Man who had heart attack after being restrained by police died of cocaine intoxication - inquest
Video report by ITV Wales' Richard Morgan
A jury has found that a man from Newport who died after being restrained by police died of cocaine intoxication "following a period of restraint."
An investigation by the Independent Office for Police Conduct (IOPC) found that the force used by Gwent Police officers on Mouayed Bashir was reasonable prior to his death.
Police were called to the home Mouayed Bashir shared with his parents on the morning of February 17th, 2021, after they became concerned about his behaviour.
Officers found him barricaded in his room and “going crazy.”
When police were able to access the bedroom they found the bed broken, with debris strewn about the room and Mouayed on the floor in his underwear.
He was lying with his head in a cupboard and appeared to kick out at officers when approached.
Police body-cam footage shows officers restraining Mouayed at the wrists and legs.
They are heard attempting to calm him while waiting for an ambulance to arrive.
The 29-year-old later suffered a cardiac arrest after being put into the ambulance, and despite the efforts of police officers and medics at the Grange hospital, could not be revived.
Recording a narrative conclusion, the jury found that Mouayed’s death was caused by “cocaine intoxication... contributed to by Acute Behavioural Disturbance following a period of restraint.”
The jury also said: "We believe from the evidence we heard that there was insufficient knowledge and understanding around identifying some of the signs of Acute Behavioural Disturbance."
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Over the course of two week’s of evidence, the jury at Newport civic centre heard from officers who decided to restrain Mouayed Bashir, plus expert medical evidence and witnesses from the Welsh Ambulance Services Trust.
The court was told that his behaviour was consistent with Acute Behavioural Disturbance or “ABD”, a condition where suffers can exhibit “superhuman strength” and an inability to feel pain, but which can leave them vulnerable to cardiac arrest.
The inquest heard ABD can be caused by drug use. Police are advised to try and avoid using restraint in such cases.
Mouayed’s parents, as well as his brothers Mohannad and Mohamed, were in court to hear today’s verdict.
Mouayed’s death in 2021 was met with protests, with demonstrators waving ‘Justice for Mo’ placards gathering outside Newport central Police Station.
'Mr Make it Happen'
With his “cheeky smile and and “warm loving glow”, Mouayed Bashir was popular at home and in the wider community.
Born in Karachi, he and his family moved to Newport in 2005.
Known as “Mr Make it Happen” because of his positive demeanour - he found it easy to make friends, and was known as a “cool” kid in school.
Later, he developed a reputation for hosting barbecues in a local park, where he’d feed friends and homeless people.
So how did this popular and charming character come to lose his life at just 29 after being restrained in his bedroom?
Body worn camera footage
At the centre of the inquest into Mouayed’s death was a hour-long compilation of police body-worn camera footage, recorded by officers who attended the house he shared with his parents in Maesglas, Newport, on February 17th 2021.
Mouayed’s mother had called emergency services at 850am that morning, after becoming worried about his behaviour.
The video - played in court - shows the scene that greeted officers.
Mouayed’s mother is clearly distressed. From behind a bedroom door, where Mouayed has barricaded himself, sounds of shouting and banging can be heard.
Eventually, officers are able to access the bedroom. The video shows that the bed has been broken and debris strewn about the room.
Mouayed - wearing just his underwear - is lying with his head in a cupboard, banging his head and shouting.
When a police officer approaches, he appears to kick out in the officer’s direction.
More officers arrive and a decision is made to restrain Mouayed - his wrists are handcuffed and restraints applied to his legs - before he is rolled on his side and attempts are made to calm him while an ambulance comes.
Paramedics eventually arrive at 10:04 am, more than hour after the first police officers are at the scene.
During the wait, officers become increasingly concerned about Mouayed’s health, recording oxygen readings as low as in the 50s, the normal level being 95.
They also report that his breathing is “fast and heavy”, that he’s sweating profusely and turning pale.
When the paramedics arrive, Mouayed is conveyed down the stairs in a chair and into the back of an ambulance, where he suffers a cardiac arrest.
Despite CPR carried out by police officers, and further resuscitation attempts at the Grange hospital, it’s impossible to restart Mouayed’s heart. He’s pronounced dead at 11:41 am.
Drug taking and “ABD”
The jury heard that, at some point in the preceding years, Mouayed had started taking illicit drugs.
In 2017 he was referred to the Gwent Drugs and Alcohol Service, and admitted taking cocaine and heroin.
After his death, an examination carried out by Forensic Scientist Lindsey Ward found a concentration of cocaine in his blood consistent with “chronic or heavy use.”
Pathologist Dr Derek James said that Mouyaed’s death was not caused by any “underlying natural causes” and that he was suffering from acute behavioural disorder as a result of cocaine use.
Acute Behavioural Disturbance, or “ABD”, the inquest heard, is an “umbrella” term for various conditions where patients can exhibit “superhuman” strength and an inability to feel pain.
Experts says restraining people with ABD can be dangerous and can cause cardiac arrest, and police are trained to restrain only “in an emergency.”
But the police officers who attended the scene said they thought that restraint was the best course of action, adding that given Mouayed’s agitated behaviour and the fear that weapons might be present in the room, containment “was not a safe option.”
When asked about the officers’ actions, police safety expert Ian Read told the inquest that the restraint carried out was “proportionate and reasonable” in the circumstances.
The inquest previously heard that officers were told about “warning markers” on Mouayed’s home related to drugs and firearms.
The wait for an ambulance
The court heard that after the request for an ambulance that morning, the case was assessed as being an “Amber 2” call.
Amber 2 relates to cases where a patient is “seriously unwell” but not in a “life-threatening” condition. The call was later upgraded to “Amber 1”, a category including people who’ve suffered heart attacks and strokes, where “every minute counts.”
“Red” or emergency calls, the jury was told, are reserved for “life-threatening” cases, where a patient is unconscious and not breathing, and where the ambulance service attempt to respond within 8 minutes.
But a “red” response would not have made any difference in this case, according to an emergency medicine consultant based at the Grange Hospital.
Dr Ryan Hobbs told the hearing: "My honest opinion is that it would not have [changed the outcome].”
“The cardiac arrest in my opinion was the final stage of a progressive deterioration”, he said. Adding that “earlier conveyance would not have altered the outcome.”
Liam Williams, the Welsh Ambulance Service’s Executive Director of Quality and Nursing, said: “Our thoughts and condolences remain with Mr Bashir’s family through what has been a difficult time.
“We will be contacting the family again in the near future to ensure we have been able to answer any outstanding concerns or questions they might have, and continue to offer our support."
The jury’s findings
The jury returned a narrative conclusion. They said: "On February 17th 2021, Mouayed Mamoun Bashir took an unknown quantity of cocaine.
"This resulted in him developing symptoms in keeping with Acute Behavioural Disturbance (ABD).
"Mouayed barricaded himself in his bedroom and was heard banging, shouting and breaking objects.
"At 0850, Mouayed's family were concerned for his welfare and proceeded to contact emergency services.
"At 0901 the first police officer arrived and informed the control room that the ambulance was required.
"Gaining entry, Mouayed was agitated. Police restrained him for his safety and the safety of others.
"We believe from the evidence we heard that there was insufficient knowledge and understanding around identifying some of the signs of Acute Behavioural Disturbance.
"Throughout, Mouayed's condition was deteriorating. Police Officers and family continued to update the ambulance services and the ambulance arrived at 1004.
"The priority was to transfer Mouayed to hospital but it was difficult to manoeuvre him out of the house.
"Shortly after he was transferred into the ambulance [at] 1037, Mouayed went into cardiac arrest.
"Police and paramedics commenced cardiopulmonary resuscitation (CPR) and conveyed Mouayed to the Grange University Hospital, Llanfechra, where the clinicians continued to attempt to revive Mouayed.
"Sadly they were unsuccessful and Mouayed died at 1141 on the 17th of February, 2021.
"In conclusion, Mouayed's death was caused by cocaine intoxication. This was contributed to by the effects of ABD following a period of restraint."
The Senior Coroner for Gwent, Caroline Saunders, said she’d be writing to the Chief Constable of Gwent Police to clarify statements officers had made in their "use of force" forms after the incident.
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