issued by the Registrar of the Court  
ECHR 214 (2019)  
11.06.2019  
Death of applicant’s brother in hospital and accusations of ill-treatment  
were not properly investigated  
The case Prizreni v. Albania (application no. 29309/16) concerned the death and alleged  
ill-treatment of the applicant’s brother in hospital after his transfer there from prison.  
In today’s Chamber judgment1 in the case the European Court of Human Rights held, unanimously,  
that there had been:  
a violation of the procedural limb of Article 2 (right to life) of the European Convention on Human  
Rights owing to the lack of an effective investigation into the applicant’s brother’s death in hospital,  
and,  
no violation of the substantive limb of Article 3 (prohibition of torture), and,  
a violation of the procedural limb of Article 3 (prohibition of torture) owing to the lack of a proper  
investigation into the applicant’s arguable claims that his brother had been ill-treated.  
The Court found in particular that the authorities had never conducted an effective investigation to  
properly establish the cause of death and whether any negligence or ill-treatment had been  
involved. A forensic medical report had raised questions which the authorities had not attempted to  
answer while the applicant had been barred by statute from complaining about the prosecution  
decision not to institute criminal proceedings over the incident.  
Principal facts  
The applicant, Fatos Prizreni, is an Albanian national who was born in 1963 and lives in Elbasan  
(Albania).  
In February 2011, the applicant’s brother, Sh.P., was transferred from Lezhë detention facility to a  
hospital. The applicant went to visit his brother on 22 February 2011, but found that he had died  
that day. It appears from the hospital file that Sh.P. had been diagnosed with elephantiasis, morbid  
obesity and multi-organ insufficiency, and had been prescribed medication.  
The authorities began to investigate the death on the day he passed away, carrying out an on-site  
examination and later questioning hospital doctors. The doctors stated that he had been treated like  
any other patient and given treatment in accordance with the rules. The applicant told investigators  
that during an earlier visit he had found his brother unconscious and tied to the bed with sheets.  
A post-mortem forensic report found no trace of medication in Sh.P.’s blood, noted bruising on both  
forearms and gave the cause of death as acute cardio-respiratory insufficiency. It left the question of  
any negligent medical treatment to another forensic medical commission.  
The Tirana prosecutor’s office decided in April 2011 against bringing criminal proceedings, citing the  
forensic report and the fact that it had found no evidence of an offence. The applicant complained  
about that decision but his case was rejected at all levels, including the Constitutional Court in 2015.  
1. Under Articles 43 and 44 of the Convention, this Chamber judgment is not final. During the three-month period following its delivery,  
any party may request that the case be referred to the Grand Chamber of the Court. If such a request is made, a panel of five judges  
considers whether the case deserves further examination. In that event, the Grand Chamber will hear the case and deliver a final  
judgment. If the referral request is refused, the Chamber judgment will become final on that day.  
Once a judgment becomes final, it is transmitted to the Committee of Ministers of the Council of Europe for supervision of its execution.  
Further information about the execution process can be found here: www.coe.int/t/dghl/monitoring/execution.  
The courts found in particular that he did not have legal standing and that under domestic law only  
people who had reported an offence could complain about a decision not to institute criminal  
proceedings.  
Complaints, procedure and composition of the Court  
Relying on Article 2 (right to life) of the European Convention on Human Rights, the applicant  
complained that there had been no effective investigation into his brother’s death.  
He also complained that his brother had been treated in hospital in a way that was contrary to  
Article 3 (prohibition of torture and inhuman treatment). In particular, he alleged that he had found  
his brother tied to his bed with sheets while unconscious, that the marks on his brother’s wrists had  
raised serious suspicions that he had been handcuffed while at the hospital, and that his brother had  
not received proper medical treatment. He also raised a complaint under Article 13 (right to an  
effective remedy) in conjunction with Article 2 and Article 3.  
The application was lodged with the European Court of Human Rights on 16 May 2016.  
Judgment was given by a Chamber of seven judges, composed as follows:  
Robert Spano (Iceland), President,  
Marko Bošnjak (Slovenia),  
Işıl Karakaş (Turkey),  
Julia Laffranque (Estonia),  
Valeriu Griţco (the Republic of Moldova),  
Arnfinn Bårdsen (Norway),  
Darian Pavli (Albania),  
and also Stanley Naismith, Section Registrar.  
Decision of the Court  
Article 2  
The applicant submitted that the investigation had failed to provide a satisfactory explanation about  
the circumstances surrounding his brother’s death. In particular it had not excluded beyond any  
reasonable doubt that the health issues described in the medical report, which had included  
observations of bruises on the body and forearms, had not been caused by ill-treatment or a lack of  
appropriate medical care. The Government rejected those arguments.  
The Court first dealt with an objection by the Government that Mr Prizreni had been too passive,  
failing to report the case to the prosecutor’s office. However, it noted that under its case-law  
authorities must act of their own motion once a matter has come to their attention. It was therefore  
immaterial whether Mr Prizreni had himself been active in involving the investigating authorities.  
The Court noted that the investigation had started promptly, on the day Mr Prizreni’s brother had  
died. However, an inconsistency had emerged as the forensic report had found no traces of drugs in  
Sh.P.’s blood, while the hospital file stated that he had been treated with medication.  
The question of whether he had been receiving drugs for his condition or not was never clarified and  
the Court was not satisfied that it had been established beyond a reasonable doubt that Sh.P.’s  
death had been caused by his illnesses or inadequate treatment and care.  
The investigation had not addressed the applicant’s allegations about his brother being handcuffed  
while in hospital and whether that had contributed to his death. Furthermore, the prosecution  
decision not to pursue the case had been based on the inconclusive forensic examination.  
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The Court stressed the importance of involving relatives in investigations into the death of a member  
of their family, in particular to ensure that their interests were properly protected, which could be in  
conflict with those of the police or the security forces. Mr Prizreni, however, had been barred by  
statute from making an effective challenge to the prosecutor’s decision against opening criminal  
proceedings. That was inconsistent with the State’s obligation to conduct an effective investigation.  
The Court held that the authorities had failed to carry out an adequate and effective investigation  
into the circumstances of the applicant’s brother’s death and there had been a breach of the State’s  
procedural obligation under Article 2 to protect the right to life.  
Article 3  
Mr Prizreni’s complaint of ill-treatment was based on his finding his unconscious brother tied to his  
hospital bed with sheets, the possibility that he had been handcuffed while in hospital and the  
question mark over his medical treatment raised by the forensic examination. The Government  
disputed the applicant’s submissions.  
The Court found that Mr Prizreni had raised an arguable claim that his brother had been ill-treated in  
hospital in a way that was contrary to Article 3, triggering an obligation on the authorities to  
investigate. The authorities had never provided any explanation for the bruises found on his  
brother’s body and had never questioned any prison police officer or hospital personnel specifically  
on this issue.  
Handcuffing, in particular if carried out in connection with lawful detention, did not normally give  
rise to an issue under this Article. The forensic medical report had mentioned the existence of marks  
on the body that could have been caused by the impact of a blunt object, but no further  
investigation had been carried out. The Court concluded that it could not establish whether there  
had been a violation of the substantive limb of Article 3.  
On the other hand, the Court found that it was clear that the authorities had failed to carry out an  
effective investigation to establish whether Mr Prizreni’s brother had been subjected to ill-treatment  
while in custody and there had thus been a violation of Article 3 under its procedural limb.  
Other Articles  
Given its findings under Article 2 and Article 3 the Court decided that it did not need to examine the  
complaints separately under Article 13 of the Convention.  
Just satisfaction (Article 41)  
The Court held that Albania was to pay the applicant 12,000 euros (EUR) in respect of non-pecuniary  
damage and EUR 1,450 in respect of costs and expenses.  
The judgment is available only in English.  
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The European Court of Human Rights was set up in Strasbourg by the Council of Europe Member  
States in 1959 to deal with alleged violations of the 1950 European Convention on Human Rights.  
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