Prevention of Future Deaths reports · 2023

Andre Moura

Regulation 28 report to prevent future deaths, reference 2023-0348, written 3 Jul 2023. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report3 Jul 2023
Reference2023-0348
DeceasedAndre Moura
CoronerAlison Mutch
Coroner areaManchester South
CategoryAlcohol, drug and medication related deaths
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:  REPORT TO PREVENT FUTURE DEATHS 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO:  The National Police Chiefs Council 
and the College of Policing 

1  CORONER 

I am Alison Mutch, Senior Coroner, for the Coroner Area of Greater 
Manchester South 

2  CORONER’S LEGAL POWERS 

I 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 

3 

INVESTIGATION and INQUEST 

On 7th  July 2018 I commenced an investigation into the death of Andre 
Felipe Mendes Moura. The investigation concluded on the 15th  December 
2022 and the conclusion of the jury was one of Narrative:  Andre Moura 
had taken cocaine in the hours leading up to his death. There was a 
significant struggle with Greater Manchester Police Officers as he 
was restrained, during which an episode of acute behavioural 
disturbance developed. He was put in the back of a police van for 
transportation. He suffered a cardiac arrest in the back of the van 
and died after attempts to resuscitate him were unsuccessful. The 
medical cause of death was 1a) Cocaine toxicity resulting in 
hyperthermia and acute behaviour disturbance in association with 
obesity and struggling against restraint. 

4  CIRCUMSTANCES OF THE DEATH 

On the 7th  July 2018 Andre Moura was declared dead at Tameside 
General Hospital. He had a cardiac arrest in a police vehicle whilst under 
police arrest to prevent a breach of the peace. Attempts to resuscitate 
him were unsuccessful. He had high levels of cocaine in his system, 
resulting in cocaine toxicity. Acute behavioural disturbance in association 
with hyperthermia, obesity and a prolonged, high stressing and physical 
struggle were all contributory factors. 

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. 

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 The MATTERS OF CONCERN are as follows.  – 

1.  During the course of the Inquest, evidence was heard about the 

understanding and training in relation to Acute Behaviour 
Disturbance (ABD). All of the officers who had received their 
College of Policing Personal Safety Training had been trained on 
the ABD module within that package. However it was clear that the 
training package had not achieved the objective i.e. to recognise 
ABD in a real life setting. The Inquest heard that ABD is an 
umbrella term and not all of the symptoms need to be present for 
someone to be suffering from ABD. It was clear from the officers’ 
evidence that the videos played in the training particularly of 
extreme examples of ABD had led them to not consider or 
recognise ABD in this situation. The Inquest heard that it could be 
difficult to recognise ABD in a dynamic situation but the training 
was there to ensure officers considered it in situations where it was 
a possible explanation for behaviour seen by officers. An emphasis 
on the nuances and less on extreme examples may assist in 
improving the recognition of ABD; 

2.  The Inquest heard that the ABD training did not have any formal 

way of measuring/testing knowledge but was reliant of the 
perception of the trainer. A more formalised approach may have 
increased the ability of officers to recognise ABD; 

3.  The role for a safety officer which is part of the College of Policing 
training in a situation such as this was not recognised. The Inquest 
heard evidence from an expert witness that a safety officer plays a 
key role in an incident such as the one involving Mr Moura and 
ensures key information is not lost/shared. This lack of an officer at 
his head taking on such a role emphasised the fact that although 
officers had attended the PST training key points had not been 
retained. Greater emphasis on this role in training would be 
beneficial in reducing the risk to prisoners being restrained; 

4.  Many of the officers who gave evidence indicated that they 

believed that Mr Moura was feigning his lack of responsiveness. 
This was despite the fact that there was very limited evidence of 
officers carrying out the recognised AVPU checks. Officers relied 
on their own perceptions rather than AVPU. An officer who did 
carry out AVPU did not clearly share his lack of responsiveness 
with other officers. The Inquest heard that there is no formal 
training on what officers should do if they believe a prisoner under 
arrest is feigning unresponsiveness. Clarification and enforcement 
of the need for objective use of AVPU may well prevent subjective 
assessments leading to erroneous and potentially fatal conclusions 
that a prisoner is feigning lack of responsiveness; 

5.  The officers escorting Mr Moura to the police station did not have 
their body worn cameras on. Greater Manchester Police (GMP) at 
the time did not have a policy at that time requiring escorting 
officers to switch on their Body Worn Video (BWV) cameras. GMP 
do now require that BWV cameras are on. This is an important 
change but it was not clear if all forces have implemented such a 
change.  Given that the evidence before the inquest made it clear 

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 that the change in practice by GMP was important in allowing 
clarity around how a prisoner is behaving whilst being escorted to 
custody it is important that its use at all times should be promoted 
nationally. 

6  ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I 
believe you 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 28th  August 2023. 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 Chief Coroner and to the following 
Interested Persons namely; 1) Southerns Solicitors on behalf of the 
Family; 2) Greater Manchester Police; 3) the Independent Office for 
Police Conduct; 4) RJW Legal and 5) Precedence Law who may find it 
useful or of interest. 

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 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. 

9  Alison Mutch OBE 
HM Senior Coroner 

03.07.2023 

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 College of Policing (PDF)
Alison Mutch 
HM Senior Coroner 

By email 

23rd August 2023 

Dear Ms Mutch  

Re: Regulation 28 Report into the death of Andre Moura 

I am writing in response to your Regulation 28 report following the investigation and inquest into 
the tragic circumstances of the death of Andre Moura on 7th July 2018.  

I hope to answer the concerns you raised that are listed within section 5 of your report, which are 
listed as follows: 

1.  During the course of the Inquest, evidence was heard about the understanding and training in 
relation to Acute Behaviour Disturbance (ABD). All of the officers who had received their College 
of Policing Personal Safety Training had been trained on the ABD module within that package. 
However it was clear that the training package had not achieved the objective i.e. to recognise 
ABD  in  a  real  life  setting.  The  Inquest  heard  that  ABD  is  an  umbrella  term  and  not  all  of  the 
symptoms need to be present for someone to be suffering from ABD. It was clear from the officers’ 
evidence that the videos played in the training particularly of extreme examples of ABD had led 
them to not consider or recognise ABD in this situation. The Inquest heard that it could be difficult 
to recognise ABD in a dynamic situation but the training was there to ensure officers considered 
it in situations where it was a possible explanation for behaviour seen by officers. An emphasis 
on the nuances and less on extreme examples may assist in improving the recognition of ABD;   

In 2020, the College of Policing commenced a national working group to update the First 
took  place  considered 
  The 
Aid  Learning  Programme 
recommendations  made  by  Coroners  and  the  IOPC,  including  the  detail  of  learning 
outcomes on Acute Behavioural Disturbance and treatment of head injuries. 

(FALP). 

review 

that 

The FALP has now been published and includes a revised learning outcome “recognise 
the signs and symptoms of acute behavioural disturbance” 

 
 
 
  
 
 
 
 
 
 The new Public and Personal Safety Training (PPST) for all police officers has recently 
been developed with the emphasis on de-escalation.  It is a scenario-based method of 
delivering training and is focused on learning, decision making, understanding decisions 
and de-briefing decisions.    The updated training will include identification of the signs 
and symptoms of ABD and management of the incident with the focus now being on de-
escalation  and  ‘contain  rather  than  restrain’,  where  officers  suspect  a  person  to  be 
experiencing  ABD.    There  will  also  be  an  emphasis  on  treating  ABD  as  a  medical 
emergency and seeking immediate medical assistance.  

2.  The  Inquest  heard  that  the  ABD  training  did  not  have  any  formal  way  of  measuring/testing 
knowledge but was reliant of the perception of the trainer. A more formalised approach may have 
increased the ability of officers to recognise ABD; 

The  new  PPST  is  designed  to  be  an  interventionailist  style  of  training  delivery.    The 
trainers observe the students managing the scenarios. The training is stopped at regular 
intervals when the trainers will test the knowledge of the students and get the students to 
explain the rationale for their decisions. PPST is a pass or fail course.   

3.  The role for a safety officer which is part of the College of Policing training in a situation such as 
this was not recognised. The Inquest heard evidence from an expert witness that a safety officer 
plays a key role in an incident such as the one involving Mr Moura and ensures key information 
is not lost/shared. This lack of an officer at his head taking on such a role emphasised the fact 
that although officers had attended the PST training key points had not been retained. Greater 
emphasis  on  this  role  in  training  would  be  beneficial  in  reducing  the  risk  to  prisoners  being 
restrained; 

Assessment criteria for the new PPST includes a requirement that officers must be able 
to  demonstrate  to  trainers  the  correct  response  to  a  person  experiencing  ABD.  This 
includes the appropriate use of a Safety Officer. The requirement for the use of a Safety 
Officer  is  also  a  learning  outcome  for  all  multi-officer  restraints  within  the  PPST 
programme.      From  April  2024,  the  College  of  Policing  will  be  conducting  a  quality 
assurance  process  and  will  undertake  licence  moderation  visits  to  ensure  that  forces 
comply with the new national standards.  

4.  Many of the officers who gave evidence indicated that they believed that Mr Moura was feigning 
his  lack  of  responsiveness.  This  was  despite  the  fact  that  there  was  very  limited  evidence  of 
officers carrying out the recognised AVPU checks. Officers relied on their own perceptions rather 
than AVPU. An officer who did carry out AVPU did not clearly share his lack of responsiveness 
with other officers. The Inquest heard that there is no formal training on what officers should do if 
they believe a prisoner under arrest is feigning unresponsiveness. Clarification and enforcement 
of  the  need  for  objective  use  of  AVPU  may  well  prevent  subjective  assessments  leading  to 
erroneous and potentially fatal conclusions that a prisoner is feigning lack of responsiveness; 

The  College  guidance  does  not  support  any  change  in  approach  where  officers  may 
believe that someone is feigning a lack of responsiveness.  All ABD guidance is focused 
on  how  to  treat  the  displayed  symptoms  and  should    be  followed  regardless  of  any 
suspicions that symptoms are feigned.   

 
 
 
 
 
 
 
 
 
 
 
 The  new  PPST  training  implementation  went  live  in  2023  and  forces  are  required  to  have 
implemented  or be  in the process of  implementation by  April 2024.    The  revised ABD training 
package will be published mid-September 2023.  

I hope this helps to answer the points that were raised but if we can assist with anything further, 
please do not hesitate to contact me. 

Yours sincerely 

Head of Delivery – Uniformed Policing 
College of Policing
Response from National Police Chiefs Council (PDF)
Alison Mutch OBE 

HM Senior Coroner  

Coroners Court  

1 Mount Tabour Street 

Stockport 

SK1 3AG 

Date: 14th September 2023 

Dear Ms Mutch,   

Regulation 28 Report – Mr Andre Moura 

I write on behalf of the National Police Chiefs Council (NPCC) in relation to paragraph 7, Schedule 5 of 
the  Coroners  and  Justice  Act  2009,  and  regulations  28  and  29  of  the  Coroners  (Investigations) 
Regulations 2013, in relation to the prevention of future deaths report sent via email to the NPCC 
dated 10th July 2023.  

The notice sets out concerns that arose from the information received during the inquest into the 
death  of  Mr  Moura which  occurred  in  July  2018.  I  am  very  sorry  to  read  of  the  circumstances  of 
Andre’s death.  My  sympathies  are  with  his  family  and  friends,  and  I  share  your  commitment  to 
addressing the issues you have highlighted.   

I note you set out five areas of concern, four of which focus on College of Policing Personal Safety 
Training,  with  particular  focus  on  Acute  Behaviour  Disturbance  (ABD).  I  am  aware  the  College  of 
Policing have written to you separately to address these points and have shared the timeframes for 
implementation of new Public and Personal Safety Training and revised ABD training.   

In relation to point 5, we are in the process of re-writing and revising the NPCC Body Worn Video 
(BWV) guidance and it has been agreed that we would include that BWV should be left running during 
periods of prisoner transport, due to the vulnerability of officers and subjects during that process, and 
to provide a documented account of that journey. This guidance will be published in October, and I 
share the relevant draft wording below: 

“Recent  national  events  and  feedback  from  HM  Coroner  have  identified  vulnerability  when 
transporting prisoners/subjects to custody centres or places of safety. All transporting and escorting 
officers  should  have  their  BWV  activated  during  this  journey  as  a  record  of  that  journey  and  any 

1st Floor, 10 Victoria Street, London SW1H 0NN   |   0203 276 3796    |   www.npcc.police.uk 

 
 
 
 
 
 
 
     
 
 
 
 
 
 
 
 
  
  
   
  
 
 incidents that occurred within. Any decision made not to record a journey should be strongly justified 
on their camera prior to stopping recording.  

This is to include any transport within vehicles that may have a separate camera system within them, 
such as caged vans, as there may be limitations to some of these systems, such as no audio and a short 
retention period that means  footage may be auto deleted before its  requirement is  known. Forces 
should check who manages the data from these camera systems and how long footage is stored for, 
and  ensure  that  between  the  use  of  BWV  and  in-vehicle  solutions,  that  a  journey  is  covered  by 
both/either, and data can be accessed and processed efficiently.” 

I hope that the information that has been provided goes some way to reassure you that the matters 
of concern you have raised have been addressed and will be subject to continual review.    

For any further information please contact my Staff Officer 
who will be happy to address any concerns and answer any questions.  

Yours sincerely,  

Chair, National Police Chiefs’ Council

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