Death in custody highlights inadequate police training

Inadequate training and a lack of communication between officers contributed to the death of a cocaine addict in police custody, a jury has ruled.

Paul Coker died at Plumstead police station just hours after he was arrested for breaching the peace at his girlfriend’s home in August 2005, an inquest heard.
Two hours after his arrest, Mr Coker became unwell and collapsed after being transported to cells.
The jury at Southwark Coroner’s Court was told that officers did not recognise the “symptoms of excited delirium”, shown by Mr Coker.

Selena Lynch, the assistant deputy coroner, told jurors that a pathologist’s report gave the cause of death as cocaine intoxication.

Mr Coker had been battling depression and substance abuse.

Delivering the verdict, the jury foreman said Mr Coker was “lawfully arrested and restrained” but added: “We find there was inadequate pooling of information and failure to communicate effectively among police officers, designated detention officers (DDO) and forensic medical examiner. It is not possible to determine whether the outcome would have been affected. Training provided to police and DDOs did not reflect accurately the spectrum of symptoms presented by people suffering from excited delirium or acute behavioural disorder.”

The jury also found that the doctor did not carry out an adequate assessment of Mr Coker and failed to advise officers, who were trained to recognise only severe symptoms.

Ms Lynch said she would make recommendations to the London Ambulance Service, the Metropolitan Police Service (MPS) Commissioner and the Faculty of Forensic Medicine on training and guidance on excited delirium, the use of police vehicles, grading 999 calls over cocaine intoxication and monitoring and observations.

In a statement, Mr Coker’s mother, Patricia Coker, said: “This verdict is a condemnation of the failures of the police and the police doctor to care properly for my son when he was clearly very ill and in need of urgent medical attention.”

The MPS said it will reflect on the recommendations and is committed to ensuring “officers and staff receive adequate training to help identify all potential life-threatening conditions”.