Clare Dupree, a 48-year-old woman from Cardiff, died in December 2022 after suffering a brain injury and respiratory infection following a fire in her cell at HMP Eastwood Park in Falfield, South Gloucestershire. The incident, which has been the subject of an inquest at Avon Coroner’s Court, revealed that Dupree screamed ‘I’m on fire’ as she waited 33 minutes to be removed from her cell during the blaze.

Delays and Fire Safety Failures

According to the inquest, Dupree’s cell was not equipped with an automatic fire detection system, and the door handle was too hot to touch by the time staff arrived. Regulations state that an inmate should be removed from their cell within 20 minutes of a fire, or the cell should be ventilated. However, this standard was not met in Dupree’s case.

A neighboring inmate testified that as smoke started to spread into Dupree’s cell, it felt like a long time before anyone came at all. Another prisoner set off the fire alarm after seeing ‘big clouds of thick smoke coming out of the top of Clare’s door.’

Dupree was screaming, ‘I’m on fire, help help, help,’ and was reportedly by the window trying to get air. ‘I think she knew she was going to die,’ the woman said. Dupree had been in high spirits the day before, which was Christmas Day, dancing on the prison wing and appearing happy, which shocked others when the tragedy occurred the next day.

Mental Health and Medication Concerns

The inquest also delved into Dupree’s mental health in the days leading up to her death. Upon arriving at the prison, she had stopped taking prescribed antipsychotic medication and was experiencing paranoia, delusional thinking, and hallucinations. A consultant psychiatrist told the court that Dupree was ‘presenting as psychotic from the moment she came back into prison.’

An assessment process to evaluate her risk of suicide and self-harm was initiated, and her mental health improved after she began taking antipsychotic medication again. As a result, the assessment process ended after three weeks, with no major concerns about her mental state remaining.

Dupree was last seen by the mental health team on 23 December, and the nurse reported she was ‘still voicing some paranoid and delusional ideas,’ but was showing better mental health and had no suicidal thoughts. ‘It might have been the best I’d ever seen her,’ the nurse told the court.

Dupree missed one dose of her antipsychotic medication on the morning before the fire broke out. However, the consultant psychiatrist said it was ‘unlikely’ to have had a ‘significant’ impact on her, as the medication does not wear off that quickly.

Family and Background

Dupree had been sent to prison a month before the fire after threatening a security guard with a knife when he caught her trying to steal a pregnancy test. Her family described her as ‘delightful and sensitive’ but said she had significant mental health problems.

The inmate who was in the cell next to Dupree’s said she had heard her shout ‘random things’ out of her window after they had collected their dinner. ‘When she was shouting out the window that she was on fire, other girls were shouting back at her to shut up and that she was mad,’ she said.

Pathologist Dr Russell Delaney testified that Dupree died from a brain injury and respiratory infection, and it was not clear whether earlier removal from her cell would have improved her chances of survival. The inquest continues, with further testimony expected in the coming weeks.

According to the coroner’s court, the fire was started by a vape in Dupree’s cell. The inquest is examining whether the prison’s response met legal and safety standards, and what steps can be taken to prevent similar incidents in the future.