A dad-of-four died having suffered a cardiac arrest in the back of a police van after taking cocaine and being involved in a 'significant' and 'high-stressing, physical struggle' with officers, an inquest jury has concluded.
Andre Moura, 30, was detained by cops outside his home on Seventh Avenue in the Limeside area of Oldham on suspicion of a breach of the peace following a number of emergency calls from his long-term partner and mother of his children about his behaviour on Friday, July 6, 2018.
The actions of the officers involved did not cause or contribute to Mr Moura's death, an inquest into his death heard. The injuries he sustained in the struggle did not contribute to his death, a pathologist said.
The inquest heard Mr Moura's partner asked the warehouse worker - originally from Portugal - to leave their home as he had been taking drugs, but that he returned and repeatedly tried to get back into the property.
After learning he was being arrested, the hearing was told Mr Moura began to 'resist' and was kneed, punched and sprayed with CS gas by an officer during attempts to restrain him, during which his clothes also came off.
He was double-handcuffed and placed naked into a police van before being taken to Ashton police station. On arrival, a custody nurse sent to check on him said he wasn't breathing and that she couldn't find a pulse.
Resuscitation attempts began, which concluded at hospital, where Mr Moura was declared dead at 1.30am the following day - Saturday, July 7.
A pathologist gave his medical cause of death as 'cocaine toxicity resulting in hyperthermia and Acute Behavioural Disturbance (ABD) in association with obesity and struggle against restraint'.
This evening (Thursday, December 15) a jury - which has heard four weeks of evidence - formally returned its conclusion. Juror's findings were read by the foreperson at South Manchester Coroners' Court in Stockport.
Setting out the circumstances surrounding Mr Moura's death they said: "On July 7, 2018, Andre Moura was declared dead at Tameside General Hospital having had a cardiac arrest in the back of a police vehicle while 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 (ABD) in association with hyperthermia, obesity and a high-stressing, physical struggle which were all contributing factors."
Recording a narrative conclusion, jurors wrote: "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 (ABD) developed. He was put in the back of a police van for transportation.
"He suffered a cardiac arrest in the back of the police van and died after attempts to resuscitate him were unsuccessful."
According to the Royal College of Emergency Medicine, ABD is 'an umbrella term used to describe a presentation which may include abnormal physiology and/or behaviour'.
The inquest has previously heard it can be brought on by psychiatric illness or substance abuse, with cocaine being the most common drug associated with cases of ABD.
Senior coroner Alison Mutch made clear that the 'failure to recognise ABD' and any concerns about the checks carried out on Mr Moura by officers were 'non-causative' of his death.
It followed evidence from an expert A&E consultant Dr Nigel Zoltie, who Ms Mutch said had concluded Mr Moura had a 'massive cardiac arrest' that 'even in a hospital setting no one realised he was going to have' and that he 'couldn't be resuscitated from'.
She said she was satisfied that a report to prevent future deaths was required.
Ms Mutch will now write a report addressed to the College of Policing and National Police Chiefs' Council regarding the training given to officers in England and Wales around ABD and AVPU - which stands for 'alert, verbal, pain, unresponsive' and is a system by which healthcare and other professionals can determine a person's level of consciousness.
The inquest heard an ambulance was initially requested for Mr Moura, but was cancelled shortly afterwards after officers at the back of the van indicated they believed him to be responding, with one suggesting he could also be 'bluffing'.
Dr Zoltie previously said he had concluded that the outcome would not have been different had police had acted differently, or if an ambulance had attended the scene.
"If the cocaine had been toxic to the heart, then that's not something you can reverse," he said.
"Trying to keep someone alive by external compressions while the cocaine wears off is not practical and by that time you are effectively looking at brain death."
He said he had not been asked to provide expert evidence on the police, but added: "My lay view is that events had already been de-escalated because he's not being man-handled.
"He's just lying there quietly with his handcuffs on and was not obviously struggling against them. At that point everything is de-escalated. If he did go into cardiac arrest, there's a reasonable assumption that he would also have done so in the back of an ambulance."
Ms Mutch said she believed there needed to be clearer guidance on the issue of people 'faking and feigning' illness and/or unresponsiveness so that 'when someone isn't feigning but is extremely unwell that's recognised at the earliest opportunity and urgent medical attention can be sought'.
She said that given changes that have now been implemented, she did not currently believe a prevention of future deaths report needed to be issued in respect of GMP.
Ms Mutch said she would be writing to GMP Chief Constable Stephen to seek clarification on the use of body-worn cameras by transporting officers' response times to domestic incidents; and a new training package now being delivered to officers on 'domestic abuse'.
Mr Watson has been given 28 days to respond to her letter.
Ms Mutch thanked the jury, saying it had been a 'very difficult inquest for all of us particularly for you as jurors' and offered her condolences to Mr Moura's family.
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