The mother of Jai Davis is considering a private prosecution or taking civil action over the death of her son at Otago Prison.
This follows the release of the coroner's findings that criticise the Corrections Department and label the police investigation into Davis' death in 2011 as flawed.
The coroner David Crerar found Davis died after swallowing about 60 valium and codeine pills from a pill bottle he had hidden in his rectum.
He had been trying to smuggle the drugs into the prison but was found out and put in isolation while guards waited for him to expel the pills.
The Howard League for Penal Reform presented evidence at the inquest.
Its lawyer Nigel Hampton QC said the guards were more interested in stopping the drugs from getting into the prison than looking out for Davis' health.
"It could be said no one individual was necessarily causative but if you stood back from it you would say all the systems in place in this particular prison on this particular occasion were woefully inadequate."
The coroner recommended the Independent Police Conduct Authority look into the case, but already the authority said this would not be happening.
It said it already reviewed the initial investigation and found the police acted appropriately.
Alcohol and Drug Councillor Roger Brooking, who acted as an advocate for Jai Davis' family, said the IPCA may have looked at the investigation of his death, but it was yet to examine the role the police played in contributing to his death in the first place.
"The police knew that Jai Davis had drugs on board when they took him out to Otago prison.
"And what they should have done was arrested him under the Misuse of Drugs Act and had him observed in the police cells. He should never have been taken to Otago Prison in the first place."
Mr Brooking welcomed a call by the coroner for the Health and Disability Commissioner to look at the case.
"Jai Davis was seen by half a dozen nurses and not one of them bothered to call the prison doctor, nor did they even bother to call the health centre manager, and ask for advice. They just left Jai Davis to die."
Davis' mother Victoria Davis said she was now considering taking either a private prosecution or a civil case against those she held responsible for her son's death.
"Where was the duty of care to my son? What they did was criminal. It was not a systemic breakdown, it was criminal."
Mr Hampton said the charge of corporate manslaughter the Minister of Justice Amy Adams was now considering introducing could apply to the Jai Davis case.
"A corporate manslaughter charge might well have fitted this particular occasion, because it's here that organisation and management could be said failed grossly in the duty of care they owed this man and that management and organisation caused this man's death."
The Corrections Department accepted the Coroner's findings and said it now dealt with drug concealment cases very differently, and sent all prisoners to hospital first.
The Health and Disability Commissioner is now considering the findings before deciding whether to investigate.