Prevention of Future Deaths reports · 2018

Karl Brunner

Regulation 28 report to prevent future deaths, reference 2018-0310, written 29 Oct 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report29 Oct 2018
Reference2018-0310
DeceasedKarl Brunner
CoronerMartin Oldham
Coroner areaBedfordshire & Luton
CategoryAlcohol, drug and medication related deaths · Police related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

40517-2016

for Bedfordshire & Luton

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

,

Mr Jon Boutcher

Chief Constable of Bedfordshire Association of Chief Police Officers
Bedfordshire Police Headquarters (ACPO)
Woburn Road q 10 Victoria Street
London
Kempston

Bedford. MK43 9AX SW1H ONN

CORONER

| am Martin Oldham, Assistant Coroner, for Bedfordshire & Luton

CORONER'S LEGAL POWERS

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

http//www. legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7

http://www. legislation .gov.uk/uksi/2013/1629/part/7/made

INVESTIGATION and INQUEST

On 12 May 2016 | commenced an Investigation into the death of KARL
BRUNNER, aged 48 years . The Investigation concluded at the end of the
inquest on 09 March 2018. The Conclusion of the inquest was ‘Accidental
Death’. Mr Brunner died because he choked after swallowing a package of
drugs to avoid arrest. Givers of first aid did not realise it was choking, therefore,
despite attempts to give CPR, he did not recover.

Mr Brunner died on Battison Street, Bedford, on the 11th May 2016 at 12.34 pm,
when he attempted to swallow a package of individually wrapped drugs -
approximately 4 x 3cm, whilst in the process of being arrested by police officers,
under Section 23 Misuse of Drugs Act. The package lodged behind his epiglottis
and choked him.

In April 2016 the police conceived an operation with the objective of arresting Mr
Karl Brunner. Mr Brunner was a known drug user and dealer, who had
undertaken rehabilitation and who sold Class A drugs in the Midland Road area
of Bedford. The operation was set in train in April, although was postponed

Senior Coroner, The Court House, Woburn Street, AMPTHILL, Bedfordshire, MK45 2HX
Tel 0300-300-6559 | Fax 0300-300-8267

because it was discovered that Mr Brunner was in hospital with breathing
problems. After Mr Brunner was discharged from hospital he was seen in town
on 9th May. On the 11th May he was seen by a Police Constable in Bedford Bus |
station. It was decided to resume the operation and two officers were drafted in
from Luton. A briefing happened over the phone and a discussion took place
before four officers, in plain clothes, left Greyfriars Police Station, Bedford, in an
unmarked van to carry out a stop-search in order to detain Mr Brunner: two
Officers wore body cameras. One of them was trained as a Police Medic, but
was not operating in that role on the day. The other three had undertaken basic
First Aid Training. Mr Brunner was a known "swallower" who had swallowed
drugs on two 2 or 3 occasions previously. To mitigate the risk of swallowing, the
plan was to approach him from behind to prevent him from swallowing so that
they could catch him with enough Class A drugs to obtain a conviction for
supplying. The CTT had successfully dealt with people who had been arrested
for swallowing before. The officers approached along Midland Road. There were
three on foot and one was in a van. Mr Brunner and another man were walking
towards Battison Street, Bedford. The weather conditions were adverse. The
Officers knew who Mr Brunner was, and Mr Brunner knew who some of the
police officers were. The element of surprise was lost when an associate of Mr
Brunner, who clearly knew the police officers, shouted a warning. Because of
this, police picked up their pace. One of the police officers moved towards the
other man, as he made moves to run away. The other two went to Mr Brunner.
One of these, Officer A, attempted to detain Mr Brunner by means of a bear hug.
The other went straight away to help arrest the second man. Mr Brunner saw the
officers and turned away and appeared to reach across to one of his pockets.
The officer in the van (B) parked and came to the assistance of A as Mr Brunner
was resisting arrest. Shortly afterwards, Mr Brunner was seen to put a package
into his mouth, by officer C, who shouted out that he had put it in. Mr Brunner did
this by dropping his weight forward and bringing his hand up to his mouth, and
mouth to hand. Mr Brunner and two of the officers fell on to the floor during the
struggle and they moved his arms towards his back to put handcuffs on him at
12.36.02 hours. The package was described as a large ball, roughly the size of a
golf ball. The three PCs (A, B and C) shouted at Mr Brunner to spit out the
package, and one of them tried to apply a mandibular angle twice. The
mandibular angle was applied with an open grip and was meant to gain
compliance by causing pain but did not succeed. This police officer believed that
Mr Brunner had swallowed the package because he saw his open mouth. The
police officers applied reasonable force to detain Mr Brunner and make him
complaint in order to spit out the package, including a ground pin and holding his
arms. On the Body Cam Mr Brunner could faintly be heard to say “I can't
breathe" but because of a number of factors - awful weather, the frenetic nature
of the incident, interruption of bystanders, relative position of officers and
cameras - he could not be heard by human ear. Once Mr Brunner had
appeared to become compliant Pc B noticed that he was in and out of
consciousness and called an ambulance at 12.36.55 hours. Another call to an
ambulance was made at 12.37.31 hours. At 12.38.10 hours an officer

mentions that he thought that Mr Brunner was not breathing. The officers
removed the

Senior Coroner, The Court House, Woburn Street, AMPTHILL, Bedfordshire, MK45 2HX.
Tel 0300-300-6559 | Fax 0300-300-8267

handcuffs, looked in his mouth, sat him up, turned him into the recovery position
before starting cardiac compressions at 12.39.20hours. Mr Brunner did not
regain consciousness or begin to breathe again. The police officers worked
together to give Mr Brunner compressions until the ambulances and paramedics
arrived at 12.46 hours. When paramedics took charge of the care of Mr Brunner,
they were happy with the PCs compressions and asked them to continue whilst
they arranged a Lucas Il Machine to mechanically carry out compressions and
attempted to establish an airway. They tried to establish an airway five times, but
this was a difficult task because of signs of blood, vomit, and Mr Brunner's
physiology/anatomy. The lead paramedic mentioned a Blue Form at 12.51
hours. By this time, because of the length of time since Mr Brunner had last
been seen to breathe, irreversible brain damage was highly likely. At no point did
anyone see the package in Mr Brunner's throat. The PCs assumed that he had
swallowed the package and although this was difficult for the jury to understand,
no-one involved in the incident, police, paramedics or afterwards in the hospital,
saw the package. Therefore choking was not considered an option.

Karl Brunner choked and stopped breathing sometime around 12.38 hours and
did not recover, despite efforts of police officers on the scene and paramedics.
His death was certified at 13.17 hours at Bedford Hospital. The cause of death

given after forensic post mortem was:

la Foreign body airway obstruction (choking) with close temporal
relationship to an attempted police arrest whilst under
the influence of heroin and diazepam

CIRCUMSTANCES OF THE DEATH

At 12:36 hrs on 11 May 2016 Tasking Officers from Bedfordshire Police were
engaged in a Drugs Operation in Midland Road, Bedford, when they saw the
deceased with another male person, The Police stopped the 2 men for the
purposes of a Section 23 Drug Search. The deceased ran a short distance and
is believed to have swallowed a quantity of Class A Drugs. The officers detained

_ the deceased in Battison Street, Bedford, and ended up on the ground when

suddenly the deceased became unresponsive. CPR was commenced and
Paramedics attended and continued with advanced life support. The deceased
was then conveyed to Bedford Hospital South Wing, Bedford, where death was
confirmed shortly after arrival.

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.

Senior Coroner, The Court House, Woburn Street, AMPTHILL, Bedfordshire, MK45 2HX
Tel 300-300-6559 | Fax 300-300-8267

The MATTERS OF CONCERN are as follows :

1. The evidence before me showed that police officers were trained to deal
with suspects who had swallowed drugs. The evidence however
disclosed a complete lack of knowledge of the risks of choking when
suspects were either arrested or in the process of being detained. This
should urgently be addressed in the Officers’ training and the appropriate
medical procedures should be adopted.

2. Police Officers are provided with mouth and face guards which are so
defective and inappropriate when dealing with high risk suspects who
may have significant health issues that they are neither carried nor used
in appropriate cases. This should be urgently addressed.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you
have the power to take such action.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this
Report, namely by 20" December 2048, 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.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following
Interested Persons:

Senior Coroner, The Court House, Woburn Street, AMPTHILL, Bedfordshire, MK45 2HX
Tel 0300-300-6559 | Fax 300-300-8267

who may find it useful or of interest.
| 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 find it useful or of interest. You may make representations to me, the
coroner, at the time of your response, about the release or the publication of
| your response by the Chief Coroner.

Dated 29" October 2018

MARTIN OLDHAM
ASSISTANT CORONER
Bedfordshire & Luton

Senior Coroner, The Court House, Woburn Street, AMPTHILL, Bedfordshire, MK45 2HX
Tel 0300-300-6559 | Fax 300-300-8267

Responses

1 response 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 Bedfordshire Police (PDF)
IN AMPTHILL CORONER’S COURT 

IN THE MATTER OF THE INQUEST TOUCHING 

UPON THE DEATH OF KARL BRUNNER 

REGULATION 29 RESPONSE ON BEHALF OF THE 

CHIEF CONSTABLE OF BEDFORDSHIRE POLICE 

A 

Introduction 

1. 

Following  an  inquest  held  into  the  death  of  Karl  Brunner,  HM  Assistant  Coroner  for 

Bedfordshire  and  Luton  Martin  Oldham  (“the  Coroner”)  exercised  his  powers  under 

regulation 28 of The Coroners (Investigations) Regulations 2013 (“the Regulations”), to 

publish a report to prevent future deaths, dated 29 October 2018 (“the PFD Report”).  

The  Chief  Constable  of  Bedfordshire  (“Bedfordshire  Police”)  hereby  provides  this 

response  to  the  PFD  Report,  pursuant  to  regulation  29  of  the  Regulations  (“the 

Response”). 

B 

Facts 

2.  The  facts  are  summarised  at  §3  of  the  PFD  report  and  will  not  be  rehearsed  here  in 

detail.    In  summary,  Mr  Brunner  died  on  11  May  2016  as  a  result  of  choking,  after 

attempting to swallow a package of drugs, whilst he was being arrested by police.  At the 

conclusion  of  the  inquest  on  09  March  2018  the  Coroner  recorded  a  conclusion  of 

‘accidental death’. 

 
 
 
 
                                                                            
                                                                            
 
 
 
 
 
 
 
 
 
 
 
 
 
 C 

Matters of Concern 

3. 

The Coroner expresses two matters of concern regarding police officers, namely: 

(i) 

(ii) 

Training on choking risks during detention; and 

Usage of mouth and face guards. 

Training 

4. 

Across  Bedfordshire,  Cambridgeshire  and  Hertfordshire  police  forces  all  officers, 

special constables, detention officers and Police Community Support Officers receive 

First  Aid  training  at  least  annually  on  a  rolling  programme.    Student  officers  receive 

training more often as it is incorporated within their two year probationary period.  Thus 

training  is  provided  in  accordance  with  the  standards  set  down  by  the  College  of 

Policing, which remain under review. 

5. 

Included within the training is a module which deals specifically with persons who are 

choking.    It  sets  out  the  appropriate  manner  in  which  a  choking  detainee  should  be 

managed,  and  specifically  incorporates  the  comprehensive  lesson  plan  produced  by 

the College of Policing  In particular, this includes: 

(i) 

(ii) 

(iii) 

(iv) 

(v) 

(vi) 

Identifying any dangers to the officer and detainee; 

Identifying  the  signs  typically  demonstrated  by  a  choking  conscious 

detainee; 

Administering back slaps to a choking detainee; 

Performing abdominal or chest thrusts on a choking detainee including 

on child or infant; 

Monitoring changes in detainee’s condition; 

Reassuring the detainee; and 

(vii) 

Taking any necessary further action. 

6.  Officers receive  training on  a training  aid known as ‘Choking  training  vest’ for  adults, 

and  ‘Baby  Annie’  for  young  children.    All  students  will  then  be  expected  to  use  the 

device in order to learn the correct procedure. The training officer will also demonstrate 

how to carry out thrusts from the front in the event that it is not possible to put arms 

around the casualty. 

 
 
 
 
 
 7.  Officers and custody staff are given the following specific instructions in the event they 

are  faced  with  a  scenario  similar  to  that  which  occurred  during  the  detention  of  Mr 

Brunner.    These  are  in  line  with  the  recommendations  issued  by  the  Independent 

Office for Police Conduct (“IOPC”) and state that: 

(i) 

If the detainee places an item in their mouth, do not attempt to remove 

it,  as  there  is  no  currently  approved  safe  and  effective  method  for 

searching mouths; 

(ii) 

Consider  what  might  have  been  placed  in  the  detainee’s  mouth  and 

assess  what  risk  it  may  present  to  the  detainee  and  the  officer.  

Officers  should  make  every  effort  to  encourage  the  detainee  to 

voluntarily empty their mouth; 

(iii) 

Officers  must  inform  the  detainee  of  the  risk  they  face  from  choking 

and/or poisoning as a result of swallowing items.  All actions should be 

recorded in full  and body  worn  video  used  where available.    Officers 

should maintain communication with the detainee and allow them the 

opportunity to voluntarily remove any items; 

(iv) 

If the detainee swallows the item, the situation should be treated as a 

medical emergency and an ambulance called.  This also applies if the 

detainee begins to choke following an attempt to swallow an item.  An 

ambulance  should  be  called  and  emergency  life  support  provided  to 

the detainee.  The College of Policing procedure outlined above at §5 

should be followed. 

8. 

The  regular  training  provided  to  all  Bedfordshire  Police  officers  complies  with  the 

recommendations  of  the  IOPC  and  meets  the  standards  set  out  by  the  College  of 

Policing. 

Mouth/face guards 

9. 

Prior  to  August  2016  all  Bedfordshire  Police  officers  were  issued  with  a  mouth/face 

guard which comprised a flat plastic sheet with either a hole or a piece of gauze in the 

middle  which  allowed  the  user  to  breathe  into  to  give  mouth  to  mouth  resuscitation.  

Since August 2016, all officers are now issued with a personal Pocket Face Mask and 

instructed  on  its  correct  use  in  mouth  to  mouth  resuscitation.    The  Personal  Safety 

Team  Leader  for  Bedfordshire,  Cambridgeshire  and  Hertfordshire  Police  has  stated 

that  this  piece  of  equipment  is  adequate  and  appropriate  for  its  required  use.    In 

addition to the mouth/face guard issued to all officers during their training, all response 

vehicles contain first aid equipment. 

 
 D 

Conclusion 

10.  Bedfordshire Police are grateful to the Coroner for the opportunity to address the steps 

which  have  been  taken  in  respect  of  the  matters  of  concern  outlined  in  the  PFD 

Report. 

Legal Services Department 

6th December 2018

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