The inquest into the death of Ian Taylor, a 54 year-old black British man from Brixton, who died after suffering a cardiac arrest whilst being held by the Met Police, concluded on 19 May 2022.
A jury found that his medical cause of death was acute asthma and situational stress, alongside two underlying health conditions. Dehydration was also cited as a contributing factor. The jury also found that the Met’s assessment of the risk to Mr Taylor inadequate. The coroner is to refer one of the officers involved to the Independent Office for Police Conduct (IOPC) for further investigation. Mr Taylor’s family was represented by Actions against Public Authorities solicitor Courtney Smith of Duncan Lewis Solicitors.
Mr Taylor pleaded for help as he became short of breath whilst under arrest on 29 June 2019. An ambulance was called but was severely delayed due to demand on the service at the time. Despite repeatedly telling the all-white police officers that he could not breathe and was going to die, Mr Taylor was left handcuffed and lying on the street on one of the hottest days of the year, without an inhaler, water, shade or medical assistance. Mr Taylor was eventually moved into a police car in an effort to cool him down, but after only a few minutes in the car he suffered a cardiac arrest. He died in hospital later that evening.
The inquest heard that although the police were told the ambulance service had suspended responses to all but the most urgent calls, the officers with Mr Taylor did not consider driving him to a hospital, which was only two streets away. The Met Police’s policy is that officers are allowed to drive detainees to hospital in exceptional circumstances. Their training is clear in that those circumstances include instances where ambulances are severely delayed, and when it is believed that a person will die or that their health will seriously deteriorate if not taken to hospital immediately. However, the officers appeared not to believe that Mr Taylor was seriously unwell, telling him to “stop acting up” and to “grow up”. One described Mr Taylor’s pleas for help as “all a load of nonsense”. In addition, the officers present appeared unaware of the Met’s policy and were repeatedly heard saying on body worn video (BWV) footage that they could do nothing but wait for an ambulance.
BWV footage viewed at the inquest showed Mr Taylor on the floor, telling officers that his airways were closing up, that he needed his inhaler and that he was dying. Although the police looked for his inhaler, they were unable to find it. On at least three occasions when Mr Taylor told the officers that he could not breathe, officers can be heard responding, “you can breathe, because you are breathing”.
Mr Taylor repeatedly begged officers to take off the handcuffs to ease the situational stress upon him. This request was repeatedly refused, due to the perceived risk he posed to officers through allegedly having been in possession of a hammer earlier in the day. Mr Taylor himself and the area around him were searched by officers and no hammer was found. Despite this, he remained handcuffed, with officer safety being prioritised over his heath.
The police are trained to measure the respiratory rate and vital signs of people suffering from asthma in order to assess the severity of their condition. The officers responsible for monitoring Mr Taylor did not do this. One officer was captured on BWV footage fetching water for herself from one of multiple plastic water bottles in a police car. When asked at the inquest why she did not offer water to Mr Taylor, she stated that this water, “belonged to other officers”.
Another police officer was recorded telling his sergeant that Mr Taylor was “playing the old ‘poor me’ card”. Six minutes before Mr Taylor went into cardiac arrest, he reported that Mr Taylor was, “saying he’s got chest pains, he can’t breathe, blah blah blah, it’s all a load of nonsense, but there we go”. When giving oral evidence at the inquest, this officer was asked several times by HM Coroner whether he had learned anything from the incident or would do things differently now. He was unable to specify a single action or learning point, maintaining that he would not change his actions in a future similar situation.
After about 25 minutes on the ground, Mr Taylor was eventually moved to a police car, where it was thought he would be cooler. It took the efforts of two police officers to walk him to the car, as by this point Mr Taylor could barely stand. When Mr Taylor had difficulty getting into the car, one officer can be heard laughing on the body worn video footage and another saying, “you’re not helping yourself”.
Once in the car, Mr Taylor was told again by an officer that there were no ambulances available and to “stop acting up” and to “grow up”. The court heard evidence from two medical experts that Mr Taylor’s asthma symptoms were likely to have been worsened by the additional stress and panic Mr Taylor would have felt from thinking that he was not believed and that no help was coming.
After only a few minutes in the car, Mr Taylor went into cardiac arrest and stopped breathing completely. The officers pulled him out of the car and started performing CPR. Paramedics then arrived and took over but sadly Mr Taylor died in hospital later that evening.
The court heard that the London Ambulance Service were extremely busy at the time of the incident due to the hot weather that day, with temperatures reaching a high of 34C. This led to the service holding all calls except the most urgent, meaning an ambulance was not available to be dispatched to Mr Taylor when the police first requested one.
There was also confusion within the London Ambulance Service over the appropriate categorisation for the electronic alert sent by the police about Mr Taylor, and a lack of staff available to call the police back to get more information about his condition. Initially, the alert was placed in category 3: the lowest priority band, which has a target attendance time of two hours. One witness from the London Ambulance Service testified that once the police had updated them that Mr Taylor was having “great difficulty breathing” and had a head injury, the alert should have been upgraded to category 2 (which has a target wait time of 18 minutes), however it remained at category 3.
Although, at one late stage, an ambulance was allocated to Mr Taylor, it was then diverted to a more urgent call. The London Ambulance Service has acknowledged that the police should have been informed of this.
Submissions were made during the inquest in respect of race being a factor in the decision making of the Met Police. HM Coroner heard that in her independent review into Deaths and Serious Incidents in Police Custody, Rt. Hon. Dame Elish Angiolini DBE QC deals specifically with race and the investigative process of policing. She notes that the “stereotyping of young black men as ‘dangerous, violent and volatile’ is a longstanding trope that is ingrained in the minds of many in our society.” She further writes that INQUEST reported that its casework revealed a use of force and restraint that is disproportionate to the risks posed ‘especially where there is one detainee and a large number of officers’. She continues: “the perceived risk posed by the detainee may obscure people to their vulnerability … [s]uch perceptions increase the likelihood of force and restraint being used against an individual who may be unwell. The detainee is effectively dehumanised. In such circumstances the police officers may also use force and restraint in order to gain compliance to the exclusion of any focus on the wellbeing of the detainee which can ultimately lead to a medical crisis or death.”
Crucially, Dame Angiolini notes that “[t]here is also concern that assumptions made about someone may lead to the denial of medical care. Experienced officers may believe they know when someone is faking an illness, but such assumptions can prove fatal.” She refers to the death of CA, where “[o]fficers laughed and joked whilst he lay dying on the floor of the custody suite. They reported that he was faking. He died after being left unconscious face down on the floor for 11 minutes.”
In his concluding remarks, the coroner said that he was surprised the officers did not automatically think about the distance to the hospital when assessing whether to take Mr Taylor there in the car. Regarding their monitoring of Mr Taylor’s respiratory problems, the coroner said that for some of the officers in this case, it was not a matter of lack of training but a lack of application of their training. In addition, HM Coroner described it as “dismaying” that the Met Police had done nothing for the last three years to address the conduct of the officer who had dismissed Mr Taylor’s pleas for help as “nonsense”. The coroner has now referred this officer to the IOPC for further investigation of his conduct.
Legal team: Courtney Smith acted for Mr Taylor’s aunt, Ms Pauline Taylor and the wider Taylor family. They were represented at the inquest by Daniel Grutters, of One Pump Court Chambers.
Mr Taylor’s Aunt, Pauline Taylor, said:
“‘I need my inhaler…I can’t breathe…I’m dying.’ These were the last pleading words of my nephew. He died on the street begging for help, not from just one, but seven police officers who casually dismissed his pleas and even went so far as to laugh and mock him. What more could he have said in those moments to solicit help and simple humane compassion from those who are sworn to serve and protect. What has been learnt? One officer said that he would do exactly the same given the same set of circumstances…May God help us! Our family is broken, our pain wakes us each morning and steals into our dreams at night, but in trying to heal we recognise that the disclosures relating to Ian’s untimely and cruel death can be used as a tool to bring about better training, effective practice and holistic awareness and challenge the ugly existence of unbiased racism.”
Supervising solicitor Courtney Smith said:
“If only the Metropolitan Police would have taken the words of Ian Taylor seriously, it might have prevented his death. He repeatedly told numerous police officers that he could not breathe and that he was dying but his cries for help were dismissed as ‘nonsense’. They did not follow their training, which would have allowed them to take him directly to hospital in a police car, to access the medical care that he so desperately needed. Instead, they left him fighting for his life on the ground, kept him handcuffed and failed to even offer him a sip of water in the 34 degree heat. Stark comparisons can be drawn from the behaviours identified through the Angiolini Review and the conduct of Met Police officers towards Mr Taylor on 29 June 2019, resulting in devastating consequences for Mr Taylor and his family.”