On the 3th 2015 in inquest was opened touching the death of Ms Michelle Ann Lawrence who died on the 2nd 205 at Flat 11 Windsor Court; 12, Dunsford Road, Wimbledon; London_ The inquest was concluded on the 8h September 2016 at Westminster Coroner's Court, sitting at the Royal Courts of Justice with a jury. The following findings and determinations were made by the jury: The medical cause of death was recorded as: 1(a) Respiratory Failure. (b)Multiple Sedative Overdose 2 Hepatitis May May Drug

How, when and where and in what circumstances the deceased came by her death: Ms Michelle Ann Lawrence died as & result of respiratory failure She was pronounced dead at 09.25 at home on 02/05/2015 at home. She died as a result of taking a cocktail of prescription and illegal drugs which caused respiratory failure. Conclusion of the Jury as to the death: Ms Michelle Ann Lawrence died as the result of a related misadventure:

Evidence taken at the inquest was that Ms Lawrence had been admitted to the custody of the police on 30/4/2016 at approximately Ipm following arrest: It was noted on booking in that there were risk markers on the PNC for conceals and drugs and that she had in February 2015 hidden drugs in her knickers and vagina, which had later been removed in hospital: The booking-in Sergeant noted this and referred her for strip searching_ This was carried out and nothing found. Following her death; the CCTV was analysed showing her removing a plastic container probably from her vagina and taking pills from it on 4 separate occasions whilst in police custody: None of this was noted by custody staff at the time_ She was released to the custody of SERCO and thence to the custody suite at Wimbledon Magistrates' Court at 7:10 am on May 2015 and released from their custody at approximately 16.00. Again nothing adverse was noted whilst she was in the custody of SERCO. She was collected by her partner and taken home where is likely to have taken heroin, She was found deceased by her partner at her home address at approximately 9 0Oam 2nd 2015 Pathological and toxicological evidence in the case was consistent with her having died from the effects of taking multiple sedative drugs, prescribed and illegal This may have included tablets taken whilst in custody The evidence was also that there was no independent investigation of the time spent in the custody of SERCO such that any CCTV from there was lost and statements were taken internally by the company with no statement of truth, sometime after the death. At no point either by the police, the nurse practitioner who saw her in police custody, r whilst in the custody of SERCO was she asked whether she had concealed anything_ This was despite the warnings on her PNC, the fact she was strip searched by a police officer who had interviewed her in relation to possession of drugs concealed whilst in custody in February, and evidence that conceals are common and increase risk to detainees and others There was also evidence that whilst in Wimbledon she shared a toilet and on that another detainee may have secreted and attempted to distribute them by leaving them in the toilet: It is apparently not routine for staff to check the toilet for such matters after detainees have used it The evidence was also that there is apparently very little provision for strip searching by SERCO, both in terms of environmental circumstances and the permissions required despite a not uncommon incidence of concealment At Wimbledon Magistrates' custody suite there is apparently only one cell with CCTV coverage and that is in the male detainees' section On the PNC section where risks are highlighted and detailed there are only 60 characters available to describe the background to the risk. In order to find more detail the custody staff have to access other electronic documents which can be difficult in a unit This meant for Michelle_that the booking_in Sergeant was not aware of details_ drug May day drugs busy that were later provided to him that he says would have caused him to upgrade her risk and possibly consider asking for an intimate search or constant supervision. This may have avoided the death.

In my opinion action should be taken to prevent future deaths and believe you [ANDIOR your organisation] have the power to take such action. It is for each addressee to identify the concerns relevant to their own areas of responsibility