Fatal Accident Inquiry into the death of Michael Towell

The following is a summary of the Determination of Sheriff Principal Craig Turnbull, following a Fatal Accident Inquiry held at Glasgow into the death of Michael Towell, a professional boxer, who died on 30 September 2016, from a head injury sustained in the final eliminator contest for the British welterweight championship against Dale Evans the previous evening.

The following is a summary of the Determination of Sheriff Principal Craig Turnbull, following a Fatal Accident Inquiry held at Glasgow into the death of Michael Towell, a professional boxer, who died on 30 September 2016, from a head injury sustained in the final eliminator contest for the British welterweight championship against Dale Evans the previous evening.

Mr Towell was given a working diagnosis of temporal lobe epilepsy in September 2013, which he did not wish to consider [45]. He declined to participate in the tests recommended by doctors and was discharged by neurology in March 2014 [93]. Mr Towell failed to disclose this diagnosis to the doctor who carried out his annual boxing medical examination in 2014 [86 - 90], 2015 [102 - 106] and 2016 [115 – 119]. Mr Towell also failed to disclose this diagnosis to the doctors who carried out his pre-fight medical examinations in each contest he participated in after September 2013. Mr Towell was told not to drive and to report his condition to DVLA on no less than five separate occasions. Mr Towell chose not to report his condition to DVLA [424].

Sheriff Principal Turnbull has found that there were six reasonable precautions which could reasonably have been taken and, had they been taken, might realistically have resulted in the death of Mr Towell being avoided. These are:

1.            for Mr Towell to have disclosed to the doctor who carried out the British Boxing Board of Control (BBBC) medical examination in connection with his application for a professional boxer’s licence in November 2012, any of the episodes he subsequently disclosed to a doctor at the neurology clinic at Ninewells Hospital (Ninewells) on 17 September 2013, which had occurred by the time of the November 2012 examination [D4.1]

2.            for Mr Towell to have followed the advice not to box which was given to him by three separate doctors in September and October 2013 [D4.2]

3.            for Mr Towell to have disclosed to the doctor who carried out the pre-contest medical examination on 11 October 2013 that he had a diagnosis of temporal lobe epilepsy [D4.3]

4.            for the BBBC to have used the consent given by Mr Towell in both 2014 and 2015 and to have contacted Mr Towell’s GP to obtain medical information relevant to his application to box [D4.4]

5.            for Mr Towell to have disclosed to the doctor he spoke to on or about 13 September 2016 the circumstances of his hospital attendance on 11 September 2016 [D4.5]

6.            for Mr Towell to have followed the head injury advice given to him on 11 September 2016 by a consultant in the accident and emergency department at Ninewells and to have returned to Ninewells after he had vomited in the early hours of 12 September 2016 [D4.6].

Sheriff Principal Turnbull has determined that there is a defect in a system operated by the BBBC, namely, that their rules and processes relevant to boxers’ fitness to box are vulnerable to the withholding and concealing of relevant information by boxers. That defect contributed to the death of Mr Towell.

Sheriff Principal Turnbull also made a total of seven recommendations which, if followed, might realistically prevent other deaths in similar circumstances. Six of those recommendations are directed to the BBBC. The seventh is directed to the British Medical Association. The recommendations are:

1.            that the BBBC should, as soon as reasonably practicable, obtain from each boxer presently licensed by them details of their current GP and of any other medical professional from whom they have received treatment in the past 12 months [R1]

2.            that the BBBC should give consideration to suspending the licence of any boxer who does not provide the details required in terms of recommendation R1 within 21 days of being requested to do so [R2]

3.            that the BBBC should, as soon as reasonably practicable, send to each boxer’s GP, and to any other relevant medical professional, a copy of the boxer’s latest BBBC medical examination form and seek from them confirmation that the information in that form is, to the best of their knowledge and belief, complete and accurate; and (b) either (i) the details of any medical history which may be relevant to the boxer’s fitness to box; or (ii) confirmation that there is nothing within the boxer’s medical history that is relevant to his or her fitness to box [R3]

4.            that the BBBC should, as soon as reasonably practicable, revise their medical examination form to require the provision of the details of the boxer’s current GP and of any other medical professional from whom they have received treatment in the previous 12 months [R4]

5.            in the case of a boxer applying for a new licence or for the renewal of an existing licence, prior to granting or renewing a licence, the BBBC should send to the boxer’s GP and to any other relevant medical professional a copy of the boxer’s latest medical examination form and obtain from them confirmation that the information in that form is, to the best of their knowledge and belief, complete and accurate; and (b) either (i) the details of any medical history which may be relevant to the boxer’s fitness to box; or (ii) confirmation that there is nothing within the boxer’s medical history that is relevant to his or her fitness to box [R5]

6.            that the British Medical Association should actively encourage all of their members to respond promptly to any request they may receive from the BBBC to provide the information set out in recommendations R3 and R5 [R6]

7.            that the BBBC should revise their rules that govern the reporting of illness or injury so as to require all boxers; trainers; managers; and promoters to immediately inform the BBBC of illnesses or injuries suffered by boxers [R7].

As a participant in the Inquiry, the BBBC are required to give a response to the recommendations directed to them within eight weeks. A response to a recommendation must set out details of what the respondent has done, or proposes to do, in response to the recommendation, or, if the respondent has not done, and does not intend to do anything in response to the recommendation, the response must set out the reasons for that.

As the BMA were not a participant in the Inquiry, they are not obliged to give a response, although they are entitled to do so.

Sheriff Principal Turnbull determined that the following facts are also relevant to the circumstances of Mr Towell’s death:

1.            Mr Towell should have been re-referred to neurology by his GP practice following his attendance at Ninewells on 21 May 2016. No such referral was made. Had such a referral been made, it is probable that Mr Towell would not have attended. In any event, had a referral been made in May 2016, it is unlikely that Mr Towell would have been offered a neurology appointment prior to his death [D6.1].

2.            No additional or different action should have been taken by the staff of NHS Tayside in relation to Mr Towell when he attended Ninewells on 11 September 2016. Mr Towell was appropriately assessed and treated that day by the staff at Ninewells [D6.2].

3.            Assuming the chronic subdural haematoma suffered by Mr Towell and discovered in the post-mortem examination was present on 11 September 2016, due to its size, it would not have been identified by the staff at Ninewells if they had carried out a CT scan of Mr Towell’s head on that date [D6.3].

4.            No additional or different action should have been taken by Mr Towell’s GP at, or subsequent to his consultation, with Mr Towell on 12 September 2016. Mr Towell was appropriately assessed and treated that day by his GP [D6.4].

References in square brackets are to paragraphs of the determination.

NOTE

This summary is provided to assist understanding of the court’s determination. It does not form part of the reasons for the decision. The full determination is the only authoritative document. Determinations in fatal accident inquiries are published on the SCTS website.