CEDH · CASELAW;COMMUNICATEDCASES;ENG — 19 février 2015

.s800EAC49 { font-size:12pt } .sFE10DC93 { margin-top:0pt; margin-bottom:0pt; text-align:center } .sBB9EE52A { font-family:Arial } .sA6BC7FA7 { margin-top:0pt; margin-bottom:0pt; text-indent:14.2pt; text-align:right } .s9793A85B { margin-top:0pt; margin-bottom:0pt; text-indent:14.2pt } .s5E1364CA { margin-top:0pt; margin-bottom:12pt; text-align:center; page-break-inside:avoid; page-break-after:avoid; font-size:14pt } .s8229ABDD { margin-top:0pt; margin-bottom:12pt; text-align:center } .s68C46B95 { margin-top:36pt; margin-bottom:12pt; text-align:center } .s3F59B822 { font-family:Arial; font-weight:bold; text-transform:uppercase } .s29100277 { font-family:Arial; font-weight:bold } .sA8776625 { margin-top:18pt; margin-left:29.2pt; margin-bottom:12pt; text-indent:-17.6pt; page-break-inside:avoid; page-break-after:avoid } .s72C8F48C { margin-top:12pt; margin-left:36.6pt; margin-bottom:6pt; text-indent:-15.05pt; page-break-inside:avoid; page-break-after:avoid } .sA36B60A1 { font-family:Arial; font-style:italic } .s32563E28 { margin-top:0pt; margin-bottom:0pt } .sF7A86111 { margin-top:6pt; margin-left:21.25pt; margin-bottom:6pt; text-indent:7.1pt; font-size:10pt } .sE3D66594 { border:0.75pt solid #000000; border-collapse:collapse } .s41E9DBF5 { border-right-style:solid; border-right-width:0.75pt; border-bottom-style:solid; border-bottom-width:0.75pt; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .s85646119 { margin-top:0pt; margin-bottom:0pt; text-align:justify; font-size:12pt } .s24AC208E { border-right-style:solid; border-right-width:0.75pt; border-left-style:solid; border-left-width:0.75pt; border-bottom-style:solid; border-bottom-width:0.75pt; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .sF004B676 { border-left-style:solid; border-left-width:0.75pt; border-bottom-style:solid; border-bottom-width:0.75pt; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .sB30C44B0 { border-top-style:solid; border-top-width:0.75pt; border-right-style:solid; border-right-width:0.75pt; border-bottom-style:solid; border-bottom-width:0.75pt; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .sC3AB69A { border-style:solid; border-width:0.75pt; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .s2342A031 { border-top-style:solid; border-top-width:0.75pt; border-left-style:solid; border-left-width:0.75pt; border-bottom-style:solid; border-bottom-width:0.75pt; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .s546C9D04 { border-top-style:solid; border-top-width:0.75pt; border-right-style:solid; border-right-width:0.75pt; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .s40B7A780 { border-top-style:solid; border-top-width:0.75pt; border-right-style:solid; border-right-width:0.75pt; border-left-style:solid; border-left-width:0.75pt; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .s4F2EDFF { border-top-style:solid; border-top-width:0.75pt; border-left-style:solid; border-left-width:0.75pt; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .s83BE5C30 { font-family:Arial; font-size:8pt; vertical-align:super } .sE24C0691 { margin-top:0pt; margin-bottom:0pt; text-indent:14.2pt; font-size:10pt } .sCB9E0544 { margin-top:0pt; margin-bottom:0pt; text-align:left } .s76CF415B { page-break-before:always; clear:both } .s2D57E2E { font-family:Arial; font-weight:bold; text-decoration:underline; text-transform:uppercase } .s37CDBE05 { margin-top:0pt; margin-bottom:0pt; page-break-inside:avoid; page-break-after:avoid } .s39A7D870 { margin-top:0pt; margin-bottom:0pt; text-indent:14.2pt; page-break-inside:avoid; page-break-after:avoid } .s4ACA9207 { page-break-before:always; clear:both; mso-break-type:section-break } .s6DB91820 { text-align:center } .s25B97BCD { margin-right:auto; margin-left:auto; border:0.75pt solid #808080; border-collapse:collapse } .sF5C9E8B1 { height:46.3pt } .sD1CDDC62 { border-right:0.75pt solid #808080; border-bottom:0.75pt solid #808080; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top; background-color:#e0e0e0 } .sDF237D91 { margin-top:0pt; margin-bottom:0pt; text-align:center; font-size:8pt } .s2490CDBC { border-right:0.75pt solid #808080; border-left:0.75pt solid #808080; border-bottom:0.75pt solid #808080; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top; background-color:#e0e0e0 } .s8DB21C27 { margin-top:0pt; margin-bottom:0pt; text-indent:14.2pt; text-align:center; font-size:8pt } .s26ADB50A { border-left:0.75pt solid #808080; border-bottom:0.75pt solid #808080; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top; background-color:#e0e0e0 } .sFD306575 { height:35.55pt } .s2F4AF114 { border-top:0.75pt solid #808080; border-right:0.75pt solid #808080; border-bottom:0.75pt solid #808080; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .s6B505E72 { margin:0pt; padding-left:0pt } .s6CF83D49 { margin-left:11.67pt; padding-left:6.18pt; font-family:Arial; font-size:8pt; font-weight:bold } .s898DAE93 { border:0.75pt solid #808080; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .sB217F55D { margin-top:0pt; margin-bottom:0pt; text-align:justify; font-size:8pt } .sA0B2759 { margin-top:0pt; margin-left:0.45pt; margin-bottom:0pt; text-indent:-0.45pt; text-align:justify; font-size:8pt } .sB71F2881 { border-top:0.75pt solid #808080; border-left:0.75pt solid #808080; border-bottom:0.75pt solid #808080; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .sFD82DC6 { margin-left:16.12pt; padding-left:1.73pt; font-family:Arial; font-size:8pt; font-weight:bold } .sBCA334AF { border-top:0.75pt solid #808080; border-right:0.75pt solid #808080; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .s7CB6920E { border-top:0.75pt solid #808080; border-right:0.75pt solid #808080; border-left:0.75pt solid #808080; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top } .s62945D10 { border-top:0.75pt solid #808080; border-left:0.75pt solid #808080; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top }   Communicated on 19 February 2015   FIRST SECTION Application no. 30125/06 Aleksandr Anatolyevich NIKULIN against Russia and 20 other applications (see list appended) STATEMENT OF FACTS The applicants, save for Mr Valeriy Vitalyevich Bulin (application no.   41785/13 ), Mr Shelest (application no. 47875/13), Mr Karyy (application no. 20888/14 ) and Mr Ramishvili (application no. 60277/14 ) , are Russian nationals. The facts of the cases, as submitted by the applicants, may be summarised as follows.   1.     Application no. 30125/06 lodged on 5 June 2006 by Aleksandr Anatolyevich Nikulin who was born on 27 July 1972 and lived until his arrest in the village of Aleksikovskiy in the Volgograd Region. A.     Facts 1.     Criminal proceedings against the applicant and his arrest On 23 September 2004 the applicant was arrested on suspicion of armed robbery. On a number of occasions the applicant’s detention was extended with a view to the gravity of the charges, his previous conviction of a violent crime and the ensuing ability to reoffend or obstruct justice. The applicant’s complaints of poor health and his having been unfit for detention were dismissed by the courts as irrelevant. The appeal court regularly upheld the detention orders. As appears from the file, the most recent extension of the detention occurred on 22 November 2006 when the Novonikolayevskiy District Court of the Volgograd Region authorised the applicant’s detention until 23   February 2007, having relied on the gravity of the charges and his previous conviction. The District Court interpreted those two facts as a sign of the applicant’s potential to abscond, reoffend and obstruct justice. At the same time, the court dismissed the applicant’s argument of rapidly deteriorating health. Having heard a tuberculosis specialist who had confirmed the applicant suffering from a serious form of infiltrative tuberculosis and absence of the necessary treatment in detention, the District Court, nevertheless, found that that consideration could not outweigh the necessity to keep the applicant detained. According to the applicant, that decision was unsuccessfully appealed against. On 16 May 2007 the Novonikolayevskiy District Court found the applicant guilty of armed robbery and unlawful possession of firearms and sentenced him to seven years of imprisonment. It appears that the judgment was upheld on appeal on 4 September 2007. 2.     Health issues The applicant suffers from tuberculosis since 1999. In 2004 the applicant was declared to be suffering from a third-degree disability. According to a letter sent to the applicant’s lawyer on 26 September 2005 by a tuberculosis specialist from the Novonikolayevskiy Central Hospital, the applicant suffered from progressing infiltrative tuberculosis of the upper limb of the right lung in the disintegration and dissemination stage complicated by the pulmonary heart disease of the second degree. Doctors recommended the applicant’s in-patient treatment in intensive care. According to another certificate issued by a deputy head of the medical correctional facility (LIU-23) the applicant had been admitted to the facility and had received intensive treatment with antibacterial drugs. As follows from yet another certificate, in March 2006 the applicant’s disability progressed with it having been registered as second-degree type. The applicant provided the Court with an extract from his medical record drawn up in August 2006. It appears that at that time he was detained in an ordinary detention facility. He complained to the warders about a further deterioration of his health. An X-ray examination performed on 21 August 2006 showed the pronounced negative dynamic of the tuberculosis process with the infiltration disseminating further and also affecting the left side. He was immediately recommended transfer to a hospital for inpatient treatment. At the same time, relying on statements made by the tuberculosis specialist in the court hearing concerning the extension of his detention, as well as on medical certificates showing a further progress of his infection, the applicant argued that he had not received necessary treatment in detention. On 13 April 2007 the applicant was transferred to the medical correctional facility LIU-23 where he remained at least until 18 March 2008. A letter sent to the applicant in response to the complaints about the quality of medical services indicated that his health continued deteriorating with his having developed multi-drug resistant tuberculosis in open form. The applicant’s condition was considered moderately grave. B.     Complaint(s) The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention and under Article 5 § 3 of the Convention about the unreasonably long detention on remand.   2.     Application no 7805/07 lodged on 9 November 2006 by Sergey Vladimirovich MAKSIMOV who was born on 11 November 1969 and lived until his arrest in the village of Duldurga, Zabaykalye Region. He is serving his sentence of imprisonment in the medical correctional colony in the town of Chita. A.     Facts In February 2001 the applicant was sent to serve his sentence at correctional colony no. 7 in the Chita Region. Upon his admission he was diagnosed with remaining changes following his having had tuberculosis. In 2003 he was transferred to the medical correctional colony in Chita with diagnosis of infiltrative tuberculosis of the upper lobe of the right lung in the dissolution stage. The applicant received antibacterial treatment for almost a year which was not successful as after the treatment had been completed the applicant tested as having open form of the illness. In September 2004 the applicant complained to a prison doctor about a serious pain in the back and during urination. He was prescribed treatment which did not produce any result. In November 2004 he was sent for an examination to the Regional prison hospital where he was diagnosed with vesical [cystic] diverticulum, secondary cystitis and pyelonephritis. A surgery was scheduled but was not performed as the hospital did not have a radiologist to prepare the applicant for the surgery. In the end of December 2004 the applicant was sent back to the medical colony. Supervision by prison doctors was recommended. The applicant continued complaining about a severe pain in the back (kidney area and bladder) and pain during urination. Drugs prescribed by a prison doctor did not have any effect. In February 2005 the applicant was sent to the prison hospital for a surgery. Having confirmed his previous diagnosis, the doctors again scheduled a surgery which was not performed as the hospital did not have necessary equipment and materials, as well as an anaesthesiologist. The absence of necessary drugs also served as the reason for the hospital’s failure to provide the applicant with specific therapeutic procedures. The applicant was returned to the colony. He provided the Court with a copy of a letter sent to him in October 2005 by a deputy head of the Chita Regional Penitentiary Service. In that letter the deputy head acknowledged that the failure to perform the surgery to the applicant resulted from the poor staffing and equipment of the hospital.   In March 2005 the applicant’s illness reached the stage when he could no longer urinate unaided. He had to use a catheter to relieve urine. Several months later he was sent to a medical colony. Between July and October 2005 the applicant was detained in a medical department of the colony where he continued using catheter and was only given Furacilin (a bactericidal compound used as an antibiotic) and Vaseline. Doctors did not assist him with using the catheter and did not provide him with disposal catheters. The applicant merely cleaned the one catheter he had with water before and after using him. The applicant followed that procedure several times a day, each time feeling pain and humiliation as he had to do it in the presence of other inmates. His complaints to various authorities, including prosecutors, were to no avail. In September 2005 the applicant was examined by a surgeon who recommended surgery. The applicant stated that following his examination by the surgeon, prison doctors attempted to force him to sign a document withdrawing his complaints about the quality of medical assistance. In response to the applicant’s refusal to do so, they refused to transfer him to the prison hospital for treatment and had included a record in his medical history stating that the applicant had himself refused transfer to the hospital, although he had been explained the consequences of the refusal. The applicant submitted that he had not signed the record. In the end of October 2005 the applicant was admitted to prison hospital in colony no. 5 where he was finally given another disposal catheter. In December 2005 the applicant was taken to Chita town hospital where he was consulted by an urologist. The latter scheduled a number of specific urinary system examinations and tests to diagnose the applicant. The tests, however, were never performed and the applicant was diagnosed on the basis of the old urological scans. The urologist recommended surgery and prescribed antibacterial therapy to the applicant to prepare him for the surgery. The treatment was only initiated in March 2006 when the hospital received necessary drugs. On 12 May 2006 the applicant underwent a suprapubic cystostomy, cystoscopy, dissection of intravesical septum and incision of Petuev’s catheter. The applicant was again admitted to the prison hospital on 29 July   2006 and stayed there until the end of August for specific chemotherapy. Following the surgery the applicant was given an empty shampoo bottle (which he still uses) to use as a medical urinal bag. Following the surgery in June 2006 doctors recommended to perform a plastic surgery of the bladder. In February 2007 that recommendation was repeated by a surgeon from the regional prison hospital. The surgeon also noted that the surgery was to be performed in a special urological medical facility. Despite the recommendation from the surgeon, in May 2007 the deputy head of the penitentiary service informed the applicant that the prison doctors who examined him in April 2007 had not established any necessity to perform that additional surgery. The applicant insisted, that in the absence of a further surgery, he became in fact a disabled person walking around with a catheter and a shampoo bottle glued to it to remove the urine. The applicant’s complaints to various authorities did not find any response. B.     Complaint(s) The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention.     3.     Application no. 51252/09 lodged on 2   September   2009 by Vladimir Sergeyevich BARSUKOV who was born on 15   February   1956 and lived before his arrest in St. Petersburg. He is serving his sentence of imprisonment. The applicant was represented by Mr K. Kuzminykh and Mr   S. Afanasyev. A.     Facts 1.     Criminal proceedings against the applicant On 23 August 2007 the applicant was arrested and two days later his arrest was authorised on the charge of an attempt to organise murder. The applicant’s detention was regularly extended with new charges having been put forward against him and the courts having relied on the gravity of the charges and increased risks of his absconding, reoffending and tampering with witnesses, as well as obstructing justice by other means. The charges against the applicant were subsequently amended to include organisation of a stable criminal group, aggravated fraud, illegal corporate raiding, extortion, fraud and attempted murder. On 9   November 2009 the Kuybyshevskiy District Court of St. Petersburg found the applicant guilty of aggravated fraud and money laundering committed within an organised criminal group and sentenced him to fourteen years of imprisonment. That judgment was upheld on appeal by the St. Petersburg City Court and became final on 30 March 2010. By another judgment of 6 March 2012 the Kuybyshevskiy District Court, in another set of criminal proceedings, found the applicant guilty of two counts of aggravated extortion committed within an organised criminal group and imposed a cumulative sentence of fifteen years of imprisonment. The judgment became final on 12 July 2012 when endorsed by the St. Petersburg City Court. It appears that a new set of criminal proceedings against the applicant is still pending. 2.     The applicant’s state of health On 1 June 1994 the applicant’s car was shot at. His bodyguard was killed and the applicant lost his right arm in the attack. The applicant spent about a month in a coma. The applicant’s medical history listing his diagnoses is more than a page long and includes, among other illnesses, ischemic disease, exertional angina of the second functional group, atherosclerotic and postinfarction cardiosclerosis (in 2000 and 2007 the applicant had suffered an acute myocardial infarction), hypertension in the third stage; a high risk of vascular complications; cardiac failure of the second functional group; chronic posttraumatic pericarditis with effusion (foreign objects in the pericardium after gunshot wounds); condition after the nephrectomy related to cancer of the left kidney: tumor; remote metastases requiring the permanent supervision; kidney stones; concretion of the right kidney; chronic pyelonephritis; chronic kidney failure of the first degree; adenocarcinoma of the prostate gland: tumor requiring permanent medical supervision; chronic prostatitis; chronic cystitis; constantly recurrent infection of the urinary tract; bronchiectasic illness in the relapse with the permanent presence of the blue pus bacillus in the sputum; condition after numerous gunshot wounds to the chest, back, upper and lower extremities leading to the extremity avulsion (right arm at the level of the upper third part of the shoulder). Given the seriousness of the condition, until his arrest in 2007 the applicant received the daily complex drug regimen comprising up to ten medicaments and underwent frequent, once in two months, in-depth medical examinations in the specialised clinical hospital where he was subjected to a number of craniological and urological tests and analysis, as well as received necessary treatment in respect of his oncological illnesses. When the applicant suffered the relapse of his urinary infections, his drug regimen was amended to include additional drugs administered intravenously. At the time of his arrest the applicant was receiving chemotherapy in respect of his oncological problems. The chemotherapy was interrupted and was not reinitiated after the applicant’s arrest. The applicant argued that he did not receive medical assistance adequate to his condition which is life-threatening. Despite the continuous deterioration of his health, in particular the relapse of urinary illnesses, the only assistance provided to him in this respect in detention included his having been catheterised, approximately 250 times during the first twenty months of his detention. The detention facility where the applicant stayed did not have license, and as follows equipment and specialists, to perform oncological, craniological and urinary medical assistance. He could only obtain services of a general specialist, a prison physician. The applicant noted that on a number of occasions ambulance had been called to trial hearings to take care of his problems, in particular those related to hisurinary illnesses. The applicant stressed that, despite his very fragile health and his being prone to infections, including due to his being constantly catheterised, he was kept in unsterile conditions of an ordinary cell with the risk of infections having been exacerbated even further. On 27 August 2009 the Kuybyshevskiy District Court of St. Petersburg dismissed the applicant’s request for his forensic medical examination. Having relied on the medical records provided by the detention facility, the court concluded that the applicant received necessary medical treatment in detention and that therefore there was no need to authorise his expert examination. A similar decision was taken by the court on 13 October 2009. On 28 December 2009 the applicant was examined in the Scientific Institute of Urology. According to the applicant, doctors recommended his urgent hospitalisation. The recommendation was not acted upon and the applicant was not provided with any treatment. As follows from a certificate issued by the acting head of the medical unit of the detention facility, in 2009 the applicant was examined, on a number of occasions, by a urologist, an oncologist and a cardiologist. On two occasions, on 22 October and 16 November 2009 he was seen by an oncologist in an oncological hospital in Moscow. The acting head also noted that during his visit to the Urology Institute necessary examinations had been performed and the applicant’s treatment had been adjusted to take account of the recommendations given by the doctors from the Institute. In March 2010 specialists of the Urology Institute, responding to prosecutors’ request for information, again insisted on the applicant’s admission to a hospital for treatment. The specialists made necessary recommendations in respect of the chemotherapy regimen that the applicant should have been provided with and issued a list of analysis to perform prior to his placement in a hospital. He continued being kept in the conditions of an ordinary detention cell. The applicant’s requests for examinations by various retained medical specialists were persistently dismissed. As follows from an expert opinion issued by three forensic medical experts on 12 October 2009, the applicant needed “systematic treatment with corrections of the chemotherapy regimen and periodic admissions to a specialised cardiology hospital for instrumental examinations and necessary amendments to drug regimen”. Given the absence of proper medical supervision, the experts also warned against a possible deterioration of the applicant’s urinary and oncological problems and a risk of those illnesses having advanced to a stage requiring radical treatment without any prospect of the applicant’s being cured or even his life saved. The experts stressed a high risk of a number of the applicant’s illnesses relapsing and made a list of procedures and examinations which were necessary to support his health. They also observed that the medical unit of the detention facility where the applicant was kept was not equipped for treating a patient in his condition. During the criminal proceedings, at a number of hearings, the trial court heard medical specialists who had treated the applicant prior to his arrest. These specialists testified that the applicant’s condition was deteriorating. In particular, at the hearing on 5 August 2009 the court interviewed the head of the clinical hospital where the applicant had undergone examinations in 2007 and the applicant’s attending doctor from that hospital. Having confirmed the gravity of the applicant’s condition, the doctor testified that the former needed permanent supervision of an urologist, oncologist and cardiologist and that there was clear evidence that his condition was deteriorating, particularly so that assistance provided to him in detention did not satisfy the required level of medical care established for such patients in Russia. In December 2009 doctors from the clinical hospital which had treated the applicant prior to his arrest wrote a letter to the head of the detention facility where the applicant was kept. The doctors noted serious negative changes in the applicant’s condition, in particular the relapse of urinary illnesses, made a list of recommendations for his examinations and treatment and proposed to perform necessary analysis in the hospital, as well as to examine the applicant by specialists from the hospital and prescribe necessary chemotherapy regimen. It appears that the proposal went unanswered. The applicant provided the Court with a long list of heart attacks, exhibitions of urinary complications he suffered, as well as other health problems he experienced from the first day of his arrest until the beginning of 2010. He also noted that his heart problems, including heart attacks which, during certain periods, he had at least once a week, had been addressed by a mere provision of nitroglycerine. His urinary problems were, as usual, solved by the introduction of a catheter. He continued complaining to the authorities of a severe pain in the back, in the kidney, or his having urinated up to 30 times per day. However, his complaints were left without any response. On 29 January 2010 an investigator dismissed the lawyers’ request for an authorisation of a forensic medical examination of the applicant. The investigator stressed that the applicant’s condition was satisfactory and that he received necessary medical assistance in detention and that therefore there was no need to authorise a forensic medical examination. On 19 March 2010 an investigator issued a decision, dismissing the lawyers’ complaints pertaining to the applicant’s health and their request for provision of the applicant’s complete medical record. The investigator noted that the applicant was under a dynamic medical supervision from the prison doctors of the medical unit of the detention facility, that he was also examined by specialists from other facilities and therefore he received necessary out-patient medical care. On 25 March 2010 the lawyers’ request for a medical examination of the applicant was dismissed because the investigator considered that the applicant was provided with the necessary medical care in the detention facility. From 28 to 30 April 2011 the applicant was surgically treated in the Urology Institute. He was sent back to the medical unit of the detention facility for post-surgical treatment of the complications related to the surgery. On 13 May 2011 doctors assessed his condition as moderately grave. Another medical examination in the Urology Institute was scheduled for 26 May 2011. The applicant also provided the Court with a copy of an expert opinion issued on 29 October 2011. Having assessed the applicant’s medical records, the expert concluded that the applicant experienced serious pains related to his underlying conditions and that additional examinations were necessary to determine the morphology of the syndrome. B.     Complaint(s) The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention.     4.     Application no. 2460/10 lodged on 4   December   2009 by Sergey Vladimirovich SILANTYEV who was born on 2   July   1970 and lived until his arrest in the town of Samara. He is serving his prison sentence in the medical colony in the Khabarovsk Region. A.     Facts 1.     Applicant’s health and the quality of medical assistance in detention The applicant was arrested in April 2009. Medical examinations, including an X-ray exam, did not reveal any pathology. On 6 May 2011 a regular X-ray examination showed changes in the applicant’s lungs. Less than two weeks later the applicant was sent to the medical colony for treatment, where he remains ever since. On 27 May 2011, following a number of examinations and tests, doctors diagnosed the applicant with infiltrative tuberculosis of the upper lobe of the left lung in the disintegration and insemination stage. He was placed on intensive regimen of chemotherapy with the first-line drugs. Given the negative dynamic in the treatment, the applicant was subjected to drug susceptibility testing which showed that his tuberculosis acquired multi-drug resistant form. The applicant was transferred onto another chemotherapy regime, comprising second-line drugs. In February 2012 doctors recorded a further deterioration of the applicant’s condition. The applicant, as follows from medical certificates provided by him, fully complied with the prescribed treatment. In April 2012 doctors again recorded an extremely negative development of the illness with the applicant having started exhibiting symptoms of intoxication. An extract from the medical history submitted by the applicant indicated that his treatment had been amended to take account of those negative developments. The applicant continued complaining of fatigue, dizziness, serious cough accompanied by sputum discharge. An X-ray examination performed in September 2012 showed a significant reduction of the applicant’s lung and its shadowing due to the infiltrative process and fibrosis. A medical certificate issued by the head of the medical colony indicated that the applicant’s condition was moderately grave in view of a further rapid development of the tuberculosis process. The applicant was in need of a lengthy, for no less than two years, treatment in a specialised tuberculosis hospital. The applicant also has only three teeth. He complains that he is unable to eat properly and that the authorities refuse to provide him with dentures. 2.     Conditions of detention in the medical colony In May 2011 the applicant was transferred to medical colony no. 2 in the Khabarovsk Region. The applicant argues that he is detained in extremely poor conditions having been forced to share a room of less than 20 square metres with 8 to 10 inmates. He complains about unsanitary conditions, poor lighting and ventilation and extremely poor quality of food. He stresses that those factors are particularly aggravating for an inmate in his condition, suffering from a serious form of pulmonary illness. B.     Complaint(s) The applicant complained, among other matters, under Articles 3 and 13 of the Convention about a lack of proper medical assistance in detention, conditions of detention in the medical colony and lack of an effective remedy for his complaints.     5.     Application no. 47236/11 lodged on 19 July 2011 by Eduard Arkadyevich NOVSELOV who was born on 14 November 1964 and lived before his arrest in the town of Oryol. A.     Facts 1.     Criminal proceedings On 6 June 2008 the applicant was arrested on suspicion of aggravated fraud. On 7 August 2008 his measure of restraint was amended and he was released under his own recognisance. By the judgment of 8 November 2010 of the Zavodskoy District Court of Oryol the applicant was convicted as charged and sentenced to three years of imprisonment. The applicant was remanded on the same day pending the appeal proceedings. On 21   January 2011 the Oryol Regional Court upheld the judgment on appeal. 2.     Applicant’s state of health The applicant had thyroid carcinoma. Prior to his detention he underwent radio-surgical treatment in the Federal Medical Radiological Scientific Health Institute. A letter sent to the applicant’s lawyer by the Director of the Institute on 12 January 2011 read, in so far as relevant: “The patient’s right lobe of thyroid gland was surgically removed in respect of papillary carcinoma up to 2 centimeters in diameter. A histological examination ... showed that [the patient had] encapsulated follicular type of papillary carcinoma of the thyroid gland with indications of invasive growth into its own capsule. [The applicant’s] life depends on daily, permanent intake of thyroxin in suppressive dosage, life-long supervision by an oncologist and endocrinologist which is possible in specialised medical facilities with necessary equipment to perform examinations of the level of thyroid hormones, thyroglobulin ... and thyroglobulin antibodies, to perform ultrasound examinations with expert level equipment, with a gamma-camera to examine the entire body with isotopes. This disease is grave. It is life-threatening for [the applicant]. [The applicant’s] state of health is aggravated by ischemic heart condition, hypertonic illness, osteoarthritis of knee, elbow and hand joints, and skin dermatitis. Interruptions in the intake of thyroxin and other drugs, conditions of detention, absence of dietary food, absence of prompt highly-qualified medical care in November-December 2010 has already led to the deterioration of [the applicant’s] health which can have irreversible effect. [The applicant] needs assessment and treatment in [the Institute] or any other medical facility which has analogical equipment.” In response to the applicant’s lawyer’s letters the head of the penitentiary service of the Oryol Region stated that neither of the detention facilities in the region could provide necessary treatment to the applicant as they did not have necessary equipment. He also informed the lawyer that the treatment which the applicant received was determined by the requirements of domestic law. The head of the Oryol Regional Health Department notified the lawyer that the necessary equipment was available in two regional hospitals. B.     Complaint(s) The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention.     6.     Application no. 3933/12 lodged on 23 December 2011 by Nikolay Petrovich PISKUNOV who was born on 2 August 1955 and lived before his arrest in Krasnoyarsk. He is serving his sentence of imprisonment in a correctional colony in the Krasnoyarsk Region. A.     Facts 1.     The state of the applicant’s health On 10 December 2010 the applicant was arrested on suspicion of having incited an attempted murder. On admission to the detention facility a prison doctor noted that the applicant suffered from third-degree hypertension with the illness having the critical nature and with blood pressure readings of 200/120 mmHg or higher. The history of the applicant’s condition went back to 2008 when he had had an ischemic stroke. The medical records also indicated that the applicant was under an increased risk of acute impairment of cerebral blood flow. He was placed under dynamic supervision. The applicant submitted that no medical care, save for infrequent visits from the prison doctor, had been provided to him in the detention facility. On 12 April 2011 the applicant received a letter from the acting head of the medical unit of the detention facility noting that the applicant’s condition called for the permanent control of his blood pressure and his being assigned specific drug therapy, including courses of vascular medicaments and nootropics twice a year. The applicant was also in need of in-patient examination and treatment. Two days later the applicant was sent to a tuberculosis prison hospital to receive treatment in respect of his pneumonia. The doctors also noted the applicant’s diagnosis of hypertension in an advanced stage and the first degree myopathy of both eyes. The applicant was released from the hospital on 19 May 2011 after his having been considered cured from pneumonia. On 19 May 2011 an expert medical commission issued a report noting that the applicant did not suffer from any medical condition warranting his release. The applicant submitted that the experts had never performed his examination in person and had only issued that conclusion upon a request from the investigating authorities to prevent his release from detention. In June 2011 the applicant’s condition deteriorated with his having suffered a hypertension attack. The prison doctor prescribed the applicant bed rest from 10 June to 19 July 2011. Another medical certificate issued in the detention facility on 20 October 2011 indicated that the applicant required dynamic supervision and treatment in respect of his hypertension. In the meantime, the applicant lodged a complaint with a court challenging the conclusions made by the experts in the report of 19   May 2011 as inaccurate and unsubstantiated. By the final judgment of 1 August 2012, the Krasnoyarsk Regional Court accepted the applicant’s complaint and declared null and void the expert report of 19 May 2011 because it was not based on any relevant medical evidence, including any proper medical examinations of the applicant. The court also noted that the applicant should be sent for another expert medical examination to determine whether he was fit to remain in custody. In the end of August 2012 the applicant’s lawyer complained to the head of the detention facility that his client was left without any medical assistance and that prison doctors had even refused to authorise bed rest to the applicant, despite his deteriorating health. In May 2013 the applicant complained to the director of the correctional colony that he had suffered from serious pains in the back and legs and that he started experiencing difficulties while walking or moving his legs. It appears that the applicant’s complaints went unanswered until January   2014 when he was sent for an MRI examination of the lumbosacral section of the spine and hip joints. As a result of the examination he was diagnosed with cancer of the prostate gland. The applicant submitted that despite the new life-threating diagnosis he continued being detained without any medical assistance. On 6 February 2014, in response to the applicant’s request for the application of interim measures under Rule 39 of the Rules of Court, the Court decided not to indicate to the Russian Government the interim measure sought and asked the parties, under Rule 54 § 4 (a) of the Rules of Court, to submit factual information regarding the applicant’s state of health and the quality of the medical care he received. Having relied on the expert report of 19 May 2011 the Government argued that the applicant did not suffer from any serious illness warranting his release and that he received complex and comprehensive medical care in respect of his diagnosis in detention. They stated that the detention facility and prison hospitals had necessary equipment and well-trained medical personnel. The Government also alleged that the applicant, in writing, refused admission to the oncology department of the prison hospital. They provided the Court with a handwritten copy of the applicant’s medical record with the majority of the entries barely legible. It appears that the record did not contain the applicant’s written refusal to undergo inpatient treatment in an oncology hospital. The applicant disputed the Government’s submissions having argued that he had not been offered treatment in relation to his oncological problems. He stressed that his placement in a tuberculosis hospital would not produce any positive effect as the hospital was not equipped to deal with an oncology patient or a patient suffering from a serious hypertension condition. He insisted that his relatives had provided him with the majority of necessary medicaments because the detention facilities had not had them, including painkillers without which he could not spend a day as he suffered from severe pains. The applicant also submitted a medical certificate issued by an oncologist who had examined him in the beginning of February 2014. The doctor, having confirmed the diagnosis of prostatic cancer, recommended the applicant’s outpatient symptomatic treatment and stage-related analgesic therapy. He also noted that the applicant may require prescription of narcotic analgesic with the unavoidable progress of the illness. 2.     Conditions of detention in the temporary detention facility After his arrest on 10 December 2010 until his transfer to a correctional colony on 8 October 2012, save for short periods of his stay in hospitals for in-patient treatment, the applicant was detained in detention facility no.1 in Krasnoyarsk. He provided the following description of the conditions of his detention: Cell no. Date: from Date: to Cell surface, m2 Number of sleeping places Number of inmates 55 10 December 2010 31 December 2010 18 7 7 174 1 January 2011 1 February 2011 24 10 11 190 1 February 2011 10 July 2011 16 6 6 185 10 July 2011 18 August 2011 24 10 10 86 18 August 2011 8 October 2012 16 4 4   The applicant insisted that he had been detained in extremely cramped conditions, with very limited personal space. He also submitted that he had had no privacy as a lavatory pan in a cell had been installed no more than two meters away from a sleeping place with only a small partition separating it from the remaining part of the cell. Inmates were allowed to take a shower once a week with the entire cell having been afforded no more than ten minutes. On a number of occasions there was no hot water in the facility and detainees had to take a shower with the freezing water. He also complained about short and infrequent outside walks in small recreation yards. The entire cell population was taken to a recreation yard measuring between 6 and 20 meters which also meant that inmates were left in overcrowded conditions even during those walks. Cells were dirty and in unsatisfactory sanitary condition. The applicant supported his description of the conditions with handwritten statements by two inmates who had shared a cell with him. 3.     Detention on remand On 10 December 2010 the Tsentralniy District Court of Krasnoyarsk authorised the applicant’s remand in custody in view of the gravity of the charges against him and the risk that the applicant could go on with his plan to commit murder if released. That decision was upheld on appeal on 21   December 2010. On a number of further occasions the Tsentralniy District Court and Zheleznodorozhniy District Court extended the applicant’s detention on remand, having each time linked the gravity of the charge against the applicant to his liability to abscond and obstruct justice. They also attributed particular weight to the fact that criminal proceedings had been instituted against the applicant on another occasion, having noted it as evidence for the applicant’s potential to re-offend. The courts did not find that his stable family situation, his having permanent place of work and residence and his poor health could outweigh the reasons calling for the applicant’s continued detention. Those detention orders were upheld on appeal with the Regional Court having each time endorsed the District courts’ reasoning. On 5 May 2012 The Tsentralniy District Court found the applicant guilty as charged and sentenced him to five years of imprisonment to be served in a correctional colony. On 4 September 2012 the Krasnoyarsk Regional Court upheld the conviction but decreased the sentence by two months. On an unspecified date the judgment of 5 May 2012 was amended with the applicant having been sent to serve his sentence in a colony settlement. B.     Complaint(s) The applicant complained, among other matters, under Article 3 of the Convention about a lack of proper medical assistance in detention and poor conditions of his detention on remand, under Article 5 § 3 of the Convention about the unreasonably lengthy detention on remand and under Article 13 of the Convention about the lack of domestic remedies to complain about a violation of his right to adequate medical care.     7.     Application no. 11823/12 lodged on 24 February 2012 by Anatoly Markovich ZAK who was born on 25 June 1973 and lived before his arrest in Perm. He is detained following conviction and sentence to imprisonment in the medical unit of a correctional colony in the Perm Region. The applicant is represented by Ms O. Sulimova and Mr P. Arsentyevich, lawyers practicing in Perm. A.     Facts The applicant was a co-owner of a nightclub in Perm, “Khromaya Loshad” (‘Lame Horse’) where a fire in December 2009 killed over 150 people and left dozens injured. Criminal proceedings were instituted on the same day on suspicion of a violation of fire safety regulations. The applicant was arrested on the following day. He remained in detention ever since, having been convicted, on 22 April 2013, and sentenced to almost ten years of imprisonment. The following account of the events is based on the information submitted by the parties in respect of the Court’s request under Rule 54 §   2   (a) of the Rules of Court. On admission to the temporary detention facility, the applicant was examined by a prison doctor. He did not make any health-related complaints. The facility administration received the applicant’s medical records which included, in particular:   - certificate no. 24044 issued by the admission department of Perm Clinical Hospital no. 4 of 7 December 2009, diagnosing the applicant with second-stage hypertension of third degree; chronic pancreatitis; asthenic syndrome. The certificate also indicated that there was no evidence of the applicant suffering from any acute cardiac pathology or being in need of in ‑ patient treatment; - an examination record issued on 8 December 2009 by the deputy chief of the Regional Hospital and diagnosing the applicant with second-stage hypertension of third degree; critical course of hyperkinetic syndrome; chronic pancreatitis. The deputy chief confirmed that the applicant was fit to remain in detention; - an examination record issued on 8 December 2009 by a neurologist and stating that the applicant did not have any acute neurologic disorder; - four electrocardiograms performed on 7 December 2009. On 14 December 2009 the applicant was examined by a prison doctor, who having again listed all the illnesses detected on previous examinations, amended them with 3-rd-degree obesity, noted the absence of any complaints on the applicant’s part and registered him for a dynamic medical supervision in the medical unit of the detention facility. On 24 December 2009 the applicant was transferred to detention facility no. IZ-99/1 in Moscow. On his return back to detention facility in Perm on 27 February 2010 he was examined by a prison physician who found his condition satisfactory. Subsequent regular medical examinations, performed at least once in few days, did not reveal any deviations. The applicant received treatment for his hypertension. On 2 June 2010 the applicant was consulted by a neurologist of the Regional prison hospital and was diagnosed with chronic headaches; neurotic condition resulting from the circumstantial situation; and apnoea of the compressive obstructive type. The doctor concluded that there was no ground to subject the applicant to apnoea treatment with a device normalising the breathing. Another examination performed by a cardiologist from the Regional prison hospital on the same day showed that the applicant suffered from second-stage hypertension of third degree; neurosis; psychogenic angina spuria; tension headaches, and dissomniya. The applicant remained under regular dynamic monitoring by prison doctors with no deterioration of his health having been recorded. According to the applicant, in November 2010 his condition sharply deteriorated. He started experiencing increasing pains in the stomach. The applicant submitted that he had not received proper treatment in respect of that episode due to an incorrect diagnosis. As follows from hospital records and the applicant’s medical history, on 16 December 2010 he complained of frequent and painful urination; he was taken under dynamic supervision of a p