Restraint contributed to former boxer's Wolverhampton hospital death

Fitz Francis died at the city's Penn Hospital.

But the jury at an inquest into his death concluded the restraint used on the 59-year-old was necessary.

Jamaican-born Mr Francis was admitted to the hospital from Winson Green Prison on the advice of doctors after refusing to take medication while in jail.

But a five-day inquiry into his death heard the former welder, of Graisley, had assaulted staff at Penn Hospital and removed his belt as he threatened to attack nurses.

This led to him being restrained and injected with lorazepam to calm him down.

Minutes later staff realised Mr Francis was not breathing and he later died.

Evidence from Prof Peter Vanezis (corr), who examined his body, found that Mr Francis had an enlarged heart and scar tissue on the muscle which suggested he had a history of high blood pressure and heart disease.

The jury of eight men and one woman gave a narrative conclusion which said: "At approximately 12.03am on February 22 2009 at Sandalwood Ward, Penn Hospital, Wolverhampton, Mr Fitz Albert Francis died from acute cardiac failure compounded by restraint. The restraint procedure was conducted by trained staff and was deemed necessary due to Mr Francis' increasing anxiety and aggression."

The jury also gave a cause of death for Mr Francis as acute cardiac failure due to heart hypertensive heart disease compounded by restraint.

The inquiry had heard from Amanda Franklin who was a senior nurse at Penn Hospital the night Mr Francis died. She said that staff had raised concerns about the ratio of female staff to male patients.

Black Country Coroner Robin Balmain asked if the concerns had been received.

Ms Franklin added: "I'm not sure how it is now because I no longer work there but I am aware that gender should be taken into account. It's not ideal if it's an all male staff or an all-female staff."

Mr Balmain also questioned Joyce Fletcher, who is the deputy director in nursing for The Black Country Partnership Trust.

He asked why there wasn't at least one male member of staff on a ward that had male patients.

She said: "Across the board, nationally, there are more female staff than male staff the ratio is about four-to-one . Having said that inpatient staff under take training and also at the time Mr Francis was being restrained there were two male members of staff. It's not always feasible. We have to cover a number of shifts and different staff and to do that is not always possible."

At the time of the death at he hospital was being run by Wolverhampton Primary Care Trust but it is now overseen by The Black Country Partnership Trust.

After the inquest the trust's chief executive Karen Dowman said: "Fitz Francis' death in 2009 was a tragic event. He was well-known and well-liked by staff at the hospital who had cared for him over a number of years. They were deeply upset by his death and we would all like to offer our sincere condolences to his family for their loss."

She said a thorough investigation was carried out, with significant improvements made to the 'psychiatric intensive care service.

"We now have a purpose built intensive care ward which provides the highest level of support for patients," she said.

"Because the physical health of our patients is very important to us, we now have a matron to oversee the physical health and wellbeing of our mental health patients. Every patient receives a thorough assessment when they are admitted to our hospitals and we closely manage their conditions such as diabetes and heart disease."

She said restraint is only used as a last resort when a situation has become unsafe for patients and staff.

"We've been working closely with the Government on their new programme to minimise the use of restraint and to manage aggression."

She added inspectors from the Care Quality Commission had made unannounced visits since and found all care standards were being met.