Causes of death among detainees: a statistical study on the casework of the Forensic Medicine Institute in Cluj-Napoca during the period 2000–2014

BACKGROUND AND AIMS: The detainees’ right to healthcare is granted by laws, in accordance with EU directives and recommendations to which our country has consented. Prison population is a particularly vulnerable and marginalized group characterized by mortality rates different from the general population. This study aims at providing a picture of the causes of death, quality of healthcare and measures needed to reduce the number of in-prison deaths, including legal medicine expertise in view of sentence postponement/interruption. METHODS: The present paper is based on the statistical analysis of in-prison deaths casework recorded at the Forensic Medicine Institute of Cluj-Napoca and provided by territorially subordinated counties forensic services. The data collected cover over 15 years (2000–2014), a period long enough for significant retrospective statistical analysis. RESULTS: The total number of deaths among the inmates was 113, the majority of male sex (110). Distribution by age groups shows a greater incidence among inmates aged 50 to 59 years (32 cases, 28.31%), followed by those in their 40s’ (30 cases, 26.54%) and 30s’ (25 cases, 22.12%). The most frequent pathological causes of death were cardiovascular (53 cases) followed by tumors (26 cases) and infectious diseases. A significant number of deaths were due to violent causes (14 cases-12,38%). CONCLUSIONS: Special problems are raised by the high number of deaths among prisoners, especially at a young age, while the high frequency of violent deaths from self- or non-self-inflicted traumatic causes requires supervision, monitoring and continuous analysis. Despite recent improvements, healthcare in prisons still poses some problems, mainly regarding diagnosis and treatment of heart diseases, neurosurgery and cancer.