In today's day it would be considered a petty crime, but James Best was thrown behind bars over the theft of a gingerbread biscuit when it took place in 2011.
Mr Best had nipped into an already ransacked bakery during the chaos of the London Riots in August that year.
The Croydon resident pinched the sugary snack but was seen by the police, who arrested him and took him to a high-security prison in Wandsworth.
Mr Best had spent several months in a cell when he tragically died of a sudden heart attack aged just 37.
His brother Owen Daniel has spoken out 10 years on to say he still doesn't think his brother's actions warranted his arrest.
“I mean, what can you really steal from a bakery, a couple of loaves of bread if you're lucky?" he told MyLondon.
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“To send someone to HMP Wandsworth, which I'm pretty sure is one of the most high security type prisons we have, is absolutely ludicrous. I don't see the actions as justifiable.
“I understand the need for prisons and the prison system, but I'm not sure [this incident] was really what it was set up for.”
A month earlier, James had been convicted of criminal damage and sectioned under the Mental Health Act after self-harming on a London street. He had never been to prison before.
Owen was shattered by the news of his brother's death but had managed to find some solace in the fact that he had died of "natural causes".
With James in prison, Owen worried he’d been killed in some type of violence.
“I got a phone call from my father saying that my brother James had died,” he said.
“Obviously that was a bit of a massive shock to the system. [But] my dad was like; ‘don't worry, it was natural causes’ which to be fair sounds like quite a nice way to go, right?”
However, as Owen began to learn more about the circumstances of his brother’s death, he said he was disturbed by what he found.
“The prison had invited my father, mother or myself to go visit the prison and see his cell which I accepted,” he explained. “So I made a journey up to London [with] a friend who's a bit bigger and braver.”
“I met his cellmate and managed to have a little private conversation,” claims Owen. “He painted a bit of a different picture about his final moments.”
The cellmate explained that, even though he wasn’t authorised to do so, James had just been in the prison gym when he’d died, pushing himself really hard.
Owen’s brother suffered from Crohn's disease, arthritis, high blood pressure and asthma, so strenuous exercise could be dangerous.
Owen said the cellmate explained that when he’d finished his workout he left the gym and one of the workers offered him a cigar, which he smoked. Moments later he suffered a heart attack.
“All the guards in the prison just kind of fobbed him off. [They] were like; ‘stop mucking around, put your t-shirt on’ ignoring him,” claims Owen.
“I thought he just died of natural causes and now there's stories of guards ignoring him as he's kind of dying and stuff.”
'Three minutes to call the ambulance'
Owen says he continued to learn more disturbing information about the way in which the prison handled his brother’s heart attack.
“Me and my mother kind of tried to take this to court to try to get some answers," he said. “There were a number of very big failures from the prison’s side. [Firstly] he probably shouldn't have been allowed in the gym unsupervised, [then] when he starts having a heart attack, obviously, no one believes him.
“[Finally] by the time they [make] the phone call from the prison to the ambulance service it lasts about three minutes. I think the average 999 call is probably 10 to 15 seconds.”
The reason for this delay, Owen explained, was because the person placing the call couldn’t answer the diagnostic questions the operator was asking because he was in a different room to his brother.
“[The prison officer making the call was saying] ‘this guy's dying’ and the ambulance service, we're saying; ‘terribly sorry from what you've told us, we can't send an ambulance straightaway," Owen said.
“They cancelled two ambulances that were meant to be going to my brother and diverted them somewhere else. By the time the ambulance arrived, about an hour later, my brother was dead.
“So that was all pretty horrific to learn about in the aftermath."
'We led the court battle'
Owen and his mother took the St George's Healthcare NHS Trust - who were responsible for providing medical care to the system to the prison - and the London Ambulance Service to court.
The process was an emotionally draining one for both Owen and his mother.
“It was difficult for me and my mum, because we sort of led the court battle. It was very, very tough," he explained.
The case made it all the way to the High Court , where the judge ultimately ruled against them.
But a positive outcome from the legal fight was one judge's ruling, which Owen said, would force prisons to call for blue light ambulances immediately.
He said: “My understanding is the judge instructed for future reference that all prisons should automatically get a blue light ambulance.
“[They] can then cancel it if they need to cancel it, rather than having to try to debate it for three minutes while someone's dying.
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“So we got some rule changed or best practice guidelines changed.”
Since James’ tragic death rules around unsupervised exercise in prisons have also changed.
Responding to the points raised in this article a Prison Service spokesperson said: “Our thoughts remain with the family and friends of Mr Best.
“Since his death we have introduced a number of improvements to ensure quicker transfers to hospital and enhanced health assessments of prisoners.”
