Today was the last day of hearing evidence at the inquest. TVP Counsel for the officers Patrick Gibbs QC tried to submit evidence of the valuation of the drugs that were found on Habib and this was objected to by Tony Metzer QC acting on behalf of the family.
He stated it is of ‘marginal relevance’ about the seizure and the length of sentencing he could have received and if the evidence is used he would want the expert called so he can be cross-examined. TVP Counsel for the officers argued that it should be submitted on the grounds of providing further information to the jurors.
According to this particular ‘learned friend’ the value of the drugs may have determined him giving it up! The Coroner Richard Hulett decided NOT to allow this evidence to be submitted on the basis of it distorting Habib’s character and it not being relevant to the nature of the inquest.
We then heard from Dr Anthony Bleetman a consultant in emergency medicine and lecturer & trained in unarmed tactics in and confirmed what documents he had access to. He like other experts was warned about ensuring that the previous CPS process is not referred to and not to talk about anything outside of their expertise.
He was asked to read through his original comments/opinion from the medical report that he produced in 2009 and asked questions on this. Coroner raised issue of ‘excited delirium’ and asked Bleetman to give an explanation of his views on this matter. He asked if this genuinely be seen as causal in this case as he only exhibits a few of these characteristics.
He asked Bleetman why wasn’t the pulse checked as part of the CPR and he referred back to the training at the time. He was asked about agonal breathing and he felt that the noises were from a partially obstructed airway. Bleetman is of the opinion that once Habib collapsed due to ‘excited delirium’ and because of the partial obstruction of his airway and that the actions of the paramedic turning him on his back caused a full obstruction.
He was asked about the process of redacting statements and any new evidence. Bleetman challenged the previous expert Pybus’s take on this but did suggest from the additional statements from PC Bazeley and PC Pomery that vagal stimulation could have played a part in Habib’s death.
Tony Metzer QC asked him about his current involvement with ACPO and the police and during the period 2008 and 2012. He confirmed that he has worked with the police since 1998. The family lawyer asked him to look at the medical review of Thames Valley Police force produced by PC Duggan which was written by him. He has continued to give evidence for the CPS and IPCC on cases and was asked about this and it was confirmed he has been asked to produce this for defence purposes. Additionally he was part of the delivery of training of pressure point techniques and stated that some of these are reviewed including use of mandibular angle techniques and shared concern about vagal stimulation in this case.
He was asked about positional asphyxia and it’s total absence in his analysis and despite Bleetman quoted DS Liles on this in his report had to agreed that it was an ‘omission’ on his part. He was asked to look at his own medical review that he produced in 1999 and that this mentions positional asphyxia in some detail. He was asked if he agreed with the risks that Habib was in according to HIS own review and he conceded this.
Bleetman was asked about his ‘excited delirium’ analysis in Habib’s death and he was aware that Dr Hunt and both Pybus had dismissed this as being causal and that also Skinner had challenged this. He was taken back by this challenge and went on the defensive and made an inappropriate reference to jury going on YouTube to look at examples of ‘excited delirium’. These were challenged by both Tony and the Coroner.
The family lawyer stated Skinner’s view that ‘excited delirium’ played no objective part in his death. Bleetman maintained his view about this phenomena. He was asked if he agreed with his own training and what he has written about positional asphyxia and that this risk is heightened by drug/alcohol use and Bleetman agreed with this. If someone is resisting arrest and is overweight he agreed that these were further risk factors. He agreed again that he should have referred to these in his reports and accepted that he should have included positional asphyxia.
He was asked if he was aware of the knee in his back, the numbers of officers and their actions in relation to this. He now accepts that positional asphyxia was a contributory factor in Habib’s death and is an independent factor. He was taken through the warning signs that were present in his own guidance about this . Was he aware of Habib’s face changing colour? No and did not factor this in. Bleetman stated that the longer a struggle and restraint the more likely someone is to die.
Bleetman confirmed that the officers could have deescalated the incident by stopping the restraint and monitored him more effectively and called an ambulance earlier and he agreed that positional asphyxia was an independent contributor in Habib’s death. Tony referred him to evidence about the sounds that Habib was making from the officers and witnesses.
He was asked him about the position that Habib was in going from breathing and being conscious, to being unconscious and dead and the role of the restraint in this. He asked Bleetman about ‘excited delirium’ again – what evidence did he have that Habib was ‘physically exhausted’? NO evidence that he was hot and overheating. NO evidence that he dehydrated? He Accepted that these were assumptions on his part. and confirmed that the restraint was prolonged.
Bleetman again tried to defend his position and wants to call ‘excited delirium’ ‘acute behaviour disturbance’ (ABD) now! Tony referred to Hunt’s post mortem that did not cite ‘excited delirium’ as being a cause of death. Bleetman referred to Habib dropping his trousers as possible justification for his assessment and went through his own rationale for ‘acute behaviour disturbance’ being present
After lunch Tony Metzer QC acted on behalf of the family continued to ask him questions about his evidence. He was asked about the report from Skinner and receipt of this last month. Bleetman agrees with some this in terms of the restraint process significantly contributed to his death and had the restraint not occurred he would have still been alive.
No universal understanding of the term ‘excited delirium’ (ED) and Tony confirms that he has challenged Bleetman on the features of ED/ABD and that the other experts disagree as well Habib had no history of heart problems and there were no signs of chest pains associated with excessive cocaine use.
Bleetman was asked about the initial backslap and confirmed that this was not ‘reasonable’ and not this a ‘sensible action’ in terms of trying to retrieve item from his mouth. He was asked about the sequence of events and it was confirmed that NO officer gave a command to spit it out prior to the backslap and he agreed that the command should have been said prior to the actions of DS Liles. In relation to the backslaps where he was clearly not choking – he no longer stands by the report findings on this.
He was asked about mandibular angle pressure point techniques – not designed to be applied from both sides and the multiple application of these could have led to vagal stimulation and contributed to his death. Agreed that at least one of the officers applied this in a way that is not accordance with training He agreed that restraint was a factor in his death but still questions remain about why he did NOT mention this in all of his three reports.
Tony referred to agonal breathing and the sequence of events – gradual reduction of breath should have led to CPR and earlier medical attention. Bleetman does not recognise hyperglussal pressure point technique as being an authorised action.
He was asked about mouth searches and criticisms raised by Pybus around use of techniques. He was referred to the Kent policy on mouth searches and allowed them to swallow an item and for the suspect to be monitored. He agreed that the guidance was eminently sensible Bleetman unable to say if Habib was put in a proper recovery position and described the management of the situation as being a ‘scrum’ and uncoordinated. Finally he agreed that collectively the actions of the police officers DID contribute to his death.
Patrick Gibbs Thames Valley Counsel for the officers then asked questions of the expert and took him to the Kent policy and also asked about the training given to the officers at the time and what the advice was around giving CPR to a conscious person
He tried to get Bleetman to talk up the impact of cocaine on Habib and his actions and his ability to feel pain but Gibbs does not feel that ‘excited delirium’ was at play. He asked about PC Pomery gripping the throat and the amount of vagal stimulation from this and if officers were aware of the consequences/risks of these pressure point techniques. Juror asked question if that Habib was exhibiting ‘excited delirium’ and ‘bizarre’ behaviour was present than him going to the carport to drop his trousers seems to show a level of thought which contradicts this.
We returned to Skinner who was unable to give evidence this morning and returned this afternoon to resume this. PG resumed his questioning about the chewing, breathing motion and the sounds that Habib was making. Skinner clarified that a cough would show some consciousness, but did not want to speculate about the chewing motion. He was asked about the state of breathing in Habib’s case and the need to monitor him and check his pulse when exhibited agonal and shallow breathing. He was asked about what guidance there would have been in 2008 regarding this. Skinner was asked about the narrowing of the arteries and cocaine use and his experience was that angina/chest pains was a common feature and not demonstrated in this case.
Gibbs continues to try and pin this on Habib’s use of drugs and that his heart was weak and gave away from the restraint leading to his death despite the overwhelming evidence against this. But overall today was a master class in the art of cross examination by the family lawyer Tony Metzer QC and the one witness that the police were counting on was taken apart systematically. Jury will be asked to return back on Wednesday and there will be summing up of the case and directions given ahead of them reaching a verdict.