Justice Action believes there is clear negligence and a breach of established duty of care by Corrective Services and Justice Health.
Below are detailed notes from each day of the inquest held Monday 13th - Friday 17th July 2020. The family of Tane Chatfield are desperate for justice.
Tane Chatfield, was a 22 year old Gomeroi and Wakka Wakka man, who was found unconscious in Tamworth Correctional Centre on the morning of 20th September 2017. He died 2 days later after being on life support at Tamworth Base Hospital. Corrective Services NSW conveyed that there were no suspicious circumstances regarding his death and that he attempted suicide via hanging in his cell.
His family believes more could have been done to prevent his death. Tane suffered two seizures before he was taken to Tamworth Base Hospital. Though the hospital was only 250m away, it took 40 minutes to get Tane to hospital. After he was discharged, the officers that accompanied him did not receive or ask for a discharge summary - an essential document regarding the health of Tane.
Tane was then taken to the Justice Health Clinic for further assessment. Because Tane’s health history was not appropriately assessed by the Nurse Unit Manager Janeen Adams at the Justice Health Clinic, he was sent to his unsupervised cell alone where he committed suicide. In the absence of advice, Tane was placed in a ‘normal’ cell which contained hanging points. These are still yet to be audited by Tamworth Correctional Centre following his death. Importantly, Nurse Adams admitted to the court that had she known the details of Tane’s condition from the discharge papers, her clinical assessment would have been different. Evidence suggests that if the care of Tane wasn’t overlooked, he wouldn’t have died in custody.
According to Dr. Neil Simon, his seizures were most likely due to psychogenic drug withdrawal. He also acknowledged that the conclusion arrived at by the medical team on the day seemed reasonable given the information they had access to, although a different conclusion may have been reached had they had all the information that he was given following Tane’s death.
Tane’s father Colin Chatfield exclaims that his son was confident of being acquitted in relation to the charges he had been on remand for two years for. This was the result of eight witnesses failing to identify him as being involved in the home invasions conducted in northern NSW in 2015. Furthermore, Tane’s family had also taken photos of his body in the hospital, which highlighted that Tane had suffered extensive injuries. Upon reflection of these images, NSW Greens MLC David Shoebridge remarked that Tane’s death was inconsistent with a hanging as the images showed skin under Tane’s nails, scratch marks on the body, bruising along the face, a busted lip and a broken nose and jaw.
This in turn has resulted in Tane’s death being counted as the 16th Aboriginal death in police custody since 2008, as per the Guardian, while corrective services highlighted this was the first Aboriginal ‘suicide’ in custody since 2010.