Confidential MedTech clinical records from 2025 reveal a deeply concerning picture of medical care provided to a high-risk prisoner inside New Zealand’s corrections system — including prolonged interruptions to essential medication, refusal of sleep treatment, and a serious injury that went unassessed for days.

The records relate to Patrick Allan Thomas, a 44-year-old man with a documented history of saddle pulmonary embolism, obstructive sleep apnoea, bipolar type II disorder, depression, anxiety, chronic insomnia, and a known adverse reaction to general anaesthesia. During 2025, he was held across Rimutaka and Whanganui prisons, relying entirely on prison health services for life-preserving care.

Classified as Priority 1
On reception into custody, Mr Thomas was assessed as Priority 1 – Immediate Health Need, reflecting the severity of his medical profile. His history placed him at high risk of sudden deterioration or death if treatment continuity failed.

MedTech intake documentation notes that medical management for Mr Thomas was assumed by prison health services upon reception into custody.

Despite this classification, the records show that continuity of care repeatedly broke down.

Seven days with Pradaxa at Whanganui
While at Whanganui Prison, Mr Thomas had access to his anticoagulant medication, dabigatran (Pradaxa), for only seven days. Dabigatran is prescribed to prevent recurrence of pulmonary embolism — a condition that can be rapidly fatal.

Clinical notes acknowledge uncertainty about prescribing history but explicitly record that continuing anticoagulation was safer than stopping it, given the severity of his embolic history.

For patients with a previous saddle pulmonary embolism, interruption of anticoagulation carries a documented risk of clot recurrence, stroke, or sudden death.

Forty-seven days without escitalopram
At the same time, the records show that Mr Thomas went 47 days without escitalopram, a medication used to stabilise mood and manage depression and anxiety.

Abrupt or prolonged cessation of antidepressant medication is associated with withdrawal symptoms, mood destabilisation, increased suicidality, agitation, and impaired judgment — risks that are amplified in custodial environments and in individuals with bipolar disorder.

This prolonged gap occurred alongside untreated insomnia and sleep apnoea, compounding both psychological and physiological stress.

Sleeping medication refused despite known sleep disorder
The records further document that Mr Thomas was refused sleeping medication, despite a known diagnosis of obstructive sleep apnoea and chronic insomnia.

He repeatedly reported severe sleep deprivation and episodes of stopped breathing during sleep. Untreated sleep apnoea is associated with hypoxia, cardiac arrhythmia, stroke, and sudden cardiac death, particularly in patients with existing cardiovascular disease.

There is no evidence in the MedTech records that a CPAP machine was provided during incarceration, nor that interim clinical safeguards were implemented.

A serious fall — and no assessment for seven days
The records also describe a major accident in which Mr Thomas fell from a prison bunk, sustaining injury. Despite the mechanism of injury and his high-risk medical status — including anticoagulant use, which increases bleeding risk — he was not clinically assessed for seven days following the fall.

For patients on anticoagulation therapy, falls carry a heightened risk of internal bleeding, intracranial haemorrhage, and delayed complications, conditions that typically warrant prompt medical evaluation.

The absence of timely assessment represents a significant departure from standard risk-based medical response.

Repeated transfers, fragmented care
Across his time in custody, Mr Thomas was transferred between facilities, with MedTech records physically couriered and later archived and reactivated following release and re-reception.

Each transfer increased reliance on administrative processes to maintain continuity of care. The records do not show evidence of a single clinician or service retaining overarching responsibility for coordinating his complex medical needs.

Mental health distress and escalation indicators
Alongside physical illness, the records document ongoing mental health distress. The MedTech system includes a Moderate Clinical Alert noting that Mr Thomas had made a written threat toward medical staff if not seen within a specified timeframe — an indicator of escalating distress rather than isolated behavioural risk.

Despite this alert, the records do not document a coordinated forensic mental health assessment, crisis intervention, or multidisciplinary care plan.

A pattern, not an anomaly
Taken together, the MedTech records do not point to a single error. They describe a pattern of systemic vulnerability, where a medically fragile individual experienced prolonged medication gaps, untreated respiratory risk, delayed injury assessment, and fragmented care across institutions.

Corrections policy emphasises equivalence of healthcare with the community. These records raise serious questions about whether that standard was met when a prisoner’s survival depended on uninterrupted anticoagulation, stabilising psychiatric medication, adequate sleep, and timely response to injury.

This is not simply one person’s experience.

It is a case study in how institutional systems can allow foreseeable, life-threatening risk to persist — quietly, and repeatedly — behind prison walls.

Pursuant to the Official Information Act 1982, I request the following information relating to the healthcare and clinical management of Patrick Allan Thomas during periods in custody at Rimutaka Prison and Whanganui Prison in 2025.

I request full, unredacted copies of the following (inclusive of electronic records, clinical notes, assessments, correspondence, policies, protocols, and internal communications):

1. Clinical and Healthcare Records
1.1. All MedTech (or equivalent clinical record system) entries for Patrick Allan Thomas from 1 January 2025 to 31 December 2025, including:
 • Medication orders, refusals, reviews and discontinuations
 • Diagnostics, risk assessments, and referral records
 • Mental health assessments and clinical alerts
 • Sleep disorder/CPAP assessments and any equipment provision records

1.2. All nursing and medical progress notes relating to Mr Thomas, including observations, clinical assessments, and responses to patient requests.

1.3. Records of any clinical risk assessments associated with anticoagulation (e.g., dabigatran/Pradaxa), mental health, sleep apnoea, and post‑fall care.

1.4. All documentation indicating reasons for withholding or refusing prescribed medications (including escitalopram and sleeping medications) and instructions from senior clinicians or managers.

2. Adverse Events, Complaints, and Incident Records
2.1. All incident reports, adverse event notifications, and internal notifications regarding falls, injuries, or other clinical safety events involving Mr Thomas.
2.2. All complaints, concerns, or grievances submitted by Mr Thomas or on his behalf in 2025.
2.3. All responses to, evaluations of, and actions taken in relation to expressed patient complaints or grievances.

3. Transfers, Handover Documentation, and Continuity of Care
3.1. All transfer summaries, handover notes, and clinical continuity documents relating to movements between Rimutaka and Whanganui prisons involving Mr Thomas.
3.2. All correspondence between Corrections health services and external providers regarding his medical care.

4. Policies, Protocols, and Standards
4.1. Copies of all relevant healthcare policies, clinical guidelines, and standard operating procedures in force during 2025 governing:
 • Anticoagulation management in prisoners
 • Mental health risk assessment and escalation
 • Sleep disorder assessment and management in custody
 • Clinical response timelines following falls or injuries
 • Medication continuity when entering, transferring, or leaving prisons

4.2. Any internal audits, reviews, or quality assurance documents related to clinical care at Rimutaka and Whanganui prisons (2023–2025).

5. Communications
5.1. All internal communications, including email and memoranda, that discuss clinical care, risk, medication continuity, escalation of care, or policy interpretation regarding Mr Thomas.

5.2. All communications between the Department of Corrections and Te Whatu Ora regarding the healthcare management of prisoners with complex medical needs, specifically in 2025.

6. Risk and Safety Reports
6.1. All clinical risk registers, serious incident reports, sentinel event reports, and corrective action plans involving Mr Thomas.

7. Expert Reviews
7.1. Any external or internal clinical reviews, second opinions, or expert evaluations commissioned in 2025 concerning Mr Thomas’s clinical care.

Form of Response
To assist public understanding, please provide:
✔ Electronic copies (searchable PDFs) of all relevant records.
✔ A table of contents/index identifying volumes of documents, dates, authors, recipients, and document type.
✔ Redactions only where required by law, with a clear statutory justification under the OIA.

If portions of the request are refused, please:
• Apply section references under the OIA for each refusal;
• Provide the names and titles of staff responsible for decisions;
• Provide a reasonable timeframe for release of any withheld material.