Reversal of post-mortem result piles pressure on the Met

The police officer who pushed Ian Tomlinson to the ground before his death at the G20 protests is facing a manslaughter charge after a second post-mortem examination revealed that the newspaper vendor died of an abdominal haemorrhage and not a heart attack.

Mr Tomlinson died after being struck and pushed to the ground by a police officer. A post-mortem examination ruled that he died of a heart attack, but after amateur footage appeared on the internet showing Mr Tomlinson being thrown to the ground by a police officer minutes before his death, a further post-mortem examination was carried out.

Yesterday a solicitor acting on behalf of Mr Tomlinson's family said it had found a different cause of death. That announcement was followed by one from the Independent Police Complaints Commission (IPCC) revealing that the officer in question, who was suspended after the footage became public but who has not yet been named, has now been questioned on suspicion of manslaughter.

Should the IPCC investigation end with a referral to the Crown Prosecution Service (CPS) and, ultimately, a charge of manslaughter, the officer will become the first since 2005 to be charged with such an offence. A charge of murder is extremely unlikely as that offence requires an intention to kill or cause grievous bodily harm. The second examination was conducted by Dr Nat Cary, one of Britain's most eminent forensic pathologists, last week, on behalf of both Mr Tomlinson's family and the Independent Police Complaints Commission. In a preliminary report, Dr Cary reported that the cause of death was abdominal haemorrhage. The cause of the haemorrhage remains to be ascertained but it could still have natural causes.

The first post-mortem examination had been carried out by Dr Freddy Patel. He had previously been remrimanded by the General Medical Council for releasing medical details of a man who died in police custody.

A statement from the City of London Coroners' Court said "Dr Cary accepts that there is evidence of coronary atherosclerosis but states that in his opinion its nature and extent is unlikely to have contributed to the cause of death."

A spokeswoman for the IPCC said: "Following the initial results of the second post mortem examination, a Metropolitan Police officer has been interviewed under caution for the offence of manslaughter as part of an ongoing inquiry into the death of Ian Tomlinson."

Jules Carey of Tuckers, the family's solicitor, said that "the video footage of the unprovoked and vicious assault on Ian by the police officer would easily justify charges of assault being brought against the officer. The findings of Dr Nat Cary significantly increase the likelihood that the officer will now face the more serious charge of manslaughter."

He added that Mr Tomlinson's family had been aware of the second post mortem examination's results for a week but had delayed releasing them publicly to give the IPCC time to question the officer involved. Mr Carey added that the family now hoped that the case would be passed to the CPS who will ultimately decide whether or not to charge the officer. The Metropolitan Police released a new statement this afternoon, reiterating its "sincere regret" in relation to Mr Tomlinson's death.

Mr Tomlinson died on 1 April as nearly 5,000 protesters took to the streets during the G20 summit. Despite not being involved in any campaigns, which were marred by violent clashes, Mr Tomlinson found himself hemmed in by police officers as he tried to make his way across the city to watch a football match.

He collapsed and later died and a Metropolitan Police statement initially said that officers had been pelted with bottles as they tried in vain to save Mr Tomlinson.

But on 7 April internet footage emerged which showed Mr Tomlinson as the victim of an unprovoked police attack. The video, captured by a New York fund manager, showed Mr Tomlinson walking with his hands in his pockets before he was pushed to the ground from behind by a police officer in riot gear.

After the footage became public Sir Paul Stephenson, the Metropolitan Police Commissioner, released a statement saying: "My thoughts are with Mr Tomlinson's family at this time. The images that have been released raise obvious concerns and it is absolutely right and proper that there is a full investigation, which the Met will fully support."

Later the officer involved, a constable from the territorial support group based in Lambeth, south London, identified himself as the man in the video and was suspended.

The Metropolitan Police have inevitably come in for criticism and it was suggested that, by releasing a statement saying that officers were attacked as they tried to resuscitate Mr Tomlinson, they had misled the media.

It has also been pondered aloud by some critics as to whether the force would have ever acknowledged the matter if the amateur footage had not emerged.

Also criticised was Dr Freddy Patel, the pathologist who carried out the first, now apparently discredited, post-mortem examination. After he erroneously ruled that Mr Tomlinson had died of a heart attack it emerged that he had previously been reprimanded by the General Medical Council over his conduct.

Paul King, Mr Tomlinson's son, said yesterday: "First we were told there had been no contact with the police, then we were told he died of a heart attack; now we know he was violently assaulted by a police officer and died from internal bleeding.

"As time goes on we hope that the full truth about how Ian died will be made known."

Questionable tactics Problems at the Met

*The "secret" police

All Met officers in uniform are required to display identity letters and numbers, but some appear to be trying to conceal them and others have removed them at demos. Kit Malthouse, London deputy mayor, yesterday demanded that Sir Paul Stephenson discipline rule-breakers.

*Second G20 protester beaten

Footage has emerged of a female demonstrator, Nicola Fisher, being baton-whipped on the legs by an officer. She gave interviews and showed her bruises, likening it to being "whipped by the Taliban". The Chief Inspector of Constabulary Denis O'Connor will review strategies such as "kettling", the confinement of crowds for long periods.

*Damian Green

Despite a £5m police investigation, the CPS ruled on Thursday that there was insufficient evidence to prosecute the shadow Immigration Minister; the information he was leaked was not secret. The Met was accused of breaching Parliamentary protocol.

*Experience vacuum

Only two of the six senior commissioners at the Met are permanent – the other four are "acting", and do not carry appropriate rank.

*Rape investigations

The IPCC is investigating how two prolific rapists, cab driver John Worboys and chef Kirk Reid, were not caught sooner despite the Met having extensive evidence.

*Bungled terrorist operation

Assistant Commissioner Bob Quick, the UK's most senior counter-terrorism officer, resigned last week after accidentally disclosing impending terror arrests.

The fatal injury How the victim died

*An abdominal haemorrhage is bleeding from somewhere within the abdominal cavity – what most people refer to as the stomach area.

There are a number of organs within the abdominal cavity, including the liver, the spleen, the kidneys and the intestines. Any one of these bleeding constitutes an abdominal haemorrhage.

There are three major causes of such abdominal haemorrhages. The first is a rupture of a major organ such as the spleen from a massive blunt trauma to the front or the side of the cavity. You would see such trauma in a serious road traffic accident. From what we know about the incident in question, this would seem an unlikely explanation.

The second cause would be the rupture of an aneurysm in the abdominal aorta (a pre-existing condition where there is swelling of the large artery passing through the abdomen).

This can be associated with massive sudden spontaneous bleeding. The third cause of such a haemorrhage is massive internal bleeding into the intestine, and this is perhaps more likely here.

Mr Tomlinson suffered from alcoholism, and from the footage he did not appear well. The chronic liver disease associated with alcoholism can lead to swollen blood vessels within the intestine which, combined with a tendency to bleed more easily, can lead to rapid, often fatal bleeding.

When [the full post-mortem report] is available, it should be possible to ... answer what type of haemorrhage caused Mr Tomlinson's death.