THE CASE OF G.CH. According to G.Ch., on 2 July 2016, he was placed in a de-escalation room in penitentiary establishment no. 6. According to G.Ch., this was not the first occasion of him being placed in the de-escalation room.291 The prisoner stated that for several days before being placed in the de-escalation room and during the stay in this room, he unsuccessfully requested for a doctor and a social worker. Three days after the return from the de-escalation room, G.Ch. became unwell and lost consciousness. The medical personnel administered emergency medical aid and the patient regained consciousness. G.Ch. told the medical personnel that he experienced shortness of breath and pains in the chest. The representative of the Public Defender of Georgia examined the medical record of the patient and established that, on 8 August 2016, the convict was visited by the primary health-care unit’s doctor and failed to give an accurate diagnosis. The doctor symptomatically administered Sol. Ketzi 1.0 ml, Sol. Drotaverini 2.0, scheduled an x-ray examination of the chest and a general blood test. On 9 August 2016, the patient received a surgeon’s consultation; the patient again complained about shortness of breath and chest pain. The surgeon did not give a diagnosis, instead he recommended to the patient to consult a cardiologist and a general practitioner. On 11 August 2016, in accordance with the planned procedure, the convict was brought to medical establishment no. 18 of the Penitentiary Department of the Ministry of Corrections to undergo white line hernia operation.292 At the same establishment, the patient underwent pre-surgery examination which established the presence of left-side spontaneous pneumothorax  293 J93.0 and bullous emphysema294 (both lungs) J43.9. Therefore, the patient did not undergo the planned white line hernia operation and was transferred promptly to the academician O.Ghudushauri National Medical Centre, where G.Ch. underwent the surgical procedure called left pleural effusion drainage. After the procedure, G.Ch. was placed in the general surgical unit and was discharged on 14 august 2016. According to the medical form NIV-100 issued by the academician O.Ghudushauri National Medical Centre on 14 August 2016, the patient was recommended to abstain from 291 There is no sensor insulation in this room; sufficient natural or artificial ventilation is absent. The floor is made of concrete and covered with a thin layer of raw rubber. There is dampness in the room. The toilet area is not separated from the rest of the space and the sink is installed almost in the middle of the room. Besides, the room is equipped with video surveillance covering the sink and the adjacent area. The tap in the cell is out of order and water is constantly running. The convict was not provided with a mattress, a blanket, toilet paper, tooth paste and a toothbrush, soap or other staples. 292 Letter no. 81600753850 of the Medical Department of the Ministry of Corrections of Georgia, dated 5 September 2016. 293 Characterised by abnormal accumulation of air in the space between the lungs and the chest cavity that can result in the partial or complete collapse of a lung. The air re-entering the pleural cavity causes the formation of stretched (ventilated) pneumothorax, which causes the massive lung collapse and shifting the mediastinum and compromising hemodynamic stability. The signs and symptoms are the following: without the presence of underlying lung disease acute onset of chest pain and shortness of breath, cyanosis, tachycardia, possible decrease of arterial blood pressure, on percussion - hyperresonant sounds, breathing sounds are weakened or absent See at: http://www.medgeo.net/2009/07/12/spontaneous_pneumothorax/ [Last visited on 23.03.2017]. 294 Bullous emphysema is a chronic obstructive pulmonary disease characterised by damaged alveoli that distend to form exceptionally large air spaces, especially within the uppermost portions of the lungs.  See at: https://www.medgeo.net/2009/06/22/emphysema/ [last visited on23.03.2017]. NATIONAL PREVENTIVE MECHANISM (NPM), 2016 135