A forensic pathologist who reviewed the death of Dalian Atkinson has told a court the continued use of handcuffs in spite of unconsciousness probably contributed to the ex-Premier League footballer’s death.
Dr Nathaniel Cary told Birmingham Crown Court that “poor management” of the former Aston Villa, Sheffield Wednesday and Ipswich Town star, after he lost consciousness, was “more likely than not” to have been a factor in the death.
In the fourth week of the trial of Pc Benjamin Monk, Dr Cary also identified a “third Taser deployment and/or kicks to the head” as playing a role in the fatal outcome.
West Mercia Police constable Monk, who denies murder and manslaughter, is standing trial alongside fellow Pc Mary Ellen Bettley-Smith, who has pleaded not guilty to assault, after striking Atkinson with a baton.
Jurors have heard Pc Monk, aged 43, claims Mr Atkinson, who had been tasered to the ground, was “very, very obviously attempting to get up” before he kicked him twice in Meadow Close, Telford, on August 15 2016.
Dr Cary told the jury he had provided a report into the “complex” death to the Independent Office for Police Conduct in 2019.
After stressing he was keen not to trespass on the burdens of proof before the jury, Dr Cary said: “In my opinion it’s beyond any reasonable doubt that (pre-existing) enlargement of the heart contributed to the fatal outcome in this case.
“My second conclusion is that in my opinion it is beyond any reasonable doubt that the deceased’s mind-altered state contributed to the fatal outcome.
“In the simplest of terms, none of this would have happened if he hadn’t had a mind-altered state.”
The expert witness went on to state that, again in his opinion, a third Taser deployment, which is accepted to have lasted for 33 seconds, and/or kicks to the head contributed to the death.
Addressing the Taser use and kicks specifically, Dr Cary added: “Because of the close proximity of one to the other I am not able to identify whether one or both was the main factor.”
Dr Cary then commented on what he described as poor management of Mr Atkinson, including poor posture, the “continued use” of handcuffs after unconsciousness, and an inability to adequately assess him.
“In my opinion, on the balance of probabilities, poor management of the deceased following the unconsciousness contributed to death.”
The Home Office-approved pathologist added: “I cannot state that this contributed to death beyond any reasonable doubt because the deceased’s fate might already have been sealed.”
During his evidence, Dr Cary also said that he believed baton strikes had not contributed to the death.
Another forensic pathologist, Dr Ashley Fegan-Earl, said he believed multiple factors had “culminated in physiological chaos and ultimately cardiorespiratory arrest”.
Dr Fegan-Earl, who was called to give evidence by Pc Monk’s defence team, said he disagreed with the view that Mr Atkinson did not have an immediate life-threatening condition before he was Tasered and kicked.
The defence witness said Mr Atkinson’s diseased heart meant he was at risk of sudden death at any point.
Dr Fegan-Earl told the court: “Each of the factors would have the potential to cause death through a variety of mechanisms.
“I don’t believe there is one specific aspect of the incident which sealed his fate.
“What cannot be known is whether Mr Atkinson would have died if one or more of the factors had not occurred.”
The situation was one where “multiple significant factors” had created a “perfect storm” ending in cardiorespiratory collapse, Dr Fegan-Earl said, adding: “The precise level or contribution of each of the factors to the death cannot be stated with certainty.”
The trial continues.