A frail and immobile prisoner was shackled to his hospital bed for three weeks until just hours before he died, despite concerns the restraints were interfering with his care, a coronial inquest has heard.

Key points: Prisoner was shackled to his hospital bed until just hours before he died

Prisoner was shackled to his hospital bed until just hours before he died Inquest hears hospital staff made repeated requests for restraints to be removed

Inquest hears hospital staff made repeated requests for restraints to be removed Doctor says the shackling was unnecessary and described it as "overkill"

Anthony Stephen Gibson, 53, was suffering from oesophageal cancer and aspiration pneumonia when he died on July 3, 2015.

He was serving a sentence at Port Augusta Prison for breaching his parole when he was transferred to the Queen Elizabeth Hospital (QEH) on June 12, 2015.

In her opening address, counsel assisting the coroner Kathryn Waite said Mr Gibson remained restrained in his bed despite repeated requests from hospital staff for the Department of Corrections to authorise the removal of his shackles.

"Mr Gibson remained shackled until the day of his death, that is despite being palliated, frail and immobile with illness," she said.

"This court will likely be questioning whether Mr Gibson's ongoing restraint has interfered with his optimal medical treatment during his period of palliation."

In her statement to police, QEH palliative care consultant Sally Williams said on several occasions she asked the guard if the shackles could be removed.

"Even during the terminal phase of his illness he was shackled by his arm and leg, with a guard in attendance continuously," she said.

"He could no longer walk and the shackling in this manner meant that we couldn't posture him upright to reduce the chances of aspiration."

In her evidence to the court, Dr Williams said the shackling was unnecessary and she described it as "overkill".

"He was so frail, he wasn't going to go anywhere quickly, he wasn't a flight risk," she said.

Staff had to seek approval to remove restraints

The court heard the hospital staff had to take it upon themselves to contact the Department of Corrections and try to track down the right official to approve the removal of restraints.

"The main issue that I felt about looking after this patient was the interface between the health system and correctional services or the guard essentially," Dr Williams said.

"It was frustrating because the guard never seemed to have any power to do anything."

The court heard since Mr Gibson's death, the department had undertaken a review into "more flexible approaches" for prisoners at the end of their life.

But Dr Williams said she did not believe having more policies was useful in a practical sense.

"A policy will be stuck somewhere and the clinicians on the shop floor — we haven't got easy access to that sort of information," she said.

"If I had to do this again I'm not sure that I would be any clearer on how to get a patient unshackled."

The court heard there was a level of confusion between the Department of Corrections and the company which hires the guards about the level of restraints required.

The inquest is expected to run until Friday with a number of Corrections officials and guards to give evidence.