Steve Hewer, who was security operations manager at Doncaster Prison at the time, told an inquest he did not think the situation had changed since he had initially ordered Stephen Brown to be taken to hospital with handcuffs.

He had seen Mr Brown because his officers had complained his mother was being abusive at Doncaster Royal Infirmary.

Leslie Thomas, representing Mr Brown's family, said Teresa Brown was merely expressing concern over the chains and over the state her son was in when he arrived in hospital with blood on his face and dirty clothes.

Mr Hewer told the jury he had not consulted doctors before Mr Brown was chained because he was keen to get him to the hospital as quickly as possible and consulting a doctor over whether he was an escape risk would have taken time.

He said he did not realise that Mr Brown was hours away from death, and it would have been extremely unusual for a prisoner not to be handcuffed.

He said the chains were not impairing his treatment.

He said: "I didn't realise he might die in the next few hours. If I had I would have removed the cuffs."

Acting deputy assistant coroner John Sleightholme asked him what he thought 'the next hours could be crucial' meant.

Mr Hewer said: "The boy was poorly, but I wasn't aware to what extent."

Mr Brown, aged 23, of Moorland View, Aston, near Rotherham, died in the Wheatley hospital after being brought in from Doncaster's Marshgate jail less than a week after arriving there as an inmate, an inquest heard.

He was admitted to the ward suffering dehydration, hypothermia, pneumonia and septicaemia.

Steven, a heroin user, was jailed for eight months on March 12 2003 and had told his mum he wanted to get his life and family back.

He died of septicaemia on March 19 after being found collapsed in the prison showers.

Mr Thomas told the inquest evidence would be heard that a nurse had asked for his handcuffs to be removed.

He said nurse Joanne Wilkinson had asked officers if the cuffs were necessary as he did not have enough energy to move, let alone run away.

He said she had applied padding because the cuffs were leaving marks on his wrist.

Regulations at the prison state chains should be removed from patients if they are causing pain and discomfort.

Mr Hewer told the inquest that if the nurse had asked for the cuffs to be removed because they were causing discomfort they should have been taken off.

The hearing continues.

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