Inquest finds inappropriate police restraint and unlawful killing

Joshua Ball, 26, died after being restrained by Staffordshire Police on 28 May 2018. An inquest jury has now found inappropriate police restraint occurred, including the use of a spithood, and ambulance failures.

Joshua was from Stoke-on-Trent. Joshua, a father of one, was a natural entertainer and regularly hosted a karaoke event at a local pub. A beloved son, his family said he “melted hearts at school, on state, on the football pitch and in any environment he found himself in throughout his life.”

On 28 May, police were called to an incident in Newchapel, Stoke-on-Trent after members of the public had seen Joshua acting erratically. Joshua was under the influence of cocaine at the time. He was covered in blood and appeared to have self-harmed. A member of the public threw a rock at Joshua which resulted in a mesenteric tear.

At 1.45pm, Staffordshire police officers arrived. They handcuffed and restrained Joshua on the ground and placed a spit hood over his head.

Body worn video footage, shows that officers discussed whether Joshua was suffering from Acute Behavioural Disturbance (ABD). This is a set of symptoms which often arise during restraint, which police are generally trained to recognise and respond to as a medical emergency.

Paramedics were called and Joshua was taken to Royal Stoke Hospital by West Midlands Ambulance Service. He suffered a seizure on the way to the hospital. There were severe criticisms made of the ambulance service in their treatment of Joshua.

Joshua arrived at the hospital at 2.40pm. He suffered two cardiac arrests and presented symptoms of internal bleeding. Joshua subsequently underwent an emergency laparotomy. During his time in theatre, Joshua suffered four further cardiac arrests and died.

The inquest concluded that a rock thrown at Joshua by a member of the public combined with acute cocaine intoxication led to serotonin syndrome and ultimately caused his death. The jury also found the following issues:

• The mesenteric tear caused by a rock thrown at Joshua by a member of the public. This amounted to unlawful killing.
• The officer’s decisions to restrain Joshua on the ground and to use a spitguard on Joshua in the circumstances were inappropriate.
• The initial patient assessment by ambulance staff was inadequate and there was a lack of fact finding and exploration of events prior to Joshua being attended by emergency services.
• Ambulance staff failed to recognise and manage Joshua’s soiled airway, arising from the blood in the oxygen mask and failed to provide adequate ventilation.
• Ambulance staff entirely missed the potential for significant trauma consideration and active internal bleeding.

Joshua’s father, Stephen Ball, said:

“It has been a long and hard 5 years since Joshua tragically died. I have always wanted the truth and justice for Joshua about the way he was treated on that fateful day. I am relieved and grateful that the jury has vindicated our longstanding belief about the inhumane and degrading way in which Joshua was treated by the police, ambulance service and hospital Trust. I am also relieved that the jury have placed on record that he was unlawfully killed. I will hold Joshua in my heart forever and we as a family will not give up on our fight for justice for him."

Caroline Finney, Caseworker at INQUEST, said: 

“Joshua’s death following the failings of both the ambulance and police services is a further indictment of the failure to treat individuals in severe mental health crisis as peoples in need of support. Indeed, despite having been physically attacked by others and bleeding, Joshua was restrained by the police and not appropriately cared for by paramedics.

Acute Behavioural Disturbance is now a well-known collection of symptoms that should trigger a medical emergency. Resources need to be urgently allocated to specialist mental health responders to end the over-reliance on policing mental ill-health.”

For further information, please contact Leila Hagmann on leilahagmann@inquest.org.uk.

The family is represented by INQUEST Lawyers Group Members Daniel Lemberger Cooper and Patrick Dunne of Imran Khan and Partners solicitors, Lorna Skinner K.C. of Matrix Chambers, and Paul Clark of Garden Court Chambers. The INQUEST caseworker is Caroline Finney.

Other interested persons represented at the inquest are Staffordshire Police, Independent Office for Police Conduct, West Midlands Ambulance Service and Royal Stoke University Hospital.

Journalists should refer to the Samaritans Media Guidelines for reporting suicide and self-harm and guidance for reporting on inquests. This press release was first published on INQUEST's website on Friday 31 March 2023.