An emergency medical specialist has told the jury in the manslaughter trial of three Hāwera police officers that the man who died in their custody was “deeply unconscious” after reviewing CCTV footage from the night he was detained in a cell.
Allen Ball died in the early hours of June 1, 2019, at the Hāwera Police Station after being arrested as the result of a family harm incident.
A toxicology report stated the 55-year-old’s cause of death was a drug overdose involving alcohol, tramadol and codeine.
Dr Paul Quigley told Crown prosecutor Cherie Clarke that if earlier medical treatment was sought, Ball would have survived.
He said an unconscious person was treated as a medical emergency by professionals, and that someone who responds to pain techniques is treated with urgency.
Dr Quigley gave the opinion that Ball was “clearly unconscious.”.
Ball did not respond to stimulation techniques used to assess if a person is responsive; he fell forward while sitting in the back of the police car "with no ability to control his body at all"; and when he was dragged into the cell his snoring pattern was not interrupted.
He said he found this concerning.
Clarke asked Dr Quigley for his thoughts on evidence from one of the accused police officers that a phone was accidentally dropped on Ball's head in the cell.
The sound of a thud was captured in the CCTV footage played today in court that Ms Clarke said was the phone dropping.
"A blow like that, you'd expect to see a reflex action," Dr Quigley said.
He said he never saw an improvement in Ball's state as the CCTV footage continued and that after some time, his "respiratory efforts dropped off significantly" with the snoring harder to hear and then not heard in the CCTV footage.
Dr Quigley said usually snoring becomes more irregular and erratic as the coma gets closer to being fatal.
"There was definitely a period of time that Mr Ball was deceased before the resuscitation commenced," he said.
He said an overdose was one of the most common reasons for an ambulance call out for a report of self-harm.
Ball made a comment about suicide before he was arrested and this was communicated to the police officers involved.
Ball denied taking any other substance apart from alcohol to an officer that asked.
"Alcohol alone could have led to the death of Mr Ball without the drugs, although they really dug it in there," Dr Quigley said.
Dr Quigley gave examples of shortcomings in the monitoring approach of Ball by police officers.
"Obviously police officer training will not, and cannot replicate yours," defence lawyer Susan Hughes QC questioned to Dr Quigley.
"Were you aware that the extent of their (first aid) training is a one day course at police college and a refresher course every two years?," Ms Hughes said.
Hughes repeated today in the trial that officers are advised not to wake a sleeping detainee.
She argued that unconscious bias can affect how people act in situations and that officers have had many experiences with people that are drunk and don't require medical treatment.
Hughes questioned Dr Quigley that based on Ball's history of heavy drinking, he would be an "unlikely candidate for alcohol poisoning.".
Hughes raised that the officers didn't know other substances had been taken by Ball.
"The cause in the end does not matter, the treatment is universal ... once the safety of the patient is obtained, you would go down an investigative pathway," Dr Quigley replied.
Dr Quigley told Clarke that the police monitoring computer system pop-up alerts with actions required are designed to challenge an officer's bias.
"They are definitely an attempt to break those confirmation biases, or an attempt to guide you in an unknown situation, in this case... to take the person to hospital," he said.
Dr Quigley said when the alert, "Arrange for the person to be taken to hospital" would have appeared on the computer screen during the processing of Ball, he heard in the CCTV footage audio that it did prompt conversation among officers.
He said that the officers "got stuck" that night with considering Ball as partially-responsive.
"How they got stuck there I'm afraid I do not understand,” he said.
Andre Slierendrecht, who manages first aid training provider Triple One Care whose clients include the police, was earlier questioned as a witness by the Crown.
Slierendrecht viewed CCTV footage recorded at Hāwera Police Station on the night Ball died.
"My initial reaction was to wonder why it was all taking so much time," he said in commenting on footage showing Mr Ball not responding to police attempts to wake him when he arrived at the Hāwera station in a police car.
"This is when a major decision should have been made that medical help was sought," he said, commenting that Ball was "beyond sleeping.".
"I think the primary indicator is he got in the (police) car and couldn't get out," Slierendrecht said.
He said when Ball's handcuffs were taken off after being removed from the vehicle, he appeared to roll onto his back, but he didn't see any other movement from Ball.
Once Ball had been moved into the cell where he lay on the ground, Slierendrecht said he was unresponsive.
"At no state did he move."
He said Ball was put in the recovery position, and that this is done to maintain the airway of a person when they're unconscious.
Defence lawyer for one of the accused officers, Susan Hughes QC, questioned Slierendrecht on whether the consideration of snoring and collapses of detainees in cell blocks were part of the first aid training provided to police.
Hughes said she had received signed statements from police officers that these areas weren't covered.
Slierendrecht said he would be "very surprised" if that was the case.
He said these issues were part of several training scenarios.
"But it's not such an important issue that it features in the training document?" Hughes said about the subject of snoring.
"No," he replied.
Slierendrecht acknowledged that the officers knew Ball had ingested alcohol, but not tramadol and codeine, and that Ball was checked on while in the cell.
He accepted Hughes' questions that snoring is "generally benign" and a drunk person can "sleep deeply."
Hughes questioned Slierendrecht if the general public would think snoring is a symptom of a drunk person.
"Most would think he was sleeping.
"I would have concern that a drunk is normally rousable, and this person was not rousable," he said.