Christopher Howarth died in custody due to natural causes, coroner rules

The Reverend Christopher Howarth, who was convicted of 26 offences against two boys in 2015, died on March 10 last year in hospital in Brighton of multiple organ failure.

The 72-year-old from Uckfield was serving a ten-year prison sentence at HMP Lewes, and had long-term health problems linked to his morbidly high body mass index, including type 2 diabetes, heart failure and chronic kidney disease.

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At the inquest into his death, which concluded yesterday at Sussex County Cricket Ground, the court heard there had been "difficulties" at Lewes Prison during part of the time Mr Howarth was an inmate, and it had been put in special measures in 2017.

Christopher Howarth was convicted of 26 offences in 2015

An investigation was carried out by the Prison and Probation Ombudsman (PPO) following his death.

An initial report written by Nicola Annon at the PPO stated the care Mr Howarth received while in custody was equivalent to care he otherwise would have received in the community.

Speaking at the inquest, Mr Howarth's wife Vivien said she disagreed with the report's findings.

She criticised the prison service for not replacing a CPAP machine which helped Mr Howarth to breathe at night when it broke in August 2019, as he suffered with a condition called obstructive sleep apnoea.

She said: "It had stopped working completely and Chris was in a terrible state.

"Lewes Prison did not do anything about it. We went up to the Victoria Hospital in East Grinstead to get a replacement."

Jonathan Bibby, head of safety and equalities at HMP Lewes, pointed to notes which showed the prison was in discussion with the sleep apnoea clinic at the Princess Royal Hospital and had requested a new machine, six days after the original one had broken.

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Senior coroner Veronica Hamilton-Deeley said it was "not ideal" the machine could not be replaced immediately.

She said: "He must have been uncomfortable during that time as with sleep apnoea you’re usually woken up with dreadful gasps as you can stop breathing.

“It’s clear Lewes Prison was chasing it, even though Mrs Howarth eventually got one. I'm satisfied the slight delay neither caused his death nor contributed to it."

HMP Lewes

Mr Howarth had been taken to hospital on Christmas Day in 2019 and was treated for a new cellulitis skin infection.

He was discharged on February 17, but the prison service failed to issue his usual medication that evening and the following morning, the court heard, three weeks before his death.

Mrs Howarth told the court her husband said a discharge note had been provided and he was left "very distressed and in an awful lot of pain" without his prescribed medication.

Mr Bibby said the prison had set up a multi disciplinary team in March last year to ensure communication between nurses and GPs at the prison healthcare department, which is now run by a new provider, Practice Plus Group Health and Rehabilitation Services Limited.

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The coroner said the missed doses had not contributed to Mr Howarth's death in hospital three weeks later, but said it highlighted an important point and that a patient's discharge care "should be seamless".

Christopher Howarth outside Hove Crown Court

She said: "A discharge summary was not supplied, or it was supplied and got mislaid.

"The lack of medication was neither causative or contributory to Mr Howarth's death.

"I'm satisfied at what has been put in place to ensure the provision and safe keeping of discharge summaries."

Mr Howarth was readmitted to hospital on February 19 after another flare-up of cellulitis, and his overall health deteriorated.

The coroner gave his cause of death as multiple organ failure and listed several conditions as significant contributors, including type 2 diabetes, a morbidly high body mass index and hypertension.

She said: "The main problem was his heart failure, and a new cellulitis which was found to be intractable to treatment.

"My conclusion is he died from natural causes.

"I find nothing from the evidence I've heard to suggest systems were so deficient to have caused or contributed to Christopher's death."