FOURTH SECTION
CASE OF SHIRKHANYAN v. ARMENIA
(Application no. 54547/16)
 
 
JUDGMENT
 
Art 13 (+ Art 3) • Art 3 (substantive) • Degrading treatment • Inadequate medical care, assistance and opportunity for outdoor exercise for detainee with health issues • No effective domestic remedy
Art 5 § 3 • Reasonableness of pre-trial detention • Failure to provide relevant and sufficient reasons when ordering and extending detention
Art 34 • Hinder the exercise of the right of petition • Authorities’ refusal to allow private meetings between applicant and his Court representatives • Alleged non-compliance with interim measure for immediate provision of adequate medical assistance not substantiated

 
STRASBOURG
22 February 2022
 
FINAL
 
22/05/2022
 
This judgment has become final under Article 44 § 2 of the Convention. It may be subject to editorial revision. In the case of Shirkhanyan v. Armenia,
The European Court of Human Rights (Fourth Section), sitting as a Chamber composed of:
 Yonko Grozev, President,
 Tim Eicke,
 Armen Harutyunyan,
 Gabriele Kucsko-Stadlmayer,
 Pere Pastor Vilanova,
 Jolien Schukking,
 Iulia Antoanella Motoc, judges,
and Ilse Freiwirth, Deputy Section Registrar,
Having regard to:
the application (no. 54547/16) against the Republic of Armenia lodged with the Court under Article 34 of the Convention for the Protection of Human Rights and Fundamental Freedoms (“the Convention”) by an Armenian national, Mr Vahan Shirkhanyan (“the applicant”), on 16  September 2016;
the decision to give notice of the application to the Armenian Government (“the Government”);
the decision of 16 November 2016 to grant priority treatment to the application under Rule 41 of the Rules of Court;
the decision of 9 November 2017 to indicate an interim measure to the respondent Government under Rule 39 of the Rules of Court;
the decision of 11 December 2018 to lift the interim measure indicated to the respondent Government under Rule 39 of the Rules of Court;
the parties’ observations;
Having deliberated in private on 1 February 2022,
Delivers the following judgment, which was adopted on that date:
INTRODUCTION
1. The case concerns the applicant’s complaints that the authorities failed to provide him with adequate medical treatment and care while in detention, that his pre-trial detention was not based on “relevant” and “sufficient” reasons, and that he was denied private meetings with his representatives before the Court. He also complained of the lack of effective remedies in relation to his complaints concerning the lack of requisite treatment and care in detention. The applicant relied on Articles 3, 5 § 3, 13 and 34 of the Convention. THE FACTS
2. The applicant was born in 1947 and lives in Yerevan. He was represented by Ms A. Maralyan and Ms K. Moskalenko, lawyers practising in Strasbourg. 3. The Government were represented by their Agent, Mr G. Kostanyan, and subsequently by Mr Y. Kirakosyan, Representative of the Republic of Armenia before the European Court of Human Rights. 4. The facts of the case, as submitted by the parties, may be summarised as follows. 5. The applicant was the Deputy Minister of Defence for Armenia from 1995 to 1999. He formerly held other high-ranking positions in the Armenian Government. 6. Prior to being remanded in custody the applicant had undergone two operations. In May 2013 two veins had been removed from his right leg in V. Avagyan Medical Centre and in spring 2015 he had undergone surgery on his kidney. The applicant also had arterial problems in his left leg. The applicant’s arrest and detention
7. On 24 November 2015 the National Security Service (“the NSS”) arrested an armed group in Yerevan. On the same date the NSS instituted criminal proceedings against A.V. for having allegedly formed and led a criminal organisation. 8. On 19 December 2015 the applicant was arrested by NSS officers on suspicion of participating in said criminal organisation. 9. On the same date the applicant was questioned as a suspect and stated, inter alia, that he had become acquainted with A.V. when, at some point, the latter was introduced to him by a mutual acquaintance. He categorically denied having known anything about A.V.’s alleged criminal activity. 10. On 21 December 2015 the applicant was charged under Article 223 § 2 of the Criminal Code (participation in a criminal organisation). 11. On the same date the investigator submitted a request before the Kentron and Nork‑Marash District Court of Yerevan (“the District Court”) seeking to have the applicant detained for a period of two months on the grounds that he might abscond and obstruct the investigation. The request also referred to the nature and gravity of the charges. 12. Later on the same date, at the hearing before the District Court, the applicant argued that no evidence had been produced to substantiate that there were grounds to believe that he would hide from the investigating authority. He had been at liberty for about a month after the discovery of the criminal organisation at issue and had had every possibility to go into hiding. Moreover, he had described the circumstances in which he had come to know the other accused in the case and he also had health problems and a permanent place of residence. 13. By a decision of the same date the District Court decided to allow the investigator’s application, finding that the circumstances of the case and the evidence obtained provided sufficient reasons to believe that, if the applicant remained at large, he could obstruct the proceedings. 14. On the same date the applicant was admitted to Yerevan-Kentron detention facility. 15. On 25 December 2015 the applicant lodged an appeal against the detention order of 21 December 2015 (see paragraph 13 above). 16. By a decision of 22 January 2016 the Criminal Court of Appeal (“the Court of Appeal”) upheld the decision of 21 December 2015 (see paragraph 13 above). 17. On 9 February the investigator sought a two-month extension of the applicant’s detention on the ground that it was necessary to continue the investigation and to conduct interviews, confrontations and examinations. 18. On 14 February 2016 the District Court decided to extend the applicant’s pre-trial detention by two months on the same grounds as those stated in its decision of 21 December 2015 (see paragraph 13 above) and with reference to the reasons stated in the investigator’s request (see paragraph 17 above). 19. The applicant lodged an appeal, which was rejected by the Court of Appeal on 12 March 2016. 20. On 6 April 2016 the applicant lodged an appeal on points of law against the decision of the Court of Appeal of 12 March 2016. 21. The investigator applied for extensions of the applicant’s pre-trial detention at two-month intervals. Those applications were granted by the District Court on 13 April, 14 June, 11 August and 12 October 2016 on the grounds that he could obstruct the investigation, hide from the investigating authority and evade criminal liability. The applicant’s appeals to the Court of Appeal and his further appeals to the Court of Cassation remained unsuccessful. 22. On 21 October 2016 Judge A. of the District Court took over the case. 23. On 24 November 2016 Judge A. made a decision to set the case down for trial whereby he decided, inter alia, to leave the applicant’s preventive measure unchanged stating that it continued to be necessary. The applicant’s appeals against this decision were also unsuccessful. 24. The applicant’s subsequent requests to be released from pre-trial detention were rejected by the District Court’s decisions of 1 September and 3 November 2017. His appeals against those decisions were not examined on the grounds that the decisions in question were not subject to appeal. The applicant’s state of health while in detention
25. On 30 January 2016 the applicant’s lawyer applied to the investigator, seeking permission to transfer the applicant to V. Avagyan Medical Centre to undergo examination and urgent surgical intervention in view of the deterioration of his health due to the presence of thrombosis in his left leg. 26. By a decision of 3 February 2016 the investigator rejected the application and referred the arguments concerning the applicant’s state of health to the administration of the detention facility. 27. On 8 February 2016 the applicant’s lawyer applied to the Head of the Penitentiary Service of the Ministry of Justice (“the Penitentiary Service”) for the applicant’s urgent transfer to V. Avagyan Medical Centre due to a drastic deterioration in his health as a result of the progress of the thrombosis in his left leg. 28. In reply, on 12 February 2016 the applicant’s lawyer was informed that on 2 February 2016 the applicant had been examined by a surgeon who had recommended a duplex scan of the lower limbs. On 5 February 2016 the Head of the Penitentiary Service had applied to the Minister of Health to organise the recommended medical examination under the public healthcare system. 29. On 15 February 2016 the applicant underwent a duplex scan of the lower limbs. 30. On 16 February 2016 the applicant was examined by a vascular surgeon from the Armenia Medical Centre who visited him in the detention facility. According to the relevant records, the applicant did not need surgery and conservative treatment with medication was prescribed. 31. On 10 March 2016 the applicant asked to be examined by his doctor. 32. On 17 March 2016 the applicant’s doctor was allowed to visit him. The doctor recorded that the applicant complained of pain, fatigue and numbness in the lower limbs. He recommended that the applicant undergo arterial duplex scanning of the lower limbs in order to obtain accurate data concerning his state of health. 33. On 18 March 2016 the applicant’s doctor visited him again and ordered his urgent transfer to hospital by ambulance. On the same day the applicant underwent surgery in V. Avagyan Medical Centre. A vascular filter was implanted to prevent the progress of thrombosis in his left leg. 34. On 21 March 2016 the applicant was taken back to the detention facility. The applicant’s discharge record stated he was being transferred to the Yerevan-Kentron detention facility for continued further treatment. Surveillance by an angiologist, a duplex scan after three months, a chest X‑ray after two weeks and certain medication as well as elastic bandaging were recommended. 35. According to the applicant, he did not receive adequate post‑operative care after his return to the detention facility. 36. On 25 March 2016 the investigator ordered a forensic medical examination of the applicant. The experts were requested to determine, inter alia, whether the applicant’s treatment could be organised in the detention facility, and whether his treatment, including the implantation of the vascular filter, had been necessary. 37. On 2 April 2016 the applicant underwent X-ray examinations at V. Avagyan Medical Centre. 38. On 8 April 2016 the forensic medical examination was completed. According to the experts’ report, the implantation of the vascular filter had been absolutely necessary to prevent life-threatening pulmonary thromboembolism. Upon discharge from V. Avagyan Medical Centre the applicant had received appropriate recommendations for his treatment, which could be organised in the detention facility. 39. On 7 July 2016 the applicant was examined by his neurologist who advised MRI (magnetic resonance imaging) and MRT (magnetic resonance tomography) scans, a transcranial Doppler ultrasound test and dynamic supervision. 40. On 20 July 2016 the Centre de la Protection Internationale, an international human rights association based in Strasbourg, made an application to the Human Rights Defender of Armenia requesting that he examine the situation regarding the applicant’s health and the authorities’ reluctance to provide him with adequate medical assistance. 41. On 3 August 2016 the applicant underwent an MRT scan. 42. On 4 August 2016 he underwent a transcranial Doppler examination which concluded that he had moderate reduction of blood flow in the brain. 43. On 11 August 2016 the applicant was examined by his neurologist who diagnosed multifocal brain damage, vascular encephalopathy and gross impairment of coordination. In view of the deterioration of the applicant’s condition, the doctor prescribed several medical examinations and recommended in-patient treatment in a specialist hospital. 44. On 26 September 2016 the applicant was examined by an angiologist at V. Avagyan Medical Centre, who recommended duplex scanning, a d‑dimer blood test and an X-ray, taking into account that six months had passed since the surgery. 45. On the same date the applicant’s lawyer made a request to the administration of the detention facility, asking them to organise the examinations indicated by the doctor. Having received no reply, the applicant’s lawyer sent a similar request on 30 September 2016. At the same time, he complained to the Human Rights Defender of the inactivity of the administration of the detention facility. 46. On 5 October 2016 a medical panel consisting of six doctors examined the applicant and the documents relating to his medical examinations. They recorded that the applicant complained of pain in the chest area, a burning sensation in the lower limbs and vertigo. The panel recommended continuing the applicant’s medical examinations. 47. In October 2016 the applicant underwent another set of duplex scans, ultrasounds and X-rays in different medical centres. 48. By a decision of 10 November 2016 the Human Rights Defender found a violation of the applicant’s rights guaranteed by the Constitution and international treaties. The relevant parts of the decision read as follows:
“... Neither Yerevan-Kentron detention facility nor the Central Prison Hospital have an angiology unit or department... therefore the Human Rights Defender finds that [the applicant’s] medical treatment in the detention facility is inadequate. In such cases persons deprived of liberty should be transferred to a specialist medical centre... According to the information provided by the Ministry of Justice in response to the Human Rights Defender’s enquiry, the medical examinations that had been recommended by the neurologist ... requested by [the applicant’s] relatives, in particular “brain MRT”, “1,5 Tesla MRI scan”, “doppler ultrasound test” had been carried out on 3 and 4 August 2016. However, during their visit to the ... Yerevan-Kentron detention facility on 11 October 2016 the members of the staff of the [Human Rights Defender’s Office] did not find any document attesting to the fact that the “1,5 Tesla MRI scan” advised by the neurologist ... had been carried out... The applicant’s care during the entire period of his stay at the detention facility has been ensured by his cell-mates... In these circumstances it is evident that [the applicant] has not been provided with proper specialist care. The Human Rights Defender considers that [the applicant’s] care by his cell-mates would not be problematic if the Ministry of Justice had submitted evidence which would establish that such care had been provided by a person deprived of liberty who had the relevant training. Furthermore, the Ministry of Justice had failed to provide evidence, including relevant medical reports, substantiating the absence of the necessity to transfer the applicant to civilian medical institutions...”
49. On 18 November 2016 a medical panel consisting of four doctors examined the applicant and the results of his medical examinations. In its conclusion the panel recommended to conduct a Holter monitor test and an echocardiography as well as a lumbar spine CT scan. The panel found that the applicant did not need inpatient treatment and proposed to return to the issue upon receipt of the results of the recommended examinations. 50. In November 2016 the applicant underwent several other medical examinations, including computer tomography, a Holter monitor test, and an electroneuromyography. Conservative treatment with medication was recommended. Prescriptions for two types of medication were given for a period of ten days. 51. On 25 November 2016 the applicant’s lawyer sent a written query to the Head of the Yerevan-Kentron detention facility asking to be informed of the last occasion on which the applicant was able to bathe. 52. By letter of 29 November 2016 the Head of the Yerevan-Kentron detention facility stated that the applicant had refused to bathe since 12 August 2016. He had been offered the possibility to bathe regularly, according to the time schedule of the detention facility, but he had refused and stated that he would only take a bath in a bath tub with the help of his wife. 53. In December 2016 the Public Observers Group to Monitor Penal Institutions and Entities under the Ministry of Justice (“the Public Observers Group”) visited the applicant and stated in its report to the Minister of Justice that, although according to the medical data the applicant’s medical treatment could be organised in the detention facility, his state of health had obviously deteriorated. The Public Observers Group proposed the applicant’s transfer to a civilian hospital, taking into account that his treatment in the detention facility had not produced any results. 54. On 9 January 2017 the applicant asked to be provided with a wheelchair in view of his mobility problems, which was refused. 55. On 9 February 2017 the Court requested information from the Government concerning the applicant’s state of health and the medical and other care provided to him in detention (see paragraph 80 below). 56. On 22 February 2017 the Government replied to the questions put by the Court and stated that the Head of the Penitentiary Service had granted permission to transfer the applicant to a civilian hospital for examination and treatment the next day (see paragraph 81 below). 57. On 23 February 2017 the applicant was taken to Erebouni Medical Centre. According to the applicant, for the first time in seven months he was able to meet his hygiene needs (that is, to take a shower) and received treatment which provided some relief from the constant pain he suffered. 58. On 3 March 2017 the applicant was discharged from hospital and transferred back to the Yerevan-Kentron detention facility. According to the applicant’s discharge record, he suffered from lumbar degenerative disc disease, lumbago (low back pain), radiculopathy, heart problems, pulmonary artery thromboembolism, enlarged prostate, kidney cysts and post-thrombotic syndrome affecting the lower limbs. The doctors recorded that the applicant could not stand independently to undergo certain neurological examinations. They indicated the need to undergo an MRT scan, prescribed medication and advised supervision by a vascular surgeon, a neurosurgeon, a cardiologist and a urologist. 59. On 5 March 2017 the applicant’s lawyer issued a media report concerning the conditions of the applicant’s detention following his return from treatment in hospital. According to the report, he was placed in the worst cell of the detention facility: it was extremely damp, the walls were covered with mould, and it was very narrow, with the beds so close to each other that even a healthy person would have difficulty moving around. The applicant was placed in a cell measuring 15 sq. m. with four other detainees and a fifth detainee was brought in after he complained to the administration about the conditions in the new cell. 60. The Public Observers Group tried to visit the applicant on 6 March 2017 in order to check the conditions of his detention. The administration of the detention facility refused the observers access to the applicant’s cell. In their report to the media in this respect the Public Observers Group stated that such a ban made it appear likely that the disseminated information on the applicant’s detention conditions was accurate. 61. On 22 March 2017 the applicant’s lawyer sent letters to the Human Rights Defender, the Minister of Justice, the Head of the Penitentiary Service and the Head of Kentron detention facility stating, in particular, that most of the medication prescribed to the applicant was not being provided to him and that the recommendations made in the discharge note of 3 March 2017, including the MRT scan and supervision by a vascular surgeon, a neurosurgeon, a cardiologist and a urologist had not been implemented. It was further stated that the conditions of the applicant’s detention after his return from hospital had significantly deteriorated: he had been placed in a very damp cell situated in the northern part of the facility with no natural light during the entire day. Not being able to move out of the cell due to his state of health, the applicant was thus deprived of natural light all the time. 62. In his reply of 27 March 2017 the head of the detention facility stated that the applicant had always been, and still was, under medical supervision and that appropriate medical specialists from the Ministry of Health had visited him. Those specialists had found that the MRT scan was permissible for the applicant while the Penitentiary Service had applied to the Ministry of Health to organise this examination within the public healthcare system. 63. On the same date the Deputy Head of the Penitentiary Service sent a letter to the applicant’s lawyer stating that only one of the four medicines had been made available to the applicant. As regards the other three, two were not included in the general purchasing list of the Penitentiary Service while the remaining one was out of stock and would be made available the following month. It was also stated that the applicant had been examined by a vascular surgeon on 22 March 2017, and by a cardiologist the following day, who had not envisaged any change in the applicant’s treatment. On 24 March 2017 consultations were held with a rheumatologist, another vascular surgeon and a neurosurgeon. The vascular surgeon had prescribed medication and elastic bandaging while walking and had recommended an MRT scan with low power equipment. The organisation of the said examination was in progress. 64. On 3 April 2017 the applicant was transferred to the Central Prison Hospital. 65. On 14 August 2017 a medical panel composed of specialists from the Yerevan State Medical University and the Ministry of Health carried out an examination of the applicant and delivered an opinion whereby it concluded that certain positive dynamics had been observed in the applicant’s state of health as compared to the previous examination. The specialists prescribed additional medication and further examinations and noted that the conditions of the applicant’s detention and the level of availability of the medical personnel were satisfactory from the perspective of the applicant’s state of health. Attempts to have a private meeting with representatives before the court
66. By an authority form signed on 19 May 2016 the applicant authorised Ms A. Maralyan, legal expert at the Centre de la Protection Internationale based in Strasbourg, to represent him in the proceedings before the Court. 67. On 17 June 2016 Ms Maralyan applied to the administration of the Yerevan-Kentron detention facility, seeking a private meeting with the applicant. She attached the authority form signed by the applicant (see paragraph 66 above) to her request. Ms Maralyan’s request was refused on the same date on the grounds that pursuant to Section 15 of the Law on Holding Arrested and Detained Persons (“the Law”) (see paragraph 95 below), she should seek the relevant permission from the body conducting the investigation. 68. On 30 June 2016 Ms Maralyan presented herself to the investigator as a legal expert at the Centre de la Protection Internationale and asked him to grant her permission to have a private meeting with the applicant as his representative before the Court. 69. On 4 July 2016 the investigator informed her that there was no procedure for a confidential meeting of a detainee with a legal expert at the Centre de la Protection Internationale and the investigating authority had no power to grant her the permission sought. It was further stated that Ms Maralyan had the right to have a non-private meeting with the applicant, taking into account that there was no restriction on the latter’s visits and telephone calls. 70. On 1 August 2016 the applicant lodged a complaint with the District Court seeking permission to have a private meeting with his representative before the Court, stating that the prohibition of such a meeting was in breach of Article 34 of the Convention. 71. By decision of 3 August 2016 the District Court returned the applicant’s complaint with reference to Sections 52 § 1 and 53 § 2 (8) and (9) of the Code of Criminal Procedure (see paragraphs 97 and 98 below) on the grounds that he had failed to complain about the prohibition to have a private meeting with Ms Maralyan to the investigating authority, the administration of the detention facility and, in the case that his complaints were not granted, then to the prosecutor supervising the investigation. 72. On 24 August 2016 Ms Maralyan once again applied to the administration of the Yerevan-Kentron detention facility, seeking a private meeting with the applicant. Her request was refused on the same date on the grounds that she had failed to submit an official document proving that she was the applicant’s authorised representative in the proceedings before the Court. Furthermore, pursuant to Section 15 of the Law (see paragraph 95 below), a detained person could have confidential meetings only with a defence lawyer or an advocate who had asked to visit a detained person with the purpose of assuming the latter’s defence. Ms Maralyan was advised that she could have a non-private meeting with the applicant. 73. On 31 August 2016 Ms Maralyan had a non-private meeting with the applicant in the presence of prison guards. 74. On 16 September 2016 the applicant lodged a completed application form with the Court, whereby he authorised Ms Maralyan and Ms K. Moskalenko, lawyers from the Centre de la Protection Internationale, to represent him in the proceedings before the Court. 75. On 27 October 2016 Ms Maralyan attended the detention facility requesting a meeting with the applicant. Having waited for hours for permission to meet him, she was eventually informed at 5 p.m. that no meetings were allowed past this hour. 76. On 20 January 2017 Ms Moskalenko requested permission to have a private meeting with the applicant in order to discuss certain issues with regard to the latter’s application before the Court. The administration of the detention facility refused this request. The Government submitted that Ms Moskalenko’s request had been refused on the grounds that she had been unable to produce a document indicating that she was the applicant’s representative before the Court. When asked whether she held an advocate’s licence in Armenia, her response had been negative. Accordingly, her request to have a private meeting with the applicant had been refused pursuant to the requirements of Section 15 of the Law (see paragraph 95 below). The applicant contests this. According to him, after Ms Moskalenko had submitted the signed authority form together with his letter expressing his wish to have a meeting with her, she had been requested to provide a letter from the Court indicating that she was his representative and the explanations that no such document could be provided by the Court were not accepted. 77. On 10 August 2017 Ms Maralyan requested the administration of the Central Prison Hospital to have a private meeting with the applicant to discuss various issues with regard to the preparation of his observations. No response was received. 78. On 11 August 2017 Ms Maralyan submitted a similar request to the District Court which by then had taken over the examination of the case (see paragraph 22 above). Her request was granted on 16 August 2017 and she had a confidential meeting with the applicant on the same day. Request for an interim measure and subsequent developments
79. On 2 February 2017 the applicant requested the Court to apply Rule 39 of the Rules of Court and to indicate to the Armenian authorities to organise his transfer to a specialist hospital for treatment. 80. On 9 February 2017 the Government were requested under Rule 54 § 2 (a) of the Rules of Court to submit information about the applicant’s health, the quality of the medical assistance he was receiving and the conditions of his detention, including whether the applicant was being provided with assistance in meeting his daily needs. 81. On 22 February 2017 the Government responded, providing the Court with some excerpts from the applicant’s medical file. Relying on the medical panel’s conclusion of 18 November 2016 (see paragraph 49 above) the Government submitted that the applicant’s state of health did not necessitate inpatient treatment. Furthermore, since February 2016 the applicant had undergone a vast number of medical examinations, most of which had been carried out in specialist clinics. The Government submitted that the applicant had occasionally been offered the opportunity to take a shower but he himself had refused, and that he was being provided with assistance and bandaging was being carried out. Lastly, the Government stated that the applicant’s transfer to a civilian hospital had been scheduled for 23 February 2017 in order for him to undergo further examinations and receive inpatient treatment. 82. In response to the Government’s submissions, on 8 March 2017 the applicant confirmed that he had indeed been taken to a civilian hospital (see paragraph 57 above) where for the first time in seven months he had been able to meet his hygiene needs. He had also received treatment which had provided him with some relief from the constant pain that he was experiencing. However, after his return he continued to be deprived of adequate medical care and, in addition, was placed in a cell with unacceptable conditions (see paragraph 59 above). The applicant contested the Government’s claims that he had refused to take a shower and stated that he had been unable to reach the shower rooms which were situated in the basement. The applicant further contested that he was provided with assistance and that bandaging was being carried out. 83. On 24 March 2017 the Court (the duty judge) decided to reject the applicant’s request under Rule 39 of the Rules of Court. 84. On 1 November 2017 the applicant submitted another request under Rule 39 of the Rules of Court whereby he requested the Court to indicate to the Armenian authorities that he should urgently be provided with specialist medical care. The applicant relied on a medical expert report delivered on the same date by an independent medical panel composed of Russian doctors, which had indicated that the applicant was receiving superficial, symptomatic treatment which increased the risk of the disease progressing and might lead to fatal consequences. In the panel’s opinion the applicant was in urgent need of specialist medical care. 85. On 9 November 2017 the Court (the duty judge) decided to indicate to the Government that the applicant should immediately be provided with requisite medical assistance including, if necessary, his placement in a specialist medical facility and that a medical panel should be set up on a parity basis to examine the applicant with a view to diagnosing his specific problems and determining the necessity of any long-term or immediate treatment. Furthermore, the Government was to ensure the applicant’s treatment in accordance with the relevant findings of the panel. 86. On 22 December 2017 the applicant’s lawyer sent a letter to the Minister of Justice stating, inter alia, that the applicant’s lawyers and relatives had already contacted several medical specialists who had given their prior agreement to be involved in the panel that was to be set up to carry out the applicant’s medical examination. 87. In his letter of 10 January 2018 sent to the Court the applicant submitted that that the Government had disregarded the interim measure indicated to them by the Court’s decision of 9 November 2017. He referred to a letter of 9 January 2018 from the Ministry of Justice according to which the applicant was receiving the treatment prescribed to him further to his medical examinations in October 2017 and there was no need for in-patient treatment or additional examinations. 88. On 24 January 2018 the Government was requested to comment on the applicant’s letter of 10 January 2018. 89. In their letter dated 7 February 2018 the Government submitted that the Court’s notification about the application of Rule 39 of the Rules of Court “had remained unnoticed due to a technical discrepancy”. The Government claimed that it had only become aware of the interim measure indicated by the Court on 25 January 2018 upon receipt of the Registry’s letter of 24 January 2018. Having found out about the interim measures indicated in the case, the Government had immediately contacted the applicant’s lawyer and a letter was sent to him expressing the Government’s willingness to set up the requested medical panel as soon as possible. In his letter of 1 February 2018 the applicant’s lawyer had submitted that the applicant had no financial means to have the doctors that he wished to be appointed to the panel and enquired about the possibility that the Government allocate the required sums. According to the Government, they ensured that all the relevant measures indicated under Rule 39 of the Rules of Court had been implemented, with the exception of setting up a medical panel, due to the applicant’s lack of means to appoint the doctors of his choice. 90. Ultimately, no medical panel was set up. The Court was not provided with further information about the relevant developments. 91. By the letter of 27 June 2018 the applicant informed the Court that he had been released from detention on 25 June 2018 by a decision of the District Court of the same date. 92. On 11 December 2018 the Court decided to lift the interim measure previously indicated under Rule 39 of the Rules of Court (see paragraph 85 above). RELEVANT LEGAL FRAMEWORK
Relevant domestic lawDetention on remand

93. The relevant provisions of the domestic law concerning the imposition of detention on remand, and the grounds and procedure for its extension are set out in the Court’s judgment in the case of Ara Harutyunyan v. Armenia (no. 629/11, §§ 30-36, 20 October 2016). The Law on Conditions for Holding Arrested and Detained Persons («Ձերբակալված և կալանավորված անձանց պահելու մասին» ՀՀ օրենք)
94. According to Section 13 of the Law on Conditions for Holding Arrested and Detained Persons, a detainee has the right, inter alia, to healthcare, including sufficient food and urgent medical assistance. A detainee, personally or via his lawyer or legal representative, has the right to lodge complaints concerning a violation of his rights with the administration of the detention facility, its superiors, the court, the Prosecutor’s office, the Human Rights Defender, State and local self‑governance bodies, non‑governmental entities and political parties, the mass media, as well as international human rights protection bodies or organisations. 95. According to Section 15, an arrested or detained person has the right to meet in private with his defence lawyer or an advocate who has asked to visit him with the purpose of assuming his defence, without limitation on the number and duration of visits, irrespective of working days or hours. Upon a detained person’s request, the investigating authority may grant him permission to have private meetings with an advocate who is not his defence lawyer in the criminal case, if that is required for the provision of legal assistance which is not related to the examination of the criminal case. The investigating authority considers and decides such a request and the latter has a right to lodge an appeal against the investigating authority’s decision in accordance with the procedure set out in the Code of Criminal Procedure. The detained person’s meeting with an advocate or defence lawyer is granted when the advocate or the defence lawyer presents an identification document and an advocate’s licence along with the relevant certificate issued by the body conducting the criminal proceedings addressed to the administration of the place for keeping arrested or detained persons. 96. Section 21 provides that the administration of a detention facility shall ensure the sanitary, hygienic and anti-epidemic conditions necessary for the preservation of health of detained persons. At least one general practitioner shall work at the detention facility. A detainee in need of specialised medical assistance must be transferred to a specialised or civilian medical institution. Code of Criminal Procedure
97. According to Article 52 § 1, the prosecutor carries out criminal prosecutions and oversees the lawfulness of any inquest and preliminary investigation. 98. According to Article 53 § 2 (8) and (9) when carrying out procedural supervision of the investigation, it is the exclusive power of the prosecutor to, inter alia, eliminate unlawful or unsubstantiated decisions of the investigation body, investigator, subordinate prosecutor and to decide on the appeals against the decisions and actions of the investigating authority, investigator, subordinate prosecutor. 99. Article 290 § 1 provides that the suspect, the accused, the defence lawyer, the victim, the participants in the proceedings and other persons whose rights and lawful interests have been violated are entitled to lodge complaints with a court against the unlawfulness and unfoundedness of the decisions and actions of the body of preliminary inquiry, the investigator, the prosecutor or the bodies carrying out operative and intelligence measures, which are prescribed by the Code, if their complaint has not been granted by a prosecutor. Law on the Prosecutor’s Office of 22 February 2007 (no longer in force)
100. According to Section 29 § 1, as in force at the material time, the prosecutor oversees the lawfulness of the application of penalties. When exercising this power the prosecutor has the right, inter alia, to visit the places of keeping persons deprived of liberty and to examine documents, including decisions, orders of the administration of the relevant detention facilities (Section 29 § 4 (1), (2) and (3)). In case the prosecutor suspects a breach of the rights of a person in respect of whom a penalty is applied, he has the right to request the relevant official to provide explanations concerning the latter’s actions or inaction. Civil code
101. The relevant provisions of the Civil Code concerning compensation for damage suffered as a result of a violation of a person’s rights guaranteed by the Convention provide the following. 102. Under Article 17 § 1, a person whose rights have been violated may claim full compensation for the damage suffered, unless the law or contract provides for a lower amount of compensation. The relevant damage consists of the expenses borne or to be borne by the person whose rights have been violated, in connection with restoring the violated rights as well as any loss of property or damage to it (material damage), including loss of income and any non-pecuniary damage (Article 17 § 2). Non-pecuniary damage may only be compensated in the cases provided for by the Civil Code (Article 17 § 4). 103. Article 162.1 § 2 provides that a person has the right to claim compensation for non-pecuniary damage if it has been established by the prosecuting authority or a court that, as a result of a decision, action or omission by a State or local governance body or one of its officials, his or her fundamental rights guaranteed by the Constitution and the Convention have been violated. 104. Article 1087.2 §§ 3 and 4 provide that non-pecuniary damage suffered as a result of a violation of fundamental rights may be compensated regardless of whether there is any fault on the part of a State official. Non‑pecuniary damage is compensated from the State budget. If the fundamental right included in Article 162.1 has been violated by a local governance body or one of its officials, non-pecuniary damage is compensated from the relevant local budget. 105. A claim for compensation for non‑pecuniary damage may be submitted to a court together with a claim seeking to establish a breach of the rights set out in Article 162.1 within one year of the time the person became aware of the breach, as well as within six months of the date on which a judicial decision establishing the breach of the right in question came into force. If the breach has been established by a law-enforcement body, a claim for compensation for non-pecuniary damage may be submitted no earlier than two months but no later than one year after the date on which the person concerned became aware of the matter (Article 1087.2 § 9). 106. Since 1 November 2014 Article 17 § 2 (see paragraph 102 above) has included non‑pecuniary damage in the list of the types of civil damage for which compensation can be claimed in civil proceedings. As a result, the Civil Code was supplemented by new Articles 162.1 and 1087.2 (see paragraphs 103 and 104 above) which regulate the procedure for claiming compensation for non-pecuniary damage from the State for violation of certain rights guaranteed by the Armenian Constitution and the Convention. Until the introduction of further amendments on 30 December 2015 (in force from 1 January 2016), compensation in respect of non-pecuniary damage could be claimed from the State where it had been established by a judicial ruling that a person’s rights guaranteed by Articles 2, 3 and 5 of the Convention had been violated, and also in cases of wrongful conviction. Relevant Council of Europe documentsCPT: Report to the Armenian Government on the visit to Armenia carried out by the CPT from 5 to 15 October 2015, CPT/Inf(2016) 3

107. The relevant parts of this report read as follows (footnotes have been omitted):
“68. Further, outdoor exercise [in Yerevan-Kentron Prison] continued to take place in small and oppressive yards on the roof of the building - enclosed areas surrounded by high walls topped with a wire mesh and fitted with a makeshift shelter against inclement weather and a bench, but no other equipment. As during the previous visits, inmates from different cells were not allowed to associate in the exercise yards, except for the lifers.
...
76. ... The health-care staff complement had remained unchanged at Yerevan-Kentron Prison i.e. it consisted of a full-time GP and a full-time nurse. There was still no 24‑hour coverage by a health-care professional.
77. ... Concerning Yerevan-Kentron Prison, the Committee recommends that steps be taken to ensure that a person qualified to provide first aid, preferably someone with a recognised nursing qualification, is present around the clock at the establishment, including on weekends.
...
78. ... the delegation received numerous complaints from prisoners in all the establishments visited about access to specialised care, and noted that, as a rule, inmates were expected to pay for anything more than the most basic care (except in emergency). Moreover, as in the past, there were long delays (up to several months) in the transfer of inmates to outside hospital facilities, including to the Central Prison Hospital. In this context, the delegation gained the impression that there was a lack of clear objective criteria for hospitalisation. The CPT calls upon the Armenian authorities to ensure that prisoners in need of specialist treatment (including outside consultations/examinations and hospitalisation) are granted access to such care without undue delay and free of charge.
... 80. The CPT notes with great concern the lack of progress as regards the supply of medicines (other than for tuberculosis) in prisons. The relevant budget remained very limited and inmates frequently had to rely on their own financial resources or those of their relatives in order to receive the medication prescribed to them. The CPT calls upon the Armenian authorities to ensure that all prisons are supplied with appropriate medication, free of charge for the inmates.”
Response of the Armenian Government to the Report of the CPT on its visit to Armenia from 5 to 15 October 2015, CPT/Inf (2016) 32
108. The relevant parts of the Armenian Government’s response read as follows (footnotes have been omitted):
“...In cooperation with Human Rights Defender’s (hereinafter, the HRD) Office and practicing lawyers the Law on Holding Arrested and Detained Persons has been amended. Following the amendments the person deprived of liberty is entitled to meet his defence counsel or an advocate visiting to undertake the defence of the case in private, without hindrance, limitation to the number and length of the meetings and irrespective of the working days or hours. He/she also has a right to meet not only with his/her defence counsel but also with any advocate not involved in the defence of his/her case for matters not connected with the investigation of the case (e.g. divorce or any other civil matter).
... 62. As to the problem of ventilation in some of the cells at the Yerevan Detention Centre, the deficiencies of the ventilation system have been eliminated, it has been cleaned, and as a result the proper ventilation has been guaranteed. At the same time, it is to be noted that major refurbishment works will be carried out at the Yerevan Detention Centre.
... 117. With regard to the remarks concerning the material conditions of Yerevan-Kentron Penitentiary Establishment, the following must be mentioned. There is no issue of overcrowding at Yerevan-Kentron Penitentiary Esablishment in terms of the living area prescribed by the legislation, as well as in terms of bed capacity. All the cells are in a satisfactory condition, and there are no dilapidated cells. Although there is no central ventilation system, daily ventilation is duly provided by opening the windows of the cells. As for ensuring proper ventilation in the cells, it will become possible after structural modifications in case of relevant financial assistance.
... 133. As to Yerevan-Kentron Penitentiary Establishment, currently, a qualified nurse is employed at the medical service unit of the establishment on a contractual basis who provides first aid - where necessary - also on non-working days and hours. The process of staffing the mentioned institution with the vacant post of a feldsher is in the spotlight of senior officials of the Penitentiary Service as a matter of urgency.
...
137. ... medical services provided in the penitentiary system are free of charge. Besides, within the scope of the free medical assistance guaranteed by the state, examinations and medical treatments are carried out at healthcare institutions of the Republic of Armenia.
... 139. Remand prisoners and convicts benefit from the services of, as well as examinations and treatment carried out by the medical specialists chosen by them and working outside of the penitentiary system - on a paid basis - in civil hospitals operating outside of the penitentiary system. Medical services are provided promptly to the remand prisoners and convicts who are in need of emergency medical assistance, while others - according to plan.
...
151. ... The comparison made according to years shows that the medical services of the Penitentiary Service are replenished with additional types of medicines every year. ... As regards medicine brought to penitentiary institutions by the relatives of persons deprived of liberty, pursuant to Government Decree No. 825-N persons deprived of liberty are entitled to freely benefit from services of other medical specialists and receive medicine not prohibited by the legislation...”
Standard Minimum Rules for the Treatment of Prisoners
109. Recommendation Rec(2006)2-rev of the Committee of Ministers to member States on the European Prison Rules states, in so far as relevant, the following:
“Legal advice
23.1      All prisoners are entitled to legal advice, and the prison authorities shall provide them with reasonable facilities for gaining access to such advice.
23.2      Prisoners may consult on any legal matter with a legal adviser of their own choice and at their own expense.
23.3      Where there is a recognised scheme of free legal aid, the authorities shall bring it to the attention of all prisoners.
23.4      Consultations and other communications, including correspondence about legal matters between prisoners and their legal advisers, shall be confidential.
23.5      A judicial authority may, in exceptional circumstances, authorise restrictions on such confidentiality to prevent serious crime or major breaches of prison safety and security.
23.6      Prisoners shall have access to, or be allowed to keep in their possession, documents relating to their legal proceedings.”
European Agreement relating to Persons Participating in Proceedings of the European Court of Human Rights
110. The relevant provisions of the European Agreement relating to Persons Participating in Proceedings of the Court state the following:
“Article 1
1. The persons to whom this Agreement applies are:
a. any persons taking part in proceedings instituted before the Court as parties, their representatives and advisers;
... Article 3
1. The Contracting Parties shall respect the right of the persons referred to in paragraph 1 of Article 1 of this Agreement to correspond freely with the Court. 2. As regards persons under detention, the exercise of this right shall in particular imply that:
...
c. such persons shall have the right to correspond, and consult out of hearing of other persons, with a lawyer qualified to appear before the courts of the country where they are detained in regard to an application to the Court, or any proceedings resulting therefrom.”
THE LAW
ALLEGED VIOLATIONs OF ARTICLEs 3 and 13 OF THE CONVENTION
111. The applicant complained that the authorities failed to provide him with adequate medical treatment and daily assistance in detention, in breach of Article 3 of the Convention, which reads as follows:
“No one shall be subjected to torture or to inhuman or degrading treatment or punishment.”
112. The applicant further complained that he had not had at his disposal an effective remedy for his complaints under Article 3 of the Convention, as required under Article 13 of the Convention, which reads as follows:
“Everyone whose rights and freedoms as set forth in [the] Convention are violated shall have an effective remedy before a national authority ....”
Admissibility
113. The Government argued that the applicant had failed to raise his complaints before the domestic authorities listed in Section 13 of the Law on Conditions for Holding Arrested and Detained Persons (“the Law”; see paragraph 94 above) and to claim compensation for non-pecuniary damage from the State (see paragraphs 101-105 above). The Government further argued that the applicant’s complaints referring to the events before 16 March 2016 should be declared inadmissible for having been lodged outside the six-month time-limit in view of the fact that the applicant had introduced his complaints on 16 September 2016. 114. The applicant submitted that his numerous complaints to the authorities, including to the administration of the detention facility, had been fruitless and that he had therefore not had an effective remedy by means of which to complain about the quality of his treatment. 115. The Court notes that the Government’s objection in respect of the non-exhaustion of domestic remedies is closely linked to the merits of the applicant’s complaint that he did not have at his disposal an effective remedy for his complaints concerning the absence of effective medical care and assistance while in detention. Accordingly, the examination of the Government’s objection should be joined to the merits of the applicant’s complaint under Article 13 of the Convention. 116. As regards the Government’s objection concerning the non-observance by the applicant of the six-month time-limit, the Court observes that the Government did not specify the final decision from which in their view the six-month period had started to run in respect of the applicant’s complaints pertaining to the period before 16 March 2016. 117. The Court reiterates that as a rule, the six-month period runs from the date of the final decision in the process of exhaustion of domestic remedies. Where it is clear from the outset, however, that no effective remedy is available to the applicant, the period runs from the date of the acts or measures complained of, or from the date of knowledge of that act or its effect on or prejudice to the applicant, and, where the situation is a continuing one, once that situation ends (see, among many other authorities, Mocanu and Others v. Romania [GC], nos. 10865/09 and 2 others, § 259, ECHR 2014 (extracts)). 118. The Court’s approach to the application of the six-month rule to complaints concerning the conditions of an applicant’s detention has been summarised as follows: a period of detention should be regarded as a “continuing situation” if the detention has been effected in the same type of detention facility in substantially similar conditions. Short periods of absence during which the applicant was taken out of the facility for interviews or other procedural acts would have no impact on the continuous nature of the detention. However, the applicant’s release or transfer to a different type of detention regime, both within and outside the facility, would put an end to the “continuing situation”. The complaint about the conditions of detention must be filed within six months of the end of the situation complained about or, if there was an effective domestic remedy to be exhausted, of the final decision in the process of exhaustion (see Ananyev and Others v. Russia, nos. 42525/07 and 60800/08, § 78, 10 January 2012; and Gorbulya v. Russia, no. 31535/09, § 47, 6 March 2014). 119. The Court observes that the applicant was admitted to Yerevan-Kentron detention facility on 21 December 2015 from where he was transferred to the Central Prison Hospital on 3 April 2017 (see paragraphs 14 and 64 above). It further observes that during his stay in Yerevan-Kentron detention facility the applicant was twice transferred to hospital for brief periods – from 18 to 21 March 2016 and from 23 February to 3 March 2017 (see paragraphs 33-34 and 57-58 above). Having regard to its approach to the application of the six-month rule to complaints concerning conditions of detention (see paragraph 118 above), the Court considers that the applicant’s detention at Yerevan-Kentron detention facility from 21 December 2015 to 3 April 2017 amounted to a “continuing situation”. As the applicant introduced his complaints on 16 September 2016 while still being detained in Yerevan-Kentron detention facility, he complied with the six-month rule in respect of his complaints concerning the entire duration of his stay in that facility (see, mutatis mutandis, Ananyev and Others, cited above, § 73). The Government’s objection of non-compliance with the six-month time-limit should therefore be dismissed. 120. The Court notes that these complaints are neither manifestly ill‑founded nor inadmissible on any other grounds listed in Article 35 of the Convention. They must therefore be declared admissible. MeritsThe parties’ submissions

(a)   The applicant
121. The applicant maintained that there was no effective domestic remedy available to him in respect of his complaints under Article 3 of the Convention in relation to the lack of requisite medical care and assistance in detention. He had continuously addressed requests to the administration of Yerevan-Kentron detention facility to enable him to undergo the necessary medical examinations but those requests were either refused or granted with undue delays. He had also sent letters to the Minister of Justice and the Penitentiary Service. The applicant argued that the Government had failed to demonstrate that there existed any effective mechanisms for detainees with serious health issues to be provided with redress if their right to adequate medical treatment or detention conditions were breached. As regards the possibility to claim non-pecuniary damages from the State, the applicant submitted that compensation under that head depended on a finding by the national courts of a breach of Article 3 of the Convention. In any event, monetary compensation could not be regarded as adequate redress for an ongoing violation of the right to requisite medical care and assistance. 122. The applicant further maintained that the administration of Yerevan-Kentron detention facility had failed properly to ensure his medical examinations and adequate medical treatment and that he had not received the requisite medical attention or medication. As a result, he had been put in a life‑threatening situation when the need for an urgent medical intervention arose. At some point he was obliged to refuse taking vital medication as a means of last resort in an attempt to draw the authorities’ attention to the critical state of his health. Furthermore, he had been deprived of basic assistance in performing daily tasks in absolute disregard of his mobility issues and had to rely most of the time on the assistance of cell-mates, who were not always available. The applicant also complained of the authorities’ failure during his stay in Yerevan-Kentron detention facility to provide him with a wheelchair, to ensure his personal hygiene and to provide him with daily walks in view of his problems with mobility. He further submitted that he was also deprived of adequate medical assistance in the Central Prison Hospital since no specialist in vascular surgery and angiology was available there. (b)   The Government
123. The Government submitted that the authorities had ensured the applicant’s high‑standard medical care with public funds, which went beyond what was required by the Court’s jurisprudence on the matter. In particular, the applicant had been treated in civilian hospitals when necessary, was frequently examined by leading professionals in the country, including by specialists of his own choosing, and had remained under constant medical supervision. At the same time, on various occasions the applicant had refused to take the medication offered to him or to be examined by the medical personnel of the detention facility. The applicant had occasionally been offered the possibility to take a shower. However, since 12 August 2016 he had refused to take a shower, explaining that he was unable to stand and would only take a bath with the help of his wife. Regular bandaging of his lower limbs with elastic bandages had been carried out. From 3 April 2017 the applicant had been placed in the Central Prison Hospital. He was able to move independently and would occasionally use the wheelchair and the crutches provided to him by the detention facility. The Government submitted that, while in the Central Prison Hospital, the applicant was regularly assisted by the relevant personnel in performing everyday tasks. 124. In their further observations dated 28 February 2018 the Government submitted, inter alia, that at that point the applicant was being provided with a wheelchair round the clock. The Government stated that certain prescribed medication had been provided to the applicant by his relatives and averred that the authorities never created any obstacles to the applicant receiving medication from other sources.

Outcome for Article 34: violation