Mr A Head injury sustained prior to detention in custody

Transcription

1 Head injury sustained prior to detention in custody Independent Investigation Final Report IPCC Reference: 2012/016073

2 Contents Introduction... Error! Bookmark not defined. Terms Introduction of reference... Error! Bookmark not defined. 3 Subjects Terms of Reference... to the investigation 53 Chronological Subjects of the summary investigation of... events 65 Policies Chronological and procedures summary of... events 396 Conclusions Policies and Procedures Error! Bookmark not defined.0 39 Conclusions Version 0.1 Page 2 of 45

3 Introduction 1. At 7.46pm on Saturday 22 September 2012, Gwent Police received a 999 call reporting that a drunk man was in the middle of Blackwood Road, Pontllanfraith, Blackwood, and was in danger. A police officer was dispatched and by the time he arrived, the man, later identified as was lying on the floor. 2. A witness to the incident called an ambulance for and he was taken to hospital. A few hours later Gwent Police received a call in relation to Mr A s behaviour, requesting his removal from the hospital. was arrested for being drunk and disorderly and taken to Ystrad Mynach police station. 3. Detained in custody, concerns were later raised about s welfare. Mr A was taken to hospital, where it was established that he had several fractures to the back of the skull and bleeding to his brain. 4. This incident was referred to the IPCC and the decision taken to independently investigate the circumstances. Terms of Reference 5. The terms of reference were set as follows: 6. To investigate: a. The police response to, and action taken following, the initial incident at the takeaway; b. The circumstances around s arrest at the hospital and subsequent conveyance to Ystrad Mynach police station; c. s interaction with and treatment by police and custody staff during his booking into and detention in custody; d. The information obtained, communicated and recorded about and the above events by the police, control room and custody staff. Version 0.1 Page 3 of 45

4 e. Whether police, control room and custody staff adhered to the relevant local and national policies and practices in dealing with Mr A. 2) To assist in fulfilling the state s investigative obligation arising under the European Convention of Human Rights (ECHR) by ensuring as far as possible that: a) the investigation is independent on a practical as well as an institutional level; b) the full facts are brought to light and any lessons are learned. 3) To identify whether any subject of the investigation may have committed a criminal offence and if appropriate make early contact with the relevant prosecuting body. 4) To identify whether any subject of the investigation may have breached their standards of professional behaviour. If such a breach may have occurred, to determine whether that breach amounts to misconduct or gross misconduct and whether there is a case to answer. 5) To consider and report on whether there is organisational learning for the appropriate authority, including: whether any change in policy or practice would help to prevent a recurrence of the event, incident or conduct investigated. whether the incident highlights any good practice that should be disseminated. These terms of reference were approved by the Commissioner, Tom Davies, on 26 September Version 0.1 Page 4 of 45

5 Subjects of the investigation 7. Under the Police (Complaints and Misconduct) amendments Regulations 2008, police officers are to be served with a Regulation 14A notice by the IPCC in instances where it is believed an officer s actions may have breached the standards of professional behaviour. These notices are served where that breach is believed to be sufficiently serious that misconduct proceedings may be brought and the individual actions of the officer require investigation. This is known as the investigation being subject to special requirements. 8. The following officers were identified as subjects to the investigation: Police Constable (PC) A, PC B and Police Sergeant (PS) C. This investigation was therefore declared subject to special requirements. 9. PC A was served with a notice of investigation which alleged that he failed to perform his duties to the required standard. The evidence suggested that hospital staff had made both officers aware of the fact had sustained a head injury but that this information had not been passed on to the custody sergeant authorising s detention; this is in contravention of Gwent Police s Custody Policy. If proven or admitted, this conduct was assessed as potentially amounting to misconduct. 10. PC B was also served with a notice of investigation which alleged that she failed to perform her duties to the required standard. The evidence suggested that hospital staff had made her and PC A aware of the fact Mr A had sustained a head injury, but that this information had not been passed on to the custody sergeant authorising s detention; this is in contravention of Gwent Police s Custody Policy. If proven or admitted, this conduct was also assessed as potentially amounting to misconduct. 11. Both officers were interviewed in respect of this potential misconduct at the IPCC offices in Cardiff, PC A on Thursday 9 May 2013 and PC B on Friday 7 June Version 0.1 Page 5 of 45

6 12. Following the interviews of these officers under caution and the evidence garnered from these, a review of the special requirements resulted in the decision to issue a notice of investigation to the custody sergeant who authorised s detention, PS C. 13. The notice served on PS C alleged that he had failed to perform his duties to the required standard, in that, having been provided with information that had sustained an injury to the back of the head, PS C failed to accurately complete the risk assessment for him, in contravention of Gwent Police s Custody Policy. It was alleged that PS C also failed to identify that s behaviour could have been indicative of the effects of a head injury rather than intoxication and, in doing so, failed to ensure that was provided with the appropriate level of medical attention, in contravention of Code C of the Codes of Practice. It was considered that the allegations, if proven or admitted, may have amounted to misconduct. 14. PS C was interviewed in respect of this potential misconduct at the IPCC offices in Cardiff on Tuesday, 16 July Chronological summary of events 15. At 7.46pm on Saturday 22 September 2012, a member of the public, Witness A, made a 999 emergency telephone call to Gwent Police. He stated that an apparently intoxicated man () was staggering in the middle of Blackwood Road in Pontllanfraith, Blackwood, walking in front of moving cars and that he was in danger. The ORIS command and control system was utilised to create a record of this incident, log 493 of that date. 16. Gwent Police create a document for every reported incident. The system, called ORIS, collates and updates information relating to ongoing matters. For example every emergency 999 call will be initiated with an ORIS entry and the creation of a log. 17. Witness A stated that, after he called the police, he lost sight of and Version 0.1 Page 6 of 45

7 went outside to see where he had gone. He saw him in a bus stop approximately 30 yards away with another man (later identified as s brother, Mr B). Witness A turned to speak to a neighbour and when he turned back, was lying on the ground. 18. Witness A went over to help and stated that he saw another man calling for an ambulance on his mobile phone as he also went across the road. Witness A said that Mr B also appeared intoxicated and said, He s my brother, leave him alone and I ll look after him, I only pushed him. Witness A stated that, at this point, was unconscious. 19. It became apparent that the other man, whom Witness A had seen across the road on his mobile phone, was Witness B. Witness B had come to Blackwood Road to buy a meal from Wong s Chinese takeaway with his wife and their friends. Witness B stated that he saw the two men in the bus stop talking to each other. He said that he could see things becoming agitated between them and saw Mr B begin to move in an aggressive manner. He then saw him raise both hands, lunge hard at and give him an aggressive, full force shove to the upper body. 20. Witness B described how the force of the impact to his body caused the first male to lift physically off the ground. He said s neck flicked back like whiplash. He stated that, Within seconds he connected hard to the concrete floor with such force that I thought he would die. 21. Witness B said that he rang for an ambulance and started first aid on. He asked for the police to be called, as s brother was behaving aggressively and he was fearful for his own and others safety. Witness A, who did not know Witness B, informed him that the police had already been called. 22. PC D answered the emergency response call to attend Blackwood Road at 7.47pm. In a statement provided to the investigation, PC D said that, when he arrived at the scene, he could see lying on the ground. He was then approached by Mr B, who appeared extremely intoxicated. PC D Version 0.1 Page 7 of 45

8 could see that was breathing normally but was unresponsive. 23. PC D said that Mr B told him how they had been out all day drinking. He said that had wanted to get food from the takeaway but, while they were in there, he became rowdy, shouting that he wanted his food. Mr B said that, because of his behaviour, he had taken outside and marched him over the road away from people, as he had started shouting at them as well. Mr B told PC D that he had let go on the other side of the road, then watched him walk backwards, fall over and bang his head on the pavement. Mr B said that had been unconscious since he hit the floor. 24. PC D stated that he checked the area around where was lying and the back of his head, but could not see or feel any blood. PC D said that a male voice from the crowd of people gathered around them said that he had seen fall over and hit his head on the floor, but PC D could not identify who said this, as he was busy checking on. 25. PC D said that the ambulance then arrived and he gave the information he had to one of the paramedics. 26. The paramedics who attended were identified as Witness C and Witness D. There is some conflict between the accounts they provided to the investigation and that of PC D. Both paramedics made an initial statement for the Gwent Police criminal investigation into s injury. 27. In the initial statement, Witness D stated that, when he and Witness C arrived at the scene, he spoke to the police officer present who told him that had struck his head on the floor and had been unconscious for three or four minutes. In the later statement to the IPCC investigation, Witness D said that the officer told him that s brother had punched Mr A and caught him on the chin, causing him to fall over and hit his head. 28. Similarly, in his statement to the police, Witness C said that the police officer told him that the man on the floor was. In a further statement Version 0.1 Page 8 of 45

9 to the IPCC, he said that the officer told him that the two men involved were brothers; known previously to the police for aggression and drinking. Witness C said that he and Witness D were told that the brothers had both been drinking and that one had hit the other. 29. Both paramedics stated that the call they received to attend the scene provided them with the information that the head injury followed an assault. The IPCC investigation obtained audio recordings of the calls made by Witness B and from the ambulance control room to the paramedics. Witness B told the ambulance control operator, I ve just seen someone push someone over and he s completely and utterly sparked out. He later said he s banged his head and informed the operator he was unconscious but breathing. Witness B can also be heard telling the ambulance control operator that it was the man s brother who had pushed him over. The operator asked Witness B if there was any serious bleeding and he replied, I don t think so, no, there s nothing on the back of his head, no. 30. During the call from ambulance control to the paramedics, the operator can be heard telling Witness C it s an unconscious male apparently he s been pushed over, he has a head injury. I m going to ring the police now, the attacker s still there. This was acknowledged by the paramedics. The operator then placed a call to the police to ask for their attendance, but the log for this call shows that it was subsequently linked to the call relating to PC D s attendance at the same incident, and so further police deployment was not required. It was closed at 7.56pm following being linked to the first one. 31. PC D maintained and stated, I can categorically state that I did not receive any information at the scene that had been hit or punched. 32. He further stated that he did not know at the time that Mr B had pushed Mr A; he stated that, if he had known, he would have asked another police unit to attend and arrest Mr B for the assault. Version 0.1 Page 9 of 45

10 33. On challenging PC D, in respect of Witness B s statement an independent witness - that he had told PC D how he had seen Mr B push, PC D said that he did not recall this and, if Witness B had said this, he did not hear it. He said that there was a great deal of noise from his earpiece, radio traffic, road traffic and Mr B shouting. Specifically, he said that if he missed this information, this was a genuine mistake caused by the noise and his attention being focussed on dealing with a seriously injured casualty. 34. There is clearly confusion over the origin of the information provided to the paramedics that Mr B was the perpetrator. The control room s entry on the log following an update from PC D regarding his attendance at the scene read, was located unconscious in the recovery position. His brother stated that he had pulled him out of the Chinese as he was drunk and causing a bit of a nuisance. When was walking over the road, he fell backwards and hit his head on the concrete pavement. There is no information on the log relating to the incident to indicate that PC D had been made aware of the assault. The police incident log relating to the call from ambulance control asking for police to attend (which was not actioned, as PC D was already there) also does not mention the fact there had been an assault; it reads wong Chinese take away, blackwood road, unconscious male head injury ambulance eta [estimated time of arrival] 4 minutes, 30tiees [thirties]. 35. As part of this investigation, a witness appeal was launched in the vicinity of Blackwood Road and a dedicated telephone line and address were set up, so that members of the public who might have witnessed Mr A and Mr B s interaction with PC D could contact the IPCC. To date, no relevant witnesses have been identified. The IPCC also sought to retrieve any relevant CCTV but there was no camera coverage of this particular area of the road and none from the Chinese takeaway. 36. The narrative section of the clinical record for completed by the Version 0.1 Page 10 of 45

11 paramedics states Male assaulted head injury. Fallen backwards striking head on floor. It also states patient under influence of vast amounts of alcohol and cannabis. Patient unconscious for 3 4 mins. 37. The paramedics placed on a spinal board at the scene as a precaution, due to his head injury. By this point, had regained a level of consciousness and was recorded as having a Glasgow coma scale level of 13, as his speech was slightly slurred and he would only open his eyes when asked to. 38. was taken to Nevill Hall hospital in Abergavenny, arriving at 7.51pm. The paramedics stated that the journey to the hospital was uneventful but, once they arrived, became agitated, kicking out and trying to get off the spinal board. He began swearing and became aggressive. 39. Witness E, a nurse at Nevill Hall, provided an initial statement to the police investigation and a further one to the IPCC. In her initial statement, she said that, when she was introduced to, he immediately sat up on the hospital trolley he was lying on, removed his neck brace collar and threw it to the bottom of the trolley. Witness E said that, at that time, had not been seen by the triage nurse but had been booked in by the paramedics at 9.01pm. 40. The notes on s clinical record made at 9.10pm state Brought in by ambulance with medical history of assault with loss of consciousness. Patient under the influence of drugs and alcohol. The record then states Observations recorded on triage patient collared and boarded. Patient lifting his head up and pulling collar off after advising him not to. Patient will not listen and very uncooperative. Patient got up off trolley and walked to toilet. 41. Witness E said that, due to s level of intoxication and head injury, she decided to keep him in a high dependency room where he could be Version 0.1 Page 11 of 45

12 observed at all times. 42. At about 10.30pm, the nurse allocated to, Witness F, came to see Witness E and said that had walked to the x-ray corridor, put himself on the floor and was refusing to get up. Witness E went to see and told him that he needed to be on the trolley so that the staff could look after him. became belligerent, mumbling and shouting fuck off and calling the staff obscene names. He started spitting at Witness F. The staff managed to get him back onto a trolley and he was wheeled into a cubicle in the high dependency room. At this time, was still awaiting observations and to see a doctor. The notes made on s clinical record at 10.30pm corroborate these events, stating patient would not allow me to record observations from him, assess pupils or take blood. Patient spitting in cubicle. 43. Witness E stated that at approximately 11.25pm, a doctor, Witness G spoke to her and told her that was refusing to be examined and was being abusive towards him. She said that she and Witness G decided to give time to calm down; she stated that the doctor made several more attempts to examine him but was continually uncooperative. 44. Witness G provided a statement to the investigation in which he said that he saw half-sitting, half-lying on the floor with his back against the wall in the Psych room, which is usually used for psychiatric patients, general overflow or for upset or difficult patients. Witness G said that he went in to see if was alright. was conscious and he asked him if he was OK and if he could have a look at him, but said no. Witness G said that was conscious, but had his eyes shut, although he opened them when spoken to; he said that lifted his head to talk and then put his head back down. Witness G said that he could recall smelling alcohol on him. 45. Witness G said he did not recognise and, as far as he could remember, did not know that had injured his head. He said that once Version 0.1 Page 12 of 45

13 he had spoken to, he made a note on s Accident and Emergency card to state that had refused examination; Witness G put the card back in the slot in the office for to be seen later. He could not recall how he knew which card belonged to but believed that he might have asked someone. Witness G said that was not abusive towards him and he did not see any injuries on him. He stated that he could not recall speaking to Witness E about this. 46. At about midnight, Witness F came to see Witness E and said that she could not manage. In her statement, Witness F said that she felt in fear for her own safety and that of other people, due to the extreme aggression in s voice. He was hostile and temperamental and she felt that he was frightening a lot of patients. Witness E asked that be brought to the interview room so that she could personally observe him from the triage room where she was working. 47. was walked into the interview room and put himself on the floor, lying on his left side. Witness E said that she decided to leave him there for his own safety, as he could not fall while he was lying there. 48. Shortly after this, Witness H, a nurse, told Witness F that had wandered into the staff room, had sat down and was refusing to leave. Witness F went to the staff room and saw sitting just behind the door on a chair. She explained to him that he was not allowed in there and needed to be looked after, but he repeatedly told her to fuck off and pulled away from her whenever she tried to take hold of him. 49. Witness F stated that, at this point, she called for porters to help take from the staff room and asked for the police to be called. She said that Mr A had been abusive and uncooperative for three hours and they needed help, because she did not know what else to do with him. She was worried that he would eventually hit out at a member of staff as he was being so aggressive towards everyone who tried to deal with him. Version 0.1 Page 13 of 45

14 50. The police were called at 12.08am by a nurse, Witness I. Command and control ORIS log, 4 of 23 September 2012, refers to this call and states patient is quite aggressive and is wandering around all areas where he shouldn t be. Request officers attend to remove him. He is in A and E and in the staff room and won t leave. 51. The log states that the police arrived at Nevill Hall hospital at 12.09am. The officers and hospital staff noted that, fortunately, the officers were already nearby. 52. Witness F said that she and two porters, Witness J and Witness K, managed to get into a wheelchair and pushed him outside the entrance to Accident and Emergency, to try and calm him down. A police van arrived with two police officers, one male and one female, attending. The officers were identified as PC A and PC B. 53. Witness F stated that she explained to the officers that was aggressive, abusive, was refusing to allow them to examine him and that she was concerned about his behaviour. At this point, was sitting in the wheelchair with a blanket over his head and would not let staff take it off. 54. Witness F stated that the female officer asked her about her concerns and she replied that her main concern was s head injury, for which he had not received treatment, because he had alcohol on board. She stated that the officers spoke to, asking him if they could contact his mum, but he just continued swearing at them. They used their radios to ask for further information on and, because he had a history of violence, PC B said that they would take him to a custody suite for observation. 55. Witness J, a hospital porter who assisted taking outside in the wheelchair, stated that he was present when the officers attended and spoke to Witness F, but said that he could not hear the conversation. He said that at no point during his involvement with was he aware why Version 0.1 Page 14 of 45

15 had been brought into the A&E department, or what treatment he required. He said that he did not hear the officers being advised of this information either. 56. Witness L, a nurse who also assisted in taking outside to await the ambulance and who was present when the officers attended, stated that he did not hear anyone from the hospital inform the police of any medical conditions had or any concerns they had on his behalf. He stated that he did not know why had been in the A&E department. 57. Witness F recalled that the male officer eventually put in handcuffs, whilst continued swearing and shouting. She recollected that walked unaided to the police van, which was less than two metres away, and was a little resistant to getting in the van, using his foot as a stopper, but he did get in the van. 58. Witness F stated that she did not hear PC B pass the information about Mr A s head injury on to PC A or on her radio. She stated that she assumed would be seen by a custody nurse at Ystrad Mynach (the custody suite to which he was taken) because she had a friend working there as a custody nurse and knew that police surgeons were usually on duty in that area. 59. Witness F said that if the police had not been an option to deal with, they would have kept him in the hospital somehow, as they would not have wanted him to leave without being treated, due to the nature of his injury and the fact that he had drunk so much alcohol. 60. However, she also stated that, as they had tried their best to treat for approximately four hours, she felt that they had little option but to call the police for help, as they feared for the safety of the staff and the other patients. 61. Witness F was asked whether she told the police officers that had been assaulted and said she could not honestly recall what was said in the Version 0.1 Page 15 of 45

16 conversation between them. 62. Witness F was also asked whether there had been an option to sedate Mr A in order to treat him rather than having him arrested. She stated this would not be a nursing decision and would instead be taken by the medical doctor treating the patient. 63. Witness G was asked if sedation is an option for doctors when trying to treat someone who is abusive and resistant to examination. He said that this question would be best answered by a specialist in emergency medicine and suggested Witness M as a suitable reference; was not abusive or resistant towards him, therefore it was not something Witness G needed to consider. 64. This investigation sought repeatedly to contact consultant Witness M at Nevill Hall hospital, in order to provide a definitive answer to this query, as s family raised it as a concern in relation to s treatment. However, it was not possible to obtain this information. The family may wish to consider a direct approach to the NHS on this point. 65. In interview, PC A stated that he was on duty with PC B in a marked police Mercedes Sprinter van. He said that they received the call regarding at roughly midnight and, although he could not be sure exactly where they were at the time, he recalled thinking that the timing was lucky as they were close to Nevill Hall hospital. 66. PC A said that the call came from Gwent Police control room and was received on his Tetra radio. The call was an emergency request for police assistance at Nevill Hall hospital, as a man was being abusive to staff, acting in a disorderly way and the staff wanted him to be removed. 67. PC A stated that they arrived in the ambulance bay at Nevill Hall hospital approximately ten minutes after receiving the call and were met by two porters and two nurses. He said that he did not know these staff; he did not recognise, had not heard his name before and could not Version 0.1 Page 16 of 45

17 remember having had any previous dealings with him. He said that, when they arrived at the hospital, was in a wheelchair, with a hospital blanket draped over his head. 68. PC A stated that was shouting and swearing. He said that he pulled the blanket down a couple of times to try and speak to and could smell intoxicants on him straight away; coupled with s behaviour, this made him form the opinion that was drunk. 69. PC A said that he could not see an injury on s head but clarified that, due to the time of night, the lighting was poor. PC A said that he tried asking questions, including how he was and where he was from, but just responded by swearing and telling him to leave him alone. PC A said that, as far as he could recall, stayed in the wheelchair throughout the time he was talking to him, but moved around in the chair, putting his legs over the side and hunching over and so on. 70. PC A said that he thought PC B had also spoken to but could not recall the conversation. He said that PC B was having a general conversation with one of the nurses about how had come to be there and the nurse said that he could not stay at the hospital any longer. PC A said that he felt he and PC B had little option other than to arrest, because he was not providing any next of kin details and was drunk and belligerent. 71. PC A said that, eventually, the nurse and PC B came over to him and and spoke to him. He said that the nurse informed them that was brought in by ambulance from Blackwood, he had a slight head injury to the back of the head, that they had done initial assessments and that these were fine. PC A said that the nurse told them how they had hoped to book him for an x-ray, but was wandering round the corridors, trying to sleep under the machines, wandering into the staff area and was clearly unmanageable for hospital staff. 72. PC A remembered that PC B asked the nurse specifically what kind of Version 0.1 Page 17 of 45

18 medical concerns there were, to be told that there were none. PC A said that he asked the nurse specifically about s head and she replied in terms similar to, in an ideal world we would do it as a precaution but we haven t got any concerns for him and he s not allowing us, he s being uncooperative and not allowing us to x-ray him. PC A stated that he did not ask what the assessment included as he trusted the nurse s judgement, stating that, if a nurse was telling him that was medically fit for discharge, he believed her. Therefore, as he could not stay at the hospital, was technically out in the street and he had to deal with him. 73. PC A said that at no point did the nurse tell him she knew that had lost consciousness and she did not tell him that had been assaulted. He said they queried why was there and the nurse said that she knew only that he came in from Blackwood, was drunk and had a slight injury to the back of his head and that they did not know the cause. 74. PC A stated that he did not see any hospital notes in relation to and he would not normally see these. 75. PC A said that he could not recall asking about the injury to his head or about how he was feeling and could not recall PC B doing so. 76. PC A stated that it was PC B s decision to arrest for being drunk and disorderly, but he had no disagreement with it. He said that he handcuffed at the front of his body following the arrest and conducted a cursory search of him before they placed him in the van. 77. PC A was directly asked if, at any point, he considered whether s behaviour may have resulted from his head injury. He stated that he had considered it. However PC A explained that, as he had two nurses there, one of whom told him that had been under their care for a few hours, had been assessed and that they had no concerns, his judgement moved from considering the matter as a medical issue, to considering it as a behavioural one, specifically drunkenness. Version 0.1 Page 18 of 45

19 78. PC A explained that, as he assessed the situation, the porters had moved outside the hospital as they did not want him back and s behaviour was likely to be the same at another hospital. He explained that, as they had unsuccessfully tried to get information about that could be followed up, the only options were to let him go whereby he would continue behaving as he had been, or arrest him. 79. PC A was asked if there was the option for to stay in hospital with a police officer in attendance. He said that he did not consider that as an option because hospital staff had stated that they did not want there, they could do nothing for him and wanted him removed. PC A said that, if was drunk, which clearly he was, and being abusive, then that could escalate. He said that, escalation would need to be managed; he said that as the staff had said they had no concerns for and wanted him removed, then it was actually safer to remove him from the hospital than keep him there tying up one or more officers. He said that all these things came into consideration when making their decision. 80. PC A was asked if he would ever check decisions like this with a sergeant or inspector. He said that, if he felt he needed more information about what he could do police-wise then he would, but he thought that the situation in front of him seemed fairly straightforward, in that a drunk person was being disorderly. He also made the point that police officers deal with a high volume of drunk and disorderly people on Friday and Saturday nights and that, if they had to speak to a sergeant or inspector about each one, this would take up a disproportionate amount of their time. 81. PC A stated that, as far as he could recall, after being arrested, was able to walk unaided to the van with him and PC B on either side, although was continually verbally abusive. He said that PC B drove the van to custody while he kept an eye on, who he said was lying on the floor kicking, kicking the cage or punching the cage, or hitting the cage. Version 0.1 Page 19 of 45

20 82. PC A described the back of the van and the caged area, noting the two doors at the back of the van that opened into the metal cage, with hard plastic surrounding it on the inside. PC A described the benches in the cage on both sides of the van; these have room to fit two or possibly three people on each side. PC A said that they tried to sit up for safety reasons but he lay down; there are no seatbelts as it is a safe, sterile area so was free to move, apart from his handcuffs. PC A said that he did not mind hearing kicking, because this indicated that he was conscious and moving. 83. PC A and PC B drove in the van to Ystrad Mynach custody suite. The command and control ORIS log, number 4 of the 23 September 2012, records updates received from PC A and PC B at 12.25am stating one in custody for D/D (drunk and disorderly) and at 12.42am stating prisoner is kicking the cage. In a statement provided to the police following the incident, PC A stated that he informed the control room of s behaviour in the van via his Tetra radio. 84. PC A said that the journey to Ystrad Mynach custody took approximately 40 to 45 minutes, with kicking out and shouting intermittently throughout the journey. He said that there was no form to be filled in when taking a detainee from hospital to custody. He was asked what he knew about the medical provisions at Ystrad Mynach custody and said that he was not sure exactly how it worked; sometimes there would be a nurse working there, but sometimes not. 85. PC A stated that, once they arrived at Ystrad Mynach, he and PC B assisted into the custody unit. He said that both he and PC B went into custody separately for a few minutes each, prior to taking in. He stated that was passively resistant, in that he was holding himself back and was still verbally abusive but could walk by himself with the officers coaxing him along. He said that they initially took into the outer holding area and that another officer, PC E, came to assist them. Version 0.1 Page 20 of 45

21 86. PC A recollected that they took to the custody sergeant s desk and PC B began giving the circumstances of the arrest. He said that again began being verbally abusive, was not listening to instructions and kept turning away from PS C, the custody sergeant. 87. PC A stated that began leaning further and further towards him; he said that, at first, he tried to hold him upright and to turn to face the custody sergeant, but then suddenly dropped down deliberately to sit on the floor. 88. PC A was asked what he heard PC B telling the sergeant. He said that he could not recall exactly, as he was focused on and what he was doing. He recollected that she described the circumstances, the time of arrest, their arrival at Nevill Hall hospital and that had been brought in from Blackwood by ambulance. She told the sergeant of their initial assessment and that had been walking around, shouting and swearing. He recalled PS C saying words to the effect of tell me more when the hospital was mentioned. 89. PC A said that PC B mainly spoke to PS C. He said that PS C asked him to move into the inner holding area. 90. When asked if PS C spoke to him directly, PC A said that he recollected telling PS C that the hospital staff had no concerns. He said that PS C queried the small cut to s head and he told him that the hospital staff had said that, in an ideal world, as a precaution, they would have liked to x-ray, but he was being un-cooperative and would not allow that to happen. PC A said he reiterated to PS C that they had no concerns because the nurses had none. 91. PC A was asked if he heard PC B giving any information to PS C about Mr A s head injury and he said that as his attention had been partially on at the time he could not recall exactly what she had said. 92. PC A stated that, even in the lit-up environment of the custody unit, he did Version 0.1 Page 21 of 45

22 not see any injury to s head. He also stated that he did not recall PS C asking him for any clarification or asking any specific questions about what he had been told about s head injury. 93. PC A described in the holding area, explaining that he was moving around and wanted to lie down, but that this was no different from his previous behaviour. was moving his arms and head and PC A said that he did not object to lying down, as, if his behaviour had started to escalate, he would have been easier to control on the floor. 94. PC A said that he performed a cursory search on during which he found nothing of note. He stated that s behaviour remained belligerent throughout and, for this reason, he was kept in handcuffs until he was taken to a cell. 95. PC A said that, once was taken to the cell, they put the mattress from the cell bed on the floor and placed him on it, in the recovery position. This was due to s apparent level of intoxication, as it was thought to be safer than placing him directly on the bed. PC A stated that the cell door was left wide open and that he sat outside it a foot from the entrance, to monitor, whom he said initially continued shouting and swearing but gradually appeared to go to sleep, although he was occasionally still moving and mumbling. 96. PC A said that PC B joined him a short time later and they sat there together. He could not recall any specific conversation between them, but said that neither had any concerns about at that point, or throughout the time they were monitoring him. 97. PC A provided details of his experience and training, stating that he had been a police officer for almost seven years and had dealt with a number of people with head injuries during that time. He stated that, from first aid training he had received, he knew the symptoms to be sickness...haziness, slight imbalance maybe and admittedly a lot like, well can be like being drunk. When questioned on whether he had had Version 0.1 Page 22 of 45

23 concerns about whether s symptoms could have been due to his head injury rather than drunkenness, PC A stated that he had great concerns on arrival at the hospital, especially when the nurse mentioned the cut to his head. However, as he was told they had assessed him, that there were no concerns and that the x-ray would purely have been a precaution, his initial concerns had been alleviated. 98. PC A stated that he had not received any specific training relating to custody procedures, other than a general introduction to how the custody unit operated. He was shown the Gwent Police Custody Manual and said that he had never seen it before and could not recall receiving any training on it. When questioned on it, he stated that he thought he had 100 per cent provided sufficient information to the custody sergeant to allow him to conduct a risk assessment of and his needs. 99. PC A was questioned about the difference between his account and that of the nurse at Nevill Hall in relation to her concerns about. He said that he could not give an explanation. PC A reiterated that he had made enquires and was told that, following an initial assessment, there were no concerns PC A stated that he did not hear the nurse tell PC B about her main concern being s head injury. PC A said that, if he had, he would have double checked it and if concerns were mentioned, he would have suggested that they stay with in hospital as a safety precaution PC A was asked why, given that he and PC B gave information to PS C about s head injury and that the hospital had no concerns, none of this information was recorded on the audio from the custody CCTV. He said that he could only assume it was because he was so far away from the custody desk. He could not explain why, in the audio recording, PC B cannot be heard relaying these details as he could recall her giving PS C all the circumstances PC A stated that, because was put on one to one observations, the Version 0.1 Page 23 of 45

24 information relating to s head injury must have been passed to the Custody Sergeant, as if no risk assessment had been made, could quite easily have been left in the cell on normal observations PC A was asked whether he was surprised or concerned that no medical professional came to see during his detention. He said that he was not PC B was also interviewed and her recollections were similar to those of PC A. She said that the radio call related to a patient who had been refusing treatment and was in areas of the hospital he should not have been. She said that hospital staff had specifically stated that they wanted the patient removed from the hospital PC B said that she did not believe s name was given in the initial call. She had not previously dealt with, nor had any prior knowledge of, before this incident PC B said that she and PC A drove to Nevill Hall hospital and pulled up outside the Accident and Emergency; she saw a nurse she recognised standing outside the building with a patient in a wheelchair. Other members of staff were present, including porters and others she assumed to be nursing staff. She estimated that there were more than five people with the patient PC B stated that she and PC A went over and she spoke to the nurse about the patient,, who was being quite vocal and swearing. PC B asked the nurse about her concerns and tried to ascertain why they had called the police. She was told that had been brought to the hospital by ambulance, but said that there was no mention of an assault or why he had been brought in. PC B said that she asked the nurse why had been brought into the hospital, but the nurse did not know. The nurse said that had been at the hospital for some time, but the staff had been unable to do anything with him; he was wandering around in various areas where he should not have been and, because he was on his own, they Version 0.1 Page 24 of 45

25 could not get anyone to take responsibility for him PC B described as trying to cover his head with his jacket and swearing repeatedly at the officers when they tried to ask him questions. She said that identifying a family member was their first consideration, to provide some support for him at the hospital, but was not cooperative and would not say who he was or where he was from Having been given his name by hospital staff, PC B and PC A requested information and Police National Computer (PNC) checks on. She recollected the information coming back to indicate that he had warning markers for violence and self harm, which she felt were significant enough to emphasise that it would not have been appropriate to let him make his own way home. PC B stated that it was one of those situations where they had to risk assess what they had and what was available to them PC B stated that she perceived to be obviously drunk. When trying to have a conversation with him, she could clearly smell alcohol on him, his eyes were glassy, he was slurring his speech and it was apparent that he was drunk. She recalled there being nothing of note in terms of injuries; she said that certainly had no apparent blood staining or any visible marks PC B stated that s behaviour remained belligerent and verbally abusive throughout her time with him and she did not recall him complaining of any pain PC B said that she specifically asked the nurse what medical concerns there were because, if there had been any, it would have been a medical issue as opposed to a police issue and she would not have taken somebody from the hospital if they required care. She said that the nurse told her the only concern she had was he had a lot of drink on board and a small cut to the back of his head. PC B said that the nurse described it as a small cut and not an injury, or a head injury. She stated that there Version 0.1 Page 25 of 45

26 was no dressing on this cut It was put to PC B that, in her statement to this investigation, the nurse had indicated that her main concern related to s head injury, for which he had not received treatment and also that he had alcohol on board. In response, PC B categorically stated that what she said was he had alcohol on board, a lot of alcohol on board, and a small cut to the back of his head. Injury wasn't a word that was used PC B was asked about her decision to arrest. She stated that it was quite clear the hospital did not want him there; the staff were unable to manage his behaviour and the information from the nurse indicated that they could do nothing further for and that he was behaving in a manner that was disruptive, not only to staff but potentially to patients coming in and out of the hospital. It was quite clear that could not stay where he was She stated that did not want to move himself and wanted to stay in the wheelchair. Even though there were no medical concerns, the fact that he was clearly drunk and, in her opinion, at risk because of that, PC B said that she could not just take to his home address. They had already tried unsuccessfully to contact a family member She said that, if the hospital had felt treatment was required, staff could have asked her to provide officer presence while treating, but this was not requested. She explained that the decision to request police presence was not one the police would make themselves, as they had no power to detain someone for a nurse or doctor to give care. PC B said that she considered taking to another hospital, but it seemed inappropriate, as she knew of no medical concerns and the next nearest hospital was actually further away than the custody unit. She stated that she considered her options to be either to walk away or to take into the custody unit where she knew he would be monitored PC B stated that PC A searched and then handcuffed him to the front Version 0.1 Page 26 of 45

27 before they assisted him into the cage at the back of the van. She said that was compliant but not exactly thrilled at this taking place PC B described the journey to custody, stating that she drove and, although she could not remember specific conversations, she believed that she asked PC A to radio in to the custody unit to warn them as was banging in the cage. She recalled having the light on in the cage so that PC A could see him PC B described their arrival at the custody unit and assisting out of the van. She said that they went into the custody unit and was in the holding area with PC A. She went inside, spoke to PS C and explained her reasoning for the arrest, noting that was arrested at the hospital. She stated that, in this first conversation with PS C, she gave him all the information she had, which included the fact she had been told of a small cut to the back of s head. PC B said that they then brought in front of PS C and she formally gave the circumstances of the arrest PC B explained that the audio recording from the custody suite CCTV covered the second conversation between her and PS C, in which she formally gave the arrest circumstances, but did not record the first informal briefing she gave PS C. In fact, the audio from the custody suite does cover the first brief conversation she had with PS C; PC B is heard to give the time of the arrest and the fact it was for d and d (drunk and disorderly) and saying that she could not get a complaint from the hospital. She is not heard to mention the cut on s head PC B said that the CCTV footage included her indicating the back of her head while she talked. She stated that she assumed this to be when she mentioned the small cut on the back of s head. At the times PC B is shown indicating the back of her head on the CCTV, she cannot be heard talking about a cut on s head on the audio recording. However, it is acknowledged that parts of the conversation she had with PS C cannot be heard, due to s shouting and general noise in the custody suite. Version 0.1 Page 27 of 45

28 122. PC B insisted that she mentioned the cut on s head to PS C. It was explained to her that the matter of the cut was not recorded on the custody log. PC B was unable to explain this, given that she was not trained as a custody sergeant, and was unaware of the criteria they worked to in terms of what they recorded When asked why she did not repeat the information about the small cut on s head in the formal account to PS C, she stated that there was no specific reason for this PC B stated that was not cooperative and was unable to understand or respond to his rights, or to any welfare questions, so the decision was made to put him straight in the cell. PC B said that, in her view, she provided sufficient information to the custody sergeant about the cut on Mr A s head for him to make an accurate risk assessment and said that there was never any doubt that would be placed on constant observations, due to his level of intoxication. She stated that she and PC A conducted two on one observations on until they were relieved by other officers later on PC B said that PC A placed on the floor in the recovery position on the mattress, so that he could not hurt himself by rolling off the bed. PC B said that he was moving, breathing and mumbling; she stated that he responded when spoken to and was behaving in a way a drunken person who wanted to go to sleep normally would PC B stated that she was up-to-date with first aid training and, although she could not think of any specific head injury cases she had dealt with in the past, she said that it was something she was always mindful of, because she would not know what had happened prior to her arrival at an incident. She stated that police officers had to deal with what they found at an incident and put their trust in their medical colleagues As part of this investigation, the IPCC obtained CCTV footage from Ystrad Mynach police station outdoor yard and custody suite. The CCTV footage Version 0.1 Page 28 of 45