Постановление Европейского суда по правам человека от 30.09.2010 «Дело Пахомов (Pakhomov) против России» [англ.]

scheduled an X-ray examination. The doctor's recommendations were promptly put into practice. Subsequent X-ray exams were also performed without undue delay.
65. However, despite the steps taken by the facility administration which the Court interprets as their evident commitment to control tuberculosis, the applicant suffered a relapse of the illness less than three months after his arrival in the facility. While the cause of the reactivation of the illness is not the subject matter of the Court's examination (see paragraphs 51 - 53 above), it considers it necessary to reiterate its constant approach that even if an applicant had contracted tuberculosis while in detention, this in itself would not imply a violation of Article 3, provided that he received treatment for it (see Alver v. Estonia, No. 64812/01, § 54, 8 November 2005, and Pitalev v. Russia, No. 34393/03, § 53, 30 July 2009, with further references). However, the State does have a responsibility to ensure prevention and treatment for prisoners in its charge and a lack of adequate medical assistance for serious health problems not suffered from prior to detention may amount to a violation of Article 3 (see Hummatov, cited above, § 108 et seq.). This principle should certainly be extrapolated to the case of the applicant, who suffered a relapse of tuberculosis after his admission to the detention facility. Absent or inadequate treatment for tuberculosis, particularly when the disease has been contracted or reactivated in detention, is most certainly a subject of the Court's concern. The Court is therefore bound to assess the quality of medical services rendered to the applicant in the present case.
66. Having studied the applicant's medical records produced by the Government, the authenticity and reliability of which the applicant did not dispute, the Court has already established that after admission to the detention facility the applicant was under constant medical supervision. After the early symptoms of the reactivation of the disease, such as fatigue, excessive sweating and high temperature, began to manifest themselves and subsequent medical examinations, including a survey X-ray exam, revealed a relapse of the illness, the applicant was promptly transferred for in-patient treatment to the pulmonary tuberculosis ward of the medical department in the detention facility. In this respect the Court does not lose sight of the timely and active screening actions of the facility medical personnel in identifying the reactivation of the applicant's infection, a cornerstone measure in the modern strategy of tuberculosis control and treatment.
67. The Court further observes that the quality of the treatment provided to the applicant following the detection of the tuberculosis relapse appears to be adequate. In particular, the evidence put before the Court shows that the Russian authorities employed all existing tools (sputum smear bacterioscopy, culture testing and chest X-ray exams) for correct diagnosis of the applicant, having considered the extent of the disease and determined the tuberculosis severity to prescribe appropriate therapy. In particular, it did not escape the Court's attention that a drug susceptibility test had been performed at the initial stage of the diagnostic process, in line with the WHO's most recent recommendations (see paragraph 50 above). The test not only allowed efficiently finalising diagnostic procedures and allocating the applicant's case to standardised treatment category, but also guided the choice of appropriate regimen adjustments given the results of the test. At the same time the Court is satisfied that the DST did not delay the start of the applicant's treatment.
68. Having been placed on a strict medication regime necessary for the tuberculosis therapy when the initial stage of the treatment was followed by the continuation stage as recommended by



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