Doctor faces manslaughter charge over custody death Andrzej Rymarzak was found dead in a cell after being examined by Dr Hisham El-Baroudy, the court heard. Photograph: Charles O'Rear/Corbis A doctor called to assess an unconscious and intoxicated man who later died in police custody has been accused of manslaughter and "gross negligence" after spending just one minute examining him, a court heard. Dr Hisham El-Baroudy, 56, believed Andrzej Rymarzak, 43, who had been diagnosed with epilepsy, schizophrenia and had suffered a head wound during arrest, was "sleeping" and failed to carry out a detailed examination. Rymarzak, originally from Poland who was homeless, was found dead in a cell at Chelsea police station three hours after Baroudy declared him fit to be detained. Baroudy, 56, denies the manslaughter of Rymarzak, who died of alcohol and opiate intoxication in the early hours of 22 January 2009. Alex Bailin QC, prosecuting, told Southwark crown court: "The prosecution allege that the defendant's examination of the deceased was grossly negligent. In particular the defendant failed to diagnose that the deceased's condition amounted to a medical emergency and required immediate medical intervention. If appropriate medical intervention had taken place the deceased would not have died. Rymarzak, was known to social services as a heavy drinker and had complained about "fits and seizures." He had previously been treated for an overdose at Charing Cross hospital after his marriage broke down. At about 8pm on 21 January 2009 a passerby found him collapsed, unresponsive and convulsing on the pavement in Old Brompton Road and called an ambulance. When paramedics arrived Rymarzak "took a swing" at one as they tried to help him to his feet and a bottle of cider fell out from under his coat. Police were called and as they tried to move him he again took a swing and fell down, cutting his forehead on the pavement. Paramedics bandaged the wound at the scene. At the police station he continued to be aggressive and "officers were called upon to restrain him," said Bailin. Heroin and unlabelled medication was found in his rucksack. In view of his condition and head wound, 15-minute checks were ordered to be carried out through the cell door, and Baroudy was called. Baroudy, who qualified as a doctor in Egypt in 1978 and moved to the UK to originally work as a gynaecologist in 1980, was working shifts for an agency as a forensic medical examiner to be called out when required by police. Rymarzak had been put in the recovery position in the cell and was unconscious when Baroudy came to examine him, said Bailin. The jury were shown CCTV of Baroudy examining Rymarzak. The defendant went into the police cell at 11.24pm. He spent just under one minute in the cell. He shouted the deceased's name . He asked 'Can you hear me?' and got no response," Bailin told the jury. He observed the deceased for about 30 seconds during which time he appeared to lean down and touch the deceased. He said throughout this a police sergeant stood in the cell doorway. The defendant left the cell having examined the deceased for about one minute. He said: "Well, I wouldn't say he is not fit for detention but obviously, he is not fit for interview." There was some laughter," said Bailin. In the forensic medical examiner records Baroudy said he had spent 15 minutes with Rymarzak. Rymarzak was found dead in his cell three hours later at 2.30am. The jury was told a postmortem concluded death was due to alcohol and opiate intoxication. The pathologist said Baroudy's examination was "cursory" and there was no evidence of him examining blood pressure, or using a torch to check Rymarzak's pupils. Experts told the court that the fact Rymarzak was unconscious should have been treated as "an acute medical emergency" and that Baroudy's lack of detailed examination and assessment failed to diagnose "his ultimately fatal intoxicated state." Accident and emergency said there was a chance of treating him if he had been taken to hospital immediately. The bandaged head should have "triggered an alarm" said Bailin. Baroudy later told police in interviews that he believed Rymarzak was "asleep rather than unconscious" because of his regular respiratory pattern, and he believed the bandage was "part of his clothing." He said he was not told about Rymarzak's use of drugs. During the interview he said: "It was a case I see all the time in custody. I did not see any significant injury to manage or treat. The prosecution alleges Baroudy owed Rymarzak a duty of care and was grossly negligent. By his inadequate examination of his patient he breached that duty of care, and that breach caused the deceased's death.