Otago Corrections Facility "failed in it's structure, communication and leadership" the weekend a prison died in an 'at risk unit' while on remand, an inquest has heard.
Detective Senior Sergeant Colin Blackie gave evidence at the Coroner's inquest into Jai Davis' death in Dunedin today.
In early February 2011, intelligence officers intercepted prison phone calls, and knew Davis was likely to try to smuggle in drugs internally.
When Davis arrived at prison, he bypassed the usual reception office, and was taken directly to a special 'dry room' with no running water, toilet or washing facilities. He was put in a prison 'suicide gown'.
Davis stayed in that room for three days. By the morning of the fourth day, he had died of a drug overdose.
The court heard that it's believed Davis had marijuana in a small plastic bag and prescription pills (dubbed 'candy') in a plastic bottle inserted in his rectum.
Although he was questioned many times about concealing drugs, he constantly denied it.
While under 15 minute observations, CCTV footage showed that an officer did not check Davis on the night he died, despite claiming that he had.
When Davis was found dead at 5am on his fourth day in the cell, an empty plastic pill box was found in the room.
DSS Blackie said Davis should not have died in that prison. He said Davis deserved the care that he could not access of his own accord.
DSS Blackie said the prison was dysfunctional over the few days Davis was there. He said there was systemic failure by certain people and certain work groups, and no one is standing up to be accountable for Davis' care.
Despite DSS Blackie's investigation, no one was ever charged over Davis' death. Sixty witnesses will be called for the inquest which is expected to last for two weeks.