INQUIRY UNDER THE FATAL ACCIDENTS AND INQUIRIES (SCOTLAND) ACT 1976 INTO THE SUDDEN DEATH OF DYLAN EVAN BRIAN STICKLE [2009] ScotSC 88 (31 March 2009)

INQUIRY UNDER THE FATAL ACCIDENTS AND INQUIRIES (SCOTLAND) ACT 1976 INTO THE SUDDEN DEATH OF DYLAN EVAN BRIAN STICKLE [2009] ScotSC 88 (31 March 2009)

The death of Dylan Stickle might have been avoided if he had been assessed as 'At Risk' on admission to prison and placed under ACT procedures. The failure to communicate critical risk information (from social work and police) to those conducting the risk assessments, and the inadequate application of ACT procedures by staff, constituted defects in the system of working that contributed to the death.

Citation
[2009] ScotSC 88
Parties
Deceased: Dylan Evan Brian Stickle; Procurator Fiscal Depute (crown): Neil Shand; Deceased's Mother: Phyllis Stickle; Witness/consultant Psychiatrist: Dr Pauline Larmour; Witness/psychiatrist: Dr Christopher Pell; Witness/gp: Dr Belinda Porter; Witness/psychiatrist: Dr Kenneth Mitchell; Interested Party: Grampian Health Board; Interested Party: Prison Officers' Association of Scotland; Interested Party: Scottish Prison Service
Jurisdiction
Scotland
Judgment Date
31 March 2009
Procedural Posture
Fatal Accident Inquiry / Determination
Outcome
Death by suicide in custody; defects in system contributed to death.
Legal Topics
Prison Suicide, Duty of Care, Risk Assessment, Procedural Defects, Information Sharing, Mental Health in Custody
Prison Law Public Law Human Rights Prison Suicide Duty of Care Risk Assessment Procedural Defects Information Sharing +1 more

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Parties

Dylan Evan Brian Stickle

Deceased

Neil Shand

Procurator Fiscal Depute (crown)

Phyllis Stickle

Deceased's Mother

Dr Pauline Larmour

Witness/consultant Psychiatrist

Dr Christopher Pell

Witness/psychiatrist

Dr Belinda Porter

Witness/gp

Dr Kenneth Mitchell

Witness/psychiatrist

Grampian Health Board

Interested Party

Prison Officers' Association of Scotland

Interested Party

Scottish Prison Service

Interested Party

Procedural Posture

Fatal Accident Inquiry / Determination

Legal Issues

  1. 1 Whether reasonable precautions could have prevented the death of Dylan Stickle in custody
  2. 2 Whether defects in the system of working contributed to the death
  3. 3 Whether the ACT (suicide risk management) procedures were properly followed

Ratio Decidendi

The death of Dylan Stickle might have been avoided if he had been assessed as 'At Risk' on admission to prison and placed under ACT procedures. The failure to communicate critical risk information (from social work and police) to those conducting the risk assessments, and the inadequate application of ACT procedures by staff, constituted defects in the system of working that contributed to the death.

Court Disposition

Death by suicide in custody; defects in system contributed to death.

Orders

  • Recommendation for improved communication and information sharing between social work, police, and prison staff regarding suicide risk.
  • Recommendation for ensuring all staff conducting risk assessments have access to relevant documents and adequate training.