A Retrospective Study of Custodial Deaths in Visakhapatnam Region During 2021-24

Introduction: Custodial deaths in detention settings such as police cells, prisons, borstal schools, and asylums raise serious human rights concerns on individual dignity and state culpability. A thorough medicolegal investigation serves as the cornerstone for ensuring accountability and transparency in addressing state-sponsored crimes in modern societies. This retrospective study examines custodial deaths autopsied between October 2021-2024 in the jurisdiction of a tertiary care hospital in south India. Aims & Objectives:1. To identify the causes of deaths in custody in the Visakhapatnam region. 2. To analyse the factors which led custodial deaths, and 3. To suggest necessary reforms in prison health care. Methodology: In this study, data from the autopsy records of Andhra Medical College, Visakhapatnam, are analysed, focusing on 25 custodial deaths that occurred between October 2021 and October 2024. Due to insufficient data, only 20 cases with detailed records are included. The study examines age, type of custody, place of death, preexisting medical conditions, cause, and manner of death. Results: Out of 20 prisoner deaths, 18 (90%) were due to natural causes, primarily due to chronic lung diseases like bronchiectasis, bronchopneumonia, and lobar pneumonia (7 cases, 35%). Psychiatric illnesses were present in 4 cases (20%). The most affected age group was 31–40 years (7 cases, 35%). Unnatural deaths (10%) involved two suicides, both without a prior psychiatric history. Discussion: Despite ongoing prison reforms, custodial deaths remain a pressing issue due to systemic shortcomings at several levels. This study highlights chronic lung diseases (35%) as the leading natural cause which can be prevented by increasing access to care. Prisoners need better healthcare services, including regular screenings for respiratory conditions like TB and comprehensive mental health assessments. Conclusion: The findings of the present study highlight the urgent need for strengthening prison healthcare systems. Effective prison healthcare should address multiple aspects, including regular screenings for lifestyle diseases, improving hygiene, and fostering better health-seeking behaviors among inmates.