Man on suicide watch ‘lay dead for hours’ in Home Office immigration removal centre

The body of a mentally distressed man may have lain undiscovered for hours in a Heathrow immigration detention centre despite him being placed on suicide watch, an inquest has heard.

Frank Ospina, 39, from Colombia, was found hanged in the shower area of his cell in the care suite of Colnbrook immigration removal centre – run by private firm Mitie for the Home Office – at about 9.15am on 26 March last year.

An inquest at West London Coroner’s Court heard how Mr Ospina had used a scarf which had not been removed from his possession despite three instances of self-harm or suicide attempts in the previous days.

The engineering graduate had purportedly been monitored throughout the night of his death by Mitie custody officer Philip Dimbleby. He was on a suicide prevention plan that required him to be checked on twice each hour after being deemed a “ticking time bomb”.

Dimbleby told the jury he checked on Mr Ospina three times an hour from 9pm on 25 March until 8:02am the next morning just before his shift ended, and believed he could see him in his bed.

But Trevor Powell, an inexperienced officer who took over from Dimbleby at around 8am,  told the court Mr Ospina was not visible at that time and the bed did not look slept in, at which point Dimbleby suggested he may be in the en-suite bathroom.

Mr Ospina’s body was then found over an hour later by Powell and another officer, Colin Sargeant, after the former raised the alarm when he arrived with Mr Ospina’s breakfast to find the bed still empty, he said.

Powell told the court: “As you walk in before we got to the toilet we could see Frank’s feet sticking out at the end. I could see that he had a scarf.

“He was freezing cold. […] Colin said to me: ‘He has been dead for hours’.”

Questioning Dimbleby on his account, Senior Coroner Lydia Brown said: “There are lots of statements which suggest he may have been dead for some time, and I’m talking hours not minutes […] Would you accept that he was not in his bed in the last few hours?”

Dimbleby told the court he may have been “deceived” by Mr Ospina arranging the bedding to make it look like he was asleep but that “to the best of my ability I’m certain he was alive”.

Powell, who said he was only working his second ever shift at the care suite, was questioned by Mrs Brown about why he had logged an observation at 8:30am despite not doing a check. He replied that he was “completely confused” by the tasks he needed to do during a shift handover, and agreed he had been “in a bit of a tizz”.

He said: “Because it’s my first time doing it […] at 8.30am I write that in to remind me to look at him at 8.30.“

He added: “Before you know it it was like 9 o’clock […] I went to the door and that’s when I felt something is not right. I’ve seen no sight or sound of Frank Ospina.”

When police arrived Powell told them he had checked on Mr Ospina at 8:30am and he “hadn’t moved from his bed”, the court heard. He told the coroner that during that interview he had been distraught and worried about getting the blame.

The inquest has heard evidence from six Mitie staff who had contact with Mr Ospina following an apparent suicide attempt on 22 March until his death four days later.

Mr Ospina had been detained for illegal working on 4 March. He had not indicated any health concerns when screened on arrival but his mental state deteriorated in detention and he was placed on suicide watch, moving between varying intensities of observation.

He told staff he was being threatened by voices in his head, jurors heard, while a mental health professional was said to have described him as a “ticking time bomb” the day before his death.

Marion Forrester-Carpenter, population centre manager at the (IRC), told the court she was not aware Mr Ospina had a scarf among his possessions and could not comment on what risk assessment had been undertaken, but items that could be used to create ligatures would not have been deemed necessary to remove as prior self-harm incidents had involved different methods.

Officer Dimbleby told the court he was “a little bit shocked” when he saw Mr Ospina had two plastic bags of personal property in his room when he began his night shift on 25 March, however.

He said: “I was told he tried to kill himself […] but if a manager has allowed it, it’s not within my remit to take it away.”

On 22 March staff first put Mr Ospina on a care plan to manage his risk of suicide after he jumped over the detention wing’s second floor railings, landing on safety netting.

He was placed under “constant supervision” in the care suite, a section of the centre with transparent doors for monitoring detainees in crisis, but downgraded to hourly observations and returned to the main wing after a review by Mitie staff the next day. Healthcare professionals did not attend the meeting but were consulted over the phone beforehand, Forrester-Carpenter told the court.

On 24 March observations were increased after he was found self-harming with a TV cable before banging his head against a wall. The court heard conflicting accounts about whether the cable was wrapped around his neck during this incident although Mr Ospina explained he was using it  to whip rather than strangle himself, Forrester-Carpenter said. He was returned to the care suite the next morning.

Forrester-Carpenter was also presented with a note in her hand writing stating Mr Ospina told her he had self-harmed on 19 March but not told anyone. She could not recall the conversation and said she did not ask him any details about his method of self-harm.

Sarah Mallender, Mitie’s centre manager for its two Heathrow immigration removal centres, told the court changes had been made following Mr Ospina’s death including better coordination with healthcare contractor Practice Plus Group to ensure their attendance at meetings to discuss plans to manage detainee’s risk of suicide.

The court heard that Ospina was conflicted about returning to his home country and over whether to speak to the police about an alleged crime he disclosed while in detention, telling custody officers who retrieved him from the netting on 22 March he was a “bad man” and had talked to underage girls via webcam.

Two Met police officers interviewed Mr Ospina the day before his death after Mitie security reported his claims, but found no evidence of a crime having been committed in the UK.

Barrister John Yianni, representing Mr Ospina’s family, questioned Mitie staff on whether they had considered the claim was the result of a mental health issue, while a police officer suggested in a witness statement read to the court that Mr Ospina could have been trying to prevent his removal to Colombia.

The inquest is scheduled to last until Friday 11 October.

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A version of this article was published with inews.