'Adequacy' of jail operator's care for ill Border inmate might be focus for coroner

An inquest into his death has heard that book-keeper Peter John Gretton pressed a call bell in his Junee jail cell on January 2, 2019, just before 3am.

Prison guards rushed to his cell and were joined by a registered nurse, who promptly had him moved to an on-site clinic.

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"In our submission," counsel assisting Anne Horvath SC said on Monday, May 15, "it's not clear why at this point in time or at least 10 minutes later when the symptoms continued why an ambulance wasn't called at that point."

But an ambulance was not called until the decision was made by an on-call doctor at 7.07am.

The first day of a five-day inquest in Sydney, before coroner Derek Lee, heard that Mr Gretton, 60, had long-standing Type-2 diabetes as well as atrial-fibrillation, or an irregular heart beat.

He was diagnosed with Type 2 diabetes in 2010 and was prescribed oral medication.

Around the same time he got the atrial-fibrillation diagnosis, as well as one for hypertension.

Paramedics reached Mr Gretton, who was light-headed, feeling unwell and who complained of severe chest and abdominal pain, at 7.30am.

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The ambulance left for Wagga hospital at 8am, but en route he went into cardiac arrest. He was intubated and ventilated, with resuscitation efforts continuing until he arrived at the hospital just before 9am.

Blood tests revealed he had significant metabolic acidosis, or too much acid in his body.

Further, Ms Horvath said tests revealed Mr Gretton's kidneys "really weren't working. His cardiac function continued to deteriorate and despite all of the interventions, Mr Gretton suffered a fatal cardiac arrest just before 7pm," she said, in her opening address.

Mr Gretton was serving a term of two years and three months and died about 18 months before he would have been eligible for parole over a 12-year theft spree from his employer, the Jones Group, which operates the Siesta Hotel, Quality Hotel on Olive Street, and Quality Hotel in Wangaratta.

Ms Horvath said a doctor who cared for Mr Gretton at Wagga hospital the day he died "was troubled" by pathology that showed he had toxic levels of metformin - a medication used to control blood glucose or sugar levels in people with Type 2 diabetes - and significant renal impairment.

"The difficulty is that five weeks before Mr Gretton died ... his kidney function was essentially normal for his age."

Ms Horvath said evidence would be given that it was likely his kidney disease "advanced significantly in the week or so, possibly two weeks, before he died".

"But exactly why it did that is something that remains a bit of a mystery," she said.

His life began to fray at the edges a couple of decades earlier.

Mr Gretton had been working as an accountant for many years, but work got hard to find and keep in the late 1990s.

His adult life had entered a state of not being "entirely smooth", with his marriage - which produced three children - breaking down in 2000.

Ms Horvath said it was then that Mr Gretton began "drinking a bit too much, smoking a bit too much and gambling".

In 2001, she said, he began the hotel chain job that ultimately led to his downfall.

Ms Horvath outlined an almost decade-long history of poor health that exacerbated his descent into problem gambling.

She said issues the coroner would be asked to consider included the "adequacy" of medical care provided to Mr Gretton by NSW Justice Health and prison operator The GEO Group Australia between the time of his incarceration in May until October 31, 2018.

That also applied to the medical care provided to him as an inmate between November 1, 2018, and January 2, 2019, plus the adequacy of GEO's response to his "acute presentation" on the day he died.

Ms Horvath said the pathology collection processes at both the Junee and Mannus jails could be closely examined.

The coroner could also make a decision, she said, as to "whether it's necessary or desirable to make any recommendations in relation to any matter connected with Mr Gretton's death".

The inquest continues.

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