The Thanyaburi Provincial Court inquest into the death in custody of a pro-democracy activist has found that she died from a mineral imbalance compounded by an enlarged heart. The ruling did not resolve whether negligence by officials and medical staff contributed to her death. 

Pro-democracy activist Netiporn Sanesangkhom died on 14 May 2024 while held in pre-trial detention on a royal defamation charge and after undergoing a long hunger strike to demand judicial reform. She was 28 years old. Her death led to questions about the treatment of detainees and demands for the release of political prisoners.

According to Thai law, when a person dies in official custody, the court is required to conduct a post-mortem. 

In this case, the inquest included four hearings since 20 August 2025. The Court heard testimony from eight witnesses, including experts, the medical staff who provided treatment, and her family. A key issue raised by the family was whether the Correctional Hospital had provided treatment and attempted resuscitation in line with medical standards.

Her family argued that an endotracheal tube had been placed incorrectly in her oesophagus instead of her trachea or windpipe. As a result, oxygen was pumped into her stomach and intestines instead of her lungs. They also argued that Netiporn was given medicine which promotes potassium excretion, although the staff were aware that she was already suffering from critically low blood potassium levels.

The Court delivered its ruling on Wednesday (15 July). According to Thai Lawyers for Human Rights (TLHR), the Thanyaburi Provincial Court found that the evidence presented by Netiporn's family alleging that her death resulted from negligence by state officials remains disputed. The Court ruled that Netiporn died from mineral imbalance along with an enlarged heart. 

Following the ruling, lawyer Krisadang Nutcharus, representing Netiporn’s family, told the media that the Court confirmed that Netiporn died in the custody of the Corrections Department, a fact that the agency could not deny.

Krisadang stated that whether her death resulted from substandard treatment by state officials remains unresolved since the Court's jurisdiction in a post-mortem inquest is limited. The purpose of the inquest is to establish the circumstances of the death and provide the basis for any subsequent criminal proceedings.

The lawyer explained that the case will be forwarded to the public prosecutor to determine whether a criminal lawsuit should be pursued. However, the law does not preclude the deceased's family from initiating criminal proceedings independently. 

Netiporn’s family had already filed an earlier complaint with Khlong Luang Police Station.

Netiporn’s activism 

In 2020, Netiporn joined the student rights group Bad Student to campaign against school dress and hairstyle codes before becoming a founding member of the monarchy reform activist group Thaluwang. The group conducted a number of polls regarding the monarchy, from road closures during royal motorcades to whether people want their tax money to be allocated to the monarchy. 

She was prosecuted in a total of 7 cases over her political activities, two of them involving the royal defamation law. One was for conducting a poll on royal motorcades at Siam Paragon shopping mall on 8 February 2022, and another was for conducting a poll on whether people agree with the government allowing the King to use his powers as he pleases.

7 activists charged with royal defamation and sedition over the motorcade poll had the charges dismissed just over a week ago on 6 July by the South Bangkok Criminal Court. Netiporn did not live to see the charges dismissed.

Netiporn was detained twice. The first time was after the South Bangkok Criminal Court revoked her bail. Netiporn and fellow monarchy reform activist Nutthanit Duangmusit went on hunger strike to protest their detention before being granted bail after 64 days of their hunger strike and 94 days of detention. 

She was detained a second time after the South Bangkok Criminal Court revoked her bail again on 26 January 2024 for participating in a protest at the Ministry of Culture on 6 August 2023. On the same day, the Court sentenced her to one month in prison for contempt of court charge for an incident on 19 October 2023 when Netiporn and activist Thanalop Phalanchai attended the trial of Saharat Sukkhamla, a graduate from Mahidol University’s College of Religious Studies and ex-novice monk, who was found guilty of royal defamation. 

The two activists reportedly climbed a fence near the cells in the basement of the South Bangkok Criminal Court in an attempt to ask if Saharat needed anything to eat while he was detained pending the result of his bail request. A court marshal and two security guards stopped them and threatened to charge them with contempt of court. An argument occurred after Netiporn and Thanalop asked the court marshal for his name and whether he had the authority to charge them. The marshal then hit Netiporn with a baton, injuring her.

Immediately on being detained, Netiporn went on a hunger strike to demand judicial reform and an end to the detention of political dissidents.

Death in detention 

On the morning of 14 May 2024, it was reported that Netiporn was pronounced dead at Thammasat University Hospital, where she had been transferred from the Corrections Hospital after suffering a cardiac arrest.

It remained unclear whether Netiporn died while at the Corrections Hospital or at Thammasat University Hospital. Records obtained from Thammasat University Hospital stated that Netiporn had no vital signs upon arrival at 9.30 on 14 May, and that doctors found that an endotracheal tube had been placed in her oesophagus instead of her windpipe. The placement of the tube is believed to be a major cause of her death, although there could be other reasons. 

Meanwhile, Netiporn’s medical records obtained from the Corrections Hospital diagnosed her with Refeeding Syndrome, a condition caused by a severe shift in electrolytes when a person who is malnourished begins feeding again.

It was not easy for the family to get the Corrections Hospital to release the records. Lawyer Krisadang said that Netiporn’s legal team was initially granted the power of attorney by Netiporn’s older sister to request her medical records and CCTV footage from her hospital ward, but was told that the Department of Corrections’ regulations stipulate that only a parent can obtain the records. Two days later, lawyers and activists who went to the Corrections Hospital were forced to wait in front of the gates for several hours as officials insisted on seeing Netiporn’s family members before eventually handing over the records to her lawyers.