Man dies in custody - West Midlands Police, September 2017

A man was arrested by West Midlands Police (WMP) in September 2017 and taken into custody. The man was found to be unresponsive in his cell during a routine check at 2am the following morning. He was pronounced dead by a doctor at the scene shortly afterwards. It was later established that he had suffered a heart attack.

An inquest held at a later stage concluded that the man’s death was drug related.

We investigated the interaction between the man and WMP, considered relevant national and local policies on detention and custody, and obtained and reviewed CCTV footage from the custody unit.

The CCTV footage showed that the man suffered a seizure about 30 minutes before he was found on the floor of his cell. At that time, following medical examination, he had been assessed as suitable for hourly checks, which had been carried out correctly.

However, earlier during his detention, he had been listed for half-hourly observations. Evidence gathered by our investigator indicated that for a period of time those had only taken place every hour.

We found a case to answer for misconduct for a custody officer in respect of the frequency of the observations during that period, and adequate record keeping. It was our opinion that this could be addressed through performance management.

After reviewing our report, West Midlands Police agreed with our proposal.