of the three drugs prescribed to Lian was not recommended.

Monitoring

Adequate monitoring should be done if the three medicines are used together, he said.

On the day of her death, Lian was observed as being slow while climbing the stairs to her cell after the drills.

She then sat down and leaned against a wall.

She could not drink water which was offered to her and was helped to the guardroom.

Two staff nurses who checked on her eight minutes later had problems finding a pulse.

Subsequent attempts to revive her failed.

Lian was taken to Changi General Hospital and was pronounced dead later that day.

The hearing will resume on Feb 23.


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