A prisoner who died awaiting sentence for child neglect and rape may have survived if diabetes levels were checked the day before he died, an inquest has heard.

Andrew Hadwin was found unresponsive on the toilet in his cell at HMP Durham on February 2 last year.

The 39-year-old, from Bowburn, County Durham was set to be jailed for crimes including child neglect and rape on April 28, 2023, after being found guilty of a string of offences alongside partner Cheryl Pickles.

An inquest into his death taking place at Crook Coroners’ Court this week heard on Monday (October 28) he died of diabetic ketoacidosis - a condition which occurs because of a shortage of insulin. It was told he had previously expressed thoughts of self-harm and refused the vital diabetes drug.

On Tuesday (October 29) expert witness Professor Partha Kar, a consultant in diabetes and NHS England specialist, told the jury Hadwin may have survived if checks of his diabetes levels the day before he died had been done to the same standards as before.

HMP Durham.HMP Durham. The court saw medical notes which said Hadwin was of a low risk on the ‘National Early Warning Score’ system for detecting deterioration of patients, but Prof Kar said this was a “guide” which should “trigger a subsequent review”.

The jury was told that according to medical notes a check of his ketone levels, branded as “pretty much paramount” by Prof Kar, did not happen on February 1, the day before he died.

The nurse who saw him on both February 1 and 2 told jurors she did complete blood glucose tests, but not ketone tests.

She added she “did not think it was diabetes” when met Mr Hadwin came to the medicine hatch complaining he was unwell with symptoms including stomach pains on the morning of his death. She told jurors she asked for a GP to see him later that day.

Asked by Senior Assistant Coroner Crispin Oliver whether he believed “gaps” in Mr Hadwin’s treatment led to his death, Prof Kar replied: “Yes. I believe so.”

He added: “I think on the balance of probabilities if his ketones were picked up, given the fact that he had recently been admitted with pretty much at the same issue which got him into hospital, then if this was picked up that he had high blood sugar and high ketones that would have triggered an admission to hospital whereby it is condition which is treated and on the balance of probabilities he would have survived.”

An inquest is taking place at Crook Coroners' Court.An inquest is taking place at Crook Coroners' Court. He added that doctors would have given him insulin if he'd presented unconscious even though he had refused it to save his life.

The inquest was told checks for his blood sugar and ketone levels had previously taken place since he arrived at the jail on January 17, including leading to him being hospitalised for two spells.

Prof Kar added: “I would say held to the same standards of what was done in the same area and following the same protocols, it would have picked up the raised ketones.

“It is just maintaining to the same standards that would have picked it up.”

The jury watched bodycam video from a prison officer of Hadwin refusing his insulin at about 5.25pm the day before his death, in which he was asked "Do you understand the repercussions of not having it?", and the 39-year-old responds saying he would die.

Prof Kar said “any reduction in insulin” could “absolutely” impact his diabetes control.

Hadwin was kept on the Vulnerable Prisoner Unit at HMP Durham after being remanded on January 17 and was under hourly observations, the jury was told.

Recommended reading:

Get more from The Northern Echo with a digital subscription. Get access for five months for just £5, or get 40% off an annual subscription with our latest offer. Click here.

He suffered with type one diabetes, used a walking stick and wheelchair over long distances and was generally “not a well man”, the court heard, and spent two stints at University Hospital North Durham between January 18 and 23, and again on January 25, 2023, during his time in custody.

His partner Cheryl Pickles watched proceedings at the Coroners’ Court via video link from prison alongside a chaplain.

The inquest, expected to last all week, continues.