A sex offender died from coronavirus on Christmas Day with an investigation finding he likely caught the illness behind bars.
Andrew Forber was being held in Walton while awaiting sentence for his crimes.
The 69-year-old had the underlying health conditions of diabetes and asthma.
He also had difficulty standing - leading to questions over why he was restrained at hospital and during his transfer there from the jail.
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Forber was initially held in Altcourse before being moved to Walton, formally known as HMP Liverpool, in October 2020 following his conviction for sex offences.
He was identified as being clinically vulnerable but chose not to shield despite being briefed of the risks he faced.
The dad was transferred to hospital on December 21 after falling twice and was confirmed as Covid-19 positive the following night. He was diagnosed with Covid-19 pneumonia on December 23 and, on Christmas Day, medics began end of life care as he was not responding to treatment.
An investigation has since been carried out by the Prisons and Probation Ombudsman, which probes the deaths of all inmates.
It found that, because Forber had last left Walton for a court appearance on November 9, it was likely he had contracted coronavirus in the jail.
He is one of three HMP Liverpool inmates to have died with Covid-19.
While the PPO found no issues with the jail's management of Forber's health, it did highlight concerns over how he was managed on his way to hospital, and while initially there.
During the journey an escort chain linked him to prison officers and he was double-handcuffed to a guard while changing into a hospital gown.
The PPO report said: "We recognise that many factors have to be taken into account in determining the level of restraint.
"However, we question whether the use of restraints was proportionate while Mr Forber was in hospital, given his reduced mobility, his struggle to even stand upright without falling because of his illness, the medical opinion on the risk assessment and that he had displayed no behavioural problems in prison or during several visits to court in the previous months.
"We certainly cannot see the justification for double cuffing (albeit briefly), which needlessly placed one of the escort officers at greater risk from being physically closer to someone with symptoms of Covid-19."
The escort chain was removed 24 hours after Forber arrived in hospital.
Sue McAllister, the ombudsman, added in her conclusion: "We are not satisfied that the use of restraints was proportionate, given Mr Forber’s reduced mobility, the medical assessment on the security risk assessment and low risk of escape.
"In particular, it seemed excessive and unnecessary to double cuff Mr Forber while he changed into a hospital gown and this also placed an escort officer at greater risk of infection from being in closer proximity to him."
The concerns led the PPO to recommend Walton's governor should ensure staff understand the legal position on the use of restraints and take into account the prisoner’s health, so any decision over restraints is based "on the actual risk he presents at the time".
In a response published alongside the PPO report, Walton accepted the recommendation and said the issues raised had been shared with the relevant staff and that the jail's head of security "has reminded his team of analysts that they should consider all information provided by healthcare concerning the fitness and mobility of any prisoner attending outside hospital when recommending the use of restraints".
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