Prevention of Future Deaths reports · 2015

Adil Habib

Regulation 28 report to prevent future deaths, reference 2015-0380, written 16 Sep 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report16 Sep 2015
Reference2015-0380
DeceasedAdil Habib
CoronerMary Hassell
Coroner areaInner North London
CategoryState Custody related deaths · Community health care and emergency services related deaths
Organisation namedLondon Ambulance Service NHS Trust
Sourcejudiciary.uk record · original PDF
Responses published2

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

Regulation 28:  Prevention of Future Deaths report 

Adil HABIB (died 31.10.14) 

THIS REPORT IS BEING SENT TO: 

1. 

Governor 
HMP Pentonville 
Caledonian Road 
London  N7 8TT 

1 

CORONER 

I am:   Coroner ME Hassell 
           Senior Coroner  
           Inner North London 
           St Pancras Coroner’s Court 
           Camley Street 
           London  N1C 4PP 

2 

CORONER’S LEGAL POWERS 

I make this report under the Coroners and Justice Act 2009,  
paragraph 7, Schedule 5, and  
The Coroners (Investigations) Regulations 2013, 
regulations 28 and 29. 

3 

INVESTIGATION and INQUEST 

On  3  November  2014,  I  commenced  an  investigation  into  the  death  of 
Adil Habib, aged 30 years. The investigation concluded at the end of the 
inquest yesterday.  

The  jury  made  a  determination  that  this  was  an  accidental  death,  when 
Adil  Habib  died  in  the  search  area  of  HM  Prison  Pentonville  at  16:54 
hours on 31 October 2014 by acute respiratory failure due to mechanical 
obstruction of his upper airway by a foreign object. 

4 

CIRCUMSTANCES OF THE DEATH 

Mr Habib died following a full search conducted after a visit.  During the 
search, he was the subject of control and restraint, but managed to put a 
small  package,  later  found  to  contain  crack  cocaine,  in  his  mouth.    He 
choked on this and died. 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 5 

CORONER’S CONCERNS 

During  the  course  of  the  inquest,  the  evidence  revealed  matters  giving 
rise to concern. In my opinion, there is a risk that future deaths will occur 
unless  action  is  taken.  In  the  circumstances,  it  is  my  statutory  duty  to 
report to you. 

The MATTERS OF CONCERN are as follows.  

I heard evidence at inquest that there is no training for prison officers that 
specifically covers the risk of prisoners choking as a result of attempts to 
conceal  an  item  from  prison  officers,  most  especially  during  a  search 
and/or  control  &  restraint.    It  seems  to  me  that  this  is  a  significant 
omission,  and  it  would  be  helpful  if  such  training  were  mandatory  and 
refreshed regularly.  I have written to the National Offender Management 
Service  as  provider of  prison  officer training  about  this  but,  in  addition,  I 
wanted  to  bring  this  direct  to  your  attention.    It  may  be  some  months 
before there is any change to the national training offered. 

I have given a great deal of thought to reporting to you regarding the fact 
that there is no mandatory first aid (including CPR) training for all prison 
officers.    However,  I  heard  evidence  that  this  is  a  nationally  made, 
resource  led  decision,  and  takes  into  account  the  24  hour  availability  of 
nurses  within  the  prison.    Upon  reflection,  it  seems  to  me  much  more 
important  that  the  gap  in  officer  training  regarding  choking  is  filled 
appropriately. 

The nurse who was on call as Hotel 7 at the prison did not respond to the 
emergency alarm that was activated at the start of the control & restraint 
of  Mr  Habib,  as  she  should  have.    Instead,  she  only  responded  once  a 
Level  1  emergency  was  radioed.    I  appreciate  that  this  nurse  no  longer 
works at HMP Pentonville and that your team has taken steps to remind 
all nurses operating as Hotel 7 of their responsibility to respond  to every 
alarm immediately. 

The  prison  officer  who  rang  999  from  the  control  room  did  not 
immediately  offer  the  LAS  call  handler  the  location  of  the  prison  gate  to 
which the ambulance should be driven.  I understand that your team has 
taken  steps  to  remind  all  officers  working  in  the  control  room  that  they 
must  do  this.    I  understand  also  that  your  team  has  an  ongoing 
conversation  with  London  Ambulance  Service  to  enable  best  care  to  be 
given to those in the prison in need of paramedic attention. 

6 

ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe  that  you  and  your  organisation  have  the  power  to  take  such 
action.  

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date 
of  this report, namely  by  6  November 2015.    I,  the  coroner, may  extend 
the period. 

Your  response  must  contain  details  of  action  taken  or  proposed  to  be 
taken,  setting  out  the  timetable  for  action.  Otherwise  you  must  explain 
why no action is proposed. 

8 

COPIES and PUBLICATION 

I have sent a copy of my report to the following. 

  HHJ Peter Thornton QC, the Chief Coroner of England & Wales 
  HM Inspectorate of Prisons 
 
 

 parents of Adil Habib 

 partner of Adil Habib 

and 

I  am  also  under  a  duty  to  send  the  Chief  Coroner  a  copy  of  your 
response.  

The Chief Coroner may publish either or both in a complete or redacted 
or summary form. He may send a copy of this report to any person who 
he  believes  may 
interest.  You  may  make 
representations to me, the Senior Coroner, at the time of your response, 
about  the  release  or  the  publication  of  your  response  by  the  Chief 
Coroner. 

it  useful  or  of 

find 

9 

DATE                                                   SIGNED BY SENIOR CORONER 

16.09.15 

3
Also filed under 2015-0380: Habib-2015-0380.pdf
Regulation 28:  Prevention of Future Deaths report 

Adil HABIB (died 31.10.14) 

THIS REPORT IS BEING SENT TO: 

1.  Dr Fionna Moore 
Chief Executive 
London Ambulance Service NHS Trust 
220 Waterloo Road 
London  SE1 8SD 

1 

CORONER 

I am:   Coroner ME Hassell 
           Senior Coroner  
           Inner North London 
           St Pancras Coroner’s Court 
           Camley Street 
           London  N1C 4PP 

2 

CORONER’S LEGAL POWERS 

I make this report under the Coroners and Justice Act 2009,  
paragraph 7, Schedule 5, and  
The Coroners (Investigations) Regulations 2013, 
regulations 28 and 29. 

3 

INVESTIGATION and INQUEST 

On  3  November  2014,  I  commenced  an  investigation  into  the  death  of 
Adil Habib, aged 30 years. The investigation concluded at the end of the 
inquest earlier today.  

The  jury  made  a  determination  that  this  was  an  accidental  death,  when 
Adil  Habib  died  in  the  search  area  of  HM  Prison  Pentonville  at  16:54 
hours on 31 October 2014 by acute respiratory failure due to mechanical 
obstruction of his upper airway by a foreign object. 

4 

CIRCUMSTANCES OF THE DEATH 

Mr Habib died following a full search conducted after a visit.  During the 
search, he was the subject of control and restraint, but managed to put a 
small  package,  later  found  to  contain  crack  cocaine,  in  his  mouth.    He 
choked on this and died. 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 5 

CORONER’S CONCERNS 

During  the  course  of  the  inquest,  the  evidence  revealed  matters  giving 
rise to concern. In my opinion, there is a risk that future deaths will occur 
unless  action  is  taken.  In  the  circumstances,  it  is  my  statutory  duty  to 
report to you. 

The MATTERS OF CONCERN are as follows.  

When  a  prison  officer  at  HMP  Pentonville  rang  999  to  ask  that 
paramedics  attend  the  prison,  the  caller  did  not  immediately  offer  the 
location of the prison gate that London Ambulance Service should attend.  
Whilst  there  is  of  course  an  issue  for  the  prison  in  terms  of  offering  the 
information, it would be helpful for LAS call handlers to be provided with a 
drop down menu showing the alternative gates when they input the prison 
details.   

I understand that the LAS computer system has been augmented in  this 
respect since Mr Habib’s death for HMP Pentonville, but not for the other 
London prisons.  Perhaps that would be a useful exercise? 

6 

ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe  that  you  and  your  organisation  have  the  power  to  take  such 
action.  

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date 
of  this report, namely  by  6  November 2015.    I,  the  coroner, may  extend 
the period. 

Your  response  must  contain  details  of  action  taken  or  proposed  to  be 
taken,  setting  out  the  timetable  for  action.  Otherwise  you  must  explain 
why no action is proposed. 

8 

COPIES and PUBLICATION 

I have sent a copy of my report to the following. 

  HHJ Peter Thornton QC, the Chief Coroner of England & Wales 
  Association of Ambulance Chief Executives (AACE) 
  National Ambulance Service Medical Directors (NASMeD) 
 
 

, parents of Adil Habib 

 partner of Adil Habib 

and 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 I  am  also  under  a  duty  to  send  the  Chief  Coroner  a  copy  of  your 
response.  

The Chief Coroner may publish either or both in a complete or redacted 
or summary form. He may send a copy of this report to any person who 
he  believes  may 
interest.  You  may  make 
representations to me, the Senior Coroner, at the time of your response, 
about  the  release  or  the  publication  of  your  response  by  the  Chief 
Coroner. 

it  useful  or  of 

find 

9 

DATE                                                   SIGNED BY SENIOR CORONER 

16.09.15 

3
Also filed under 2015-0380: Habib-2015-03803.pdf
Regulation 28:  Prevention of Future Deaths report 

Adil HABIB (died 31.10.14) 

THIS REPORT IS BEING SENT TO: 

1.  Mr Michael Spurr 
Chief Executive 
National Offender Management Service 
Clive House 
70 Petty France 
London  SW1H 9EX 

1 

CORONER 

I am:   Coroner ME Hassell 
           Senior Coroner  
           Inner North London 
           St Pancras Coroner’s Court 
           Camley Street 
           London  N1C 4PP 

2 

CORONER’S LEGAL POWERS 

I make this report under the Coroners and Justice Act 2009,  
paragraph 7, Schedule 5, and  
The Coroners (Investigations) Regulations 2013, 
regulations 28 and 29. 

3 

INVESTIGATION and INQUEST 

On  3  November  2014,  I  commenced  an  investigation  into  the  death  of 
Adil Habib, aged 30 years. The investigation concluded at the end of the 
inquest  yesterday.    The  jury  made  a  determination  that  this  was  an 
accidental death, when Adil Habib died in the search area of HM Prison 
Pentonville  at  16:54  hours  on  31  October  2014  by  acute  respiratory 
failure  due  to  mechanical  obstruction  of  his  upper  airway  by  a  foreign 
object. 

4 

CIRCUMSTANCES OF THE DEATH 

Mr Habib died following a full search conducted after a visit.  During the 
search, he was the subject of control and restraint, but managed to put a 
small  package,  later  found  to  contain  crack  cocaine,  in  his  mouth.    He 
choked on this and died. 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 5 

CORONER’S CONCERNS 

During  the  course  of  the  inquest,  the  evidence  revealed  matters  giving 
rise to concern. In my opinion, there is a risk that future deaths will occur 
unless  action  is  taken.  In  the  circumstances,  it  is  my  statutory  duty  to 
report to you. 

The MATTER OF CONCERN is as follows.  

I heard evidence at inquest that there is no training for prison officers that 
specifically covers the risk of prisoners choking as a result of attempts to 
conceal  an  item  from  prison  officers,  most  especially  during  a  search 
and/or  control  &  restraint.    It  seems  to  me  that  this  is  a  significant 
omission,  and  it  would  be  helpful  if  such  training  were  mandatory  and 
refreshed regularly. 

6 

ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe  that  you  and  your  organisation  have  the  power  to  take  such 
action.  

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date 
of  this report, namely  by  6  November 2015.    I,  the  coroner, may  extend 
the period. 

Your  response  must  contain  details  of  action  taken  or  proposed  to  be 
taken,  setting  out  the  timetable  for  action.  Otherwise  you  must  explain 
why no action is proposed. 

8 

COPIES and PUBLICATION 

I have sent a copy of my report to the following. 

  HHJ Peter Thornton QC, the Chief Coroner of England & Wales 
  HM Inspectorate of Prisons 
 
 

and 
partner of Adil Habib 

, parents of Adil Habib 

I  am  also  under  a  duty  to  send  the  Chief  Coroner  a  copy  of  your 
response.  

The Chief Coroner may publish either or both in a complete or redacted 
or summary form. He may send a copy of this report to any person who 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 find 

interest.  You  may  make 
he  believes  may 
representations to me, the Senior Coroner, at the time of your response, 
about  the  release  or  the  publication  of  your  response  by  the  Chief 
Coroner. 

it  useful  or  of 

9 

DATE                                                   SIGNED BY SENIOR CORONER 

16.09.15 

3

Responses

2 responses published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from London Ambulance Service NHS Trust (PDF)
Headquarters 
220 Waterloo Road 
London  
SE1 8SD 
Tel:  020 7783 2000 
Fax:  020 7783 2265 
        www.londonambulance.nhs.uk 

Ms ME Hassell 
Senior Coroner  
Inner North London 
St Pancras Coroners Court 
Camley Street 
London 
N1C 4PP 

Date:13  November 2015 

Our ref : INQ/10225/14 

Dear Ms Hassell, 

Regulation 28; Prevention of Future Deaths Report arising from the inquest into the 
death of Adil Habib  

Thank you for your Regulation 28 Report to prevent future deaths, dated 16th September 
2015, bringing to my attention the matters of concern: 

When a prison officer at HMP Pentonville rang 999 to ask that paramedics attend the prison, 
the caller did not immediately offer the location of the prison gate that London Ambulance 
Service should attend.  Whilst there is of course an issue for the prison in terms of offering 
the information, it would be helpful for LAS call handlers to be provided with a drop down 
menu showing the alternative gates when they input the prison details. 
I understand the LAS computer system has been augmented in this respect since Mr 
Habib’s death for HMP Pentonville, but not for the other London prisons. Perhaps that would 
be a useful exercise? 

Before responding to the matter of concern I would like to apologise to Mr Habib’s family for 
not being able to reach Mr Habib earlier than we did and to offer my condolences.   

The evidence submitted to the Court during the inquest outlined the actions the London 
Ambulance Service NHS Trust (LAS) had taken since the death of Mr Habib to ensure that 
we attend the correct prison gate at HMP Pentonville.  At the time of the 999 call to attend 
Mr. Habib, the  Gazetteer in the Emergency Operations Centre (EOC) only held the main 
postal address in Caledonian Road for HMP Pentonville and the prison officer making the 
999 call did not volunteer that a different prison gate was to be used.  After being advised 
that a second gate was operated in Roman Way the address was added to the Gazetteer 
with accurate GPS information so that when selected, ambulance staff would be guided to 
the address by satellite navigation. 

Following the inquest HMP Pentonville’s Head of Residence, 
to the LAS’s Senior Quality Assurance Manager, 
continue to operate  two prison gates. We requested that staff at HMP Pentonville are  
prompted to give the address of the prison gate ambulance staff are  to attend at the 
beginning of the emergency call to the LAS. 

, that HMP Pentonville will 

 has confirmed 

1 

 
 
 
         
 
 
 
 
 
 
 
 
 
 
 
 
 With the assistance of the National Offender Management Service (NOMS)  we have 
obtained a list of postal addresses for all prisons and young offender institutions in the UK 
and have been assured that the Local Safer Custody Leads have been asked to contact 
their respective local Ambulance Service Trusts to advise if there are additional or temporary 
gates to be used, either on a temporary or longer term basis, to those held by NOMS. We 
have made contact with the Safer Custody Lead for Greater London and established that 
aside from HMP Pentonville the thirteen prison and young offender institutions  operate with 
a single vehicle access gate. 

To share the learning about the call to attend Mr Habib with EOC staff, the November 
Control Services Team Talk disseminated on 6 November 2015, see copy enclosed, asked  
staff to confirm the address to attend when taking a call from any prison or young offender 
institution. Further, as is our practice, a copy of this reply will be shared with the Association 
of Ambulance Chief Executives and the National Ambulance Service Medical Directors to 
share our learning with other ambulance services.   

I hope that this reply is helpful to you and to Mr Habib’s family in explaining what we have 
done to address your matters of concern. 

Yours sincerely, 

Dr Fionna Moore 
Chief Executive London Ambulance Service NHS Trust 

Enclosure : November 2015 Control Services Team Talk 

2
Response from Noms (PDF)
National Offender Management Service 
Equality, Rights & Decency Group. 
4th Floor (post point 4.12),  
Clive House 
70 Petty France 
London SW1H 9HD 

Her Majesty’s Coroner M E Hassall 
Senior Coroner Inner North London 

Dear Ms Hassall 

10 November 2015 

Thank  you  for  your  Regulation  28  report  dated  16  September  and  addressed  to  the 
Governor of HMP Pentonville concerning the recent inquest into the death of Adil Habib who 
died on 31 October 2014. Your report has been passed to the Equality, Rights and Decency 
Group  (ERDG)  in  the  National  Offender  Management  Service  (NOMS),  as  we  have 
responsibility for the policy on suicide prevention and self-harm management and for sharing 
learning from deaths in custody.  

In  your  letter  you  raise  concern  that  the  national  training  for  search  and  restraint  does  not 
cover those situations where a prisoner is at risk of choking after  attempting to conceal an 
item during control and restraint procedures. You will be aware that  the Chief Executive of 
NOMS  accepted  the  Prisons  and  Probation  Ombudsman’s  recommendation  that  clear 
guidance  and  training  be  given  on  the  safe  use  of  force,  including  pain  compliance 
techniques,  when  resistant  prisoners  have  items  in  their  mouths,  which  might  compromise 
their  breathing.  In  the  response,  NOMS  confirmed  that  a  DVD  was  being  produced  to  aid 
staff  training  in  the  safe  use  of  force,  in  conjunction  with  current  medical  advice,  and  that 
NOMS  would  consider  the  best  way  to  include  specific  guidance  within  the  DVD  on  what 
action should be taken where items are concealed in a resistant prisoner’s mouth. 

I can confirm that the DVD has been completed and that the accompanying training material 
has been prepared and is out for consultation with key stakeholders. I can also confirm that 
the DVD includes medical advice related to the use of control and restraint and covers: 

  Principles of safe restraint 
  Medical complications of restraint 
  Mechanics of breathing 
  Restraint asphyxia 
  Medical conditions and risk factors 
  Medical emergencies 

The DVD will be sent to all prison Governors by Christmas along with a Notice to Governors 
advising them of the content and that it should be made available for all operational staff to 
view. The content will be reinforced in due course when all operation staff receive updated 
control and restraint training from the National Control & Restraint Instructors. It is expected 
that  the  roll  out  of  training  will  commence  in  January  2016.  All  Prison  Officer  Entry  Level 
Trainees  (POELTs)  will  receive  training  relating  to  the  contents  of  this  DVD  from  in 
December.  

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 I hope you find the contents of this letter have been helpful in providing some assurance that 
the concerns that you have raised have been, or are being, addressed by NOMS. 

Yours sincerely

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