Open verdict in inquest of man who died after arrest at ED

A jury has returned an open verdict in the inquest of a father of three who died after being arrested and removed from the emergency department of Midlands Regional Hospital Mullingar in 2019.

According to pathologist, Dr Michael Curtis, Danny McCormack (40), was several days, if not an entire week into having a heart attack when he arrived at the hospital on the evening of March 23, 2019, complaining of chest pains.

The situation was so severe that his wife, Hazel, had sent him ahead of her in a taxi while she waited for a babysitter to arrive for their two youngest children. She rang ahead to alert the hospital to the urgency of the situation.

Hospital staff said they found Mr McCormack to be “aggressive” and “abusive”, as well as “uncooperative with treatment” before gardaí were called and the patient arrested under Section 6 of the Criminal Justice (Public Order) Act 1994.

CCTV footage played at the inquest showed two gardaí using what they said was “reasonable force” to bring Mr McCormack to the ground and effect arrest.

In his postmortem report, Dr Curtis concluded that Mr McCormack had died of ischemic heart disease, where the heart doesn't receive enough blood flow, and a “large heart attack”, which had extended and grown bigger.

The postmortem report also listed several abrasions on the forehead and face, as well as a tiny bruise on the left nostril. There were also abrasions clustered around one of his knees and shins, as well as bruising on his wrists from struggling while handcuffed.

An injury on his left shoulder was not necessarily caused by a knee from an arresting garda, but it could have resulted from a knee “pressing him into the ground”, Dr Curtis said, noting from CCTV footage of Mr McCormack without his T-shirt, that the injury was not there prior to his arrest.

Dr Curtis also stressed that there were no traces of alcohol or any illicit drugs detected.

Mr McCormack was conveyed to Mullingar Garda Station, but was released after just 17 minutes in custody, and given a lift home by gardaí.

It was shortly afterwards that he collapsed on the floor of his home and ultimately was returned to hospital, where he was pronounced dead.

Dr Curtis, having viewed footage of the arrest, said he cannot comment on the operational appropriateness of garda actions, but said it was not, in his view, effected with “minimal force”.

“Clearly there was an element of force - if you like, violence - in bringing him to the ground,” he said, adding that the incident would have caused Mr McCormack “stress and fear”.

However, he emphasised that Mr McCormack did not die of a “traumatic injury” from the arrest and that he did not wish to “diminish the extent of the disease” in the patient's body.

“This was a heart attack, probably of about a week's duration and, probably over the course of that week, it got bigger and killed more of the heart muscle,” he said.

“This was severe coronary heart disease with a severe, massive heart attack, which in itself is life-threatening.

“But one can speculate that the stress in which he found himself, both physically and emotionally, may have accelerated his death,” he continued, stressing that this would just be “speculation”.

“Treatment will improve chances and the earlier you receive it, the better your chances. But with this degree of disease, I don't know if it would have helped.”

After hearing evidence from 23 witnesses, including family of the deceased, hospital staff, gardaí, and others, the jury returned an open verdict following almost two hours of deliberations.

They listed a number of recommendations for both the hospital and gardaí, which will be passed on to relevant authorities.

Among those recommendations were the suggestion that, should challenging patients be removed, they be made aware that they are welcome to return once calm and compliant.

The jury also recommended that, should gardaí be required for a challenging patient, garda supervised treatment should be administered and patients should not be removed from the hospital without express permission.

Mr McCormack's wife, who rang ahead to alert the hospital to her husband's condition, asked that someone meet him from the taxi. However, nobody was there for him and so the jury has recommended that such arrivals, preceded by a phone call, be treated with a similar urgency to the arrival of an ambulance.

They also recommended the use of an isolation room for challenging patients.

Among the recommendations to An Garda Síochána was that all gardaí receive basic and up-to-date first aid training, and that there be better record-keeping to determine when that training last took place.

It was also recommended that, should a family member present at an arrest wish to speak on behalf of a vulnerable patient about medical issues, gardaí take that into account.

Gardaí are also recommended to properly identify themselves to hospital staff upon arrival, and that best practice be reviewed in relation to vulnerable patients that are presenting with challenging behaviour.