Prison culture of transferring ‘problems’ resulted in violent death of young inmate
Neither medical records nor medication followed killer during ‘reckless’ transfer
Stephen Egan: The report into the death of Gary Douch reveals a prison service so keen to transfer the troublesome, violent and mentally ill Egan that no one group of staff or facility ever took ownership of his care. In one 2½-year period, he was transferred 17 times. Photograph: Collins/Court
The Irish Prison Service and the Central Mental Hospital were to blame for serious errors leading up to the killing in Mountjoy Prison of Gary Douch, who was beaten and stamped to death in a crowded basement holding cell by Stephen Egan, a commission of investigation has concluded.
The report by Gráinne McMorrow SC has also found that the dead man, his killer and five other men they were sharing a basement cell with when the 2006 murder occurred were all being accommodated in a manner that breached their human rights.
Overcrowding at the jail had “completely undermined” the prison staff’s ability to facilitate Douch’s request to be housed away from the main prison population because he feared for his safety.
Douch, originally from Coolock in north Dublin, was 21 at the time of his murder in the early hours of August 1st, 2006, when serving a sentence of three years for assault causing harm. In the days leading up to his killing, he had requested that he be housed away from the main prison population because he feared for his safety. He was placed in a holding cell in the basement of the jail that was designed to hold prisoners temporarily for short periods while being committed to the prison.
However, because of acute overcrowding, it was being used as a communal cell into which prisoners who had requested protection were placed to sleep.
Stephen Egan, then aged 22 and from Coolock, Dublin, was placed in the cell with Douch and five others because there was nowhere else in the jail to house him. He had been transferred into the jail two days earlier from Cloverhill Prison after spending just over two weeks there following his discharge from a nine-day treatment at the Central Mental Hospital for psychosis and hallucinations. Some time in the night, he fatally attacked Douch, stamping and punching him to death before smearing excrement on his body. The dead man was found unresponsive, wrapped in a blanket, the following morning when the cell was unlocked.
At the time Egan, who had been in and out of institutions from the time he was 15, was waiting to be tried on charges relating to the robbery of a betting shop in north Dublin.
The commission concludes that Mountjoy staff who agreed to Egan’s transfer into the jail on July 29th, 2006, did not know that prison governor John Lonergan had refused to take him into the jail two weeks earlier. It concludes of Egan’s transfer into Mountjoy: “[He] was not given a proper medical on arrival. There were evident deficits in management, decision-making, record-keeping and communication in this regard.” His medical files did not travel with him when he was transferred to Mountjoy, nor did his medication, meaning he was not in receipt of his medication in the days leading up to the killing.
In 2009 he was found not guilty of murder but guilty of manslaughter on the grounds of diminished responsibility. The commission found that when he began to display verbally the same signs of psychosis in Mountjoy as he had had done in the Central Mental Hospital, this went apparently unrecognised by staff. They had not been furnished with his medical files and so he was locked in a communal cell, where he murdered Douch.
“In particular, Mr Egan displayed the same delusional preoccupations with ‘the beast’ and ‘rapes’ as well as other symptoms of psychosis in holding cell 2 on the 31st July/1st August that he had displayed previously when unwell,” the commission notes.
The report also reveals a prison service so keen to transfer the troublesome, violent and mentally ill Egan that no one group of staff or facility ever took ownership of his care. In one 2½-year period, he was transferred 17 times.
The commission also concluded that given the seriousness of his mental health issues, Egan should never have been transferred from the Central Mental Hospital on July 14th, 2006, back into the prison system just nine days after admission to the hospital. It said the transfer to Cloverhill occurred despite the Central Mental Hospital knowing that once Egan was back in the prison system, it would lose any influence over his care.
After just two weeks in Cloverhill, he was transferred to Mountjoy and within 72 hours he had killed Douch in a basement holding cell. This was despite a precondition of his release from the Central Mental Hospital that he be sent to a particular wing in Cloverhill and kept there.
Staff at Cloverhill are excoriated in the new report for seeking to offload Egan from their care because he was so difficult and place him in the overcrowded environment of Mountjoy that they knew was not as well placed to care for him. The commission says they displayed a “reckless disregard” for the safety of staff and prisoners at Mountjoy.
“The transfer also involved moving Stephen Egan from the safety of a high-observation single cell on Cloverhill’s D2 wing to Mountjoy, when they knew, or could reasonably be expected to have known that he would not be accommodated, in anything approximating the facilities available in D2.”