What happened
Roger Sylvester died on 18 January 1999 in Tottenham, north London. Metropolitan Police officers had detained him under section 136 of the Mental Health Act. That is a mental health detention made in the street, not a criminal arrest.
The record places the events across the street and the police station, and classifies the restraint as prone. He was held on the ground. He died.
The record does not give his age, how long the restraint lasted, or who held which limb.
The outcome
An inquest jury returned a verdict of unlawful killing on 3 October 2003, four years and eight months after the death.
On 26 November 2004 the Administrative Court quashed that verdict and substituted an open verdict, in R (Anderson and others) v HM Coroner for Inner North London [2004] EWHC 2729 (Admin), before Collins J.
The open verdict is the standing conclusion. No criminal prosecution of officers followed.
Published material still describes the case as an unlawful-killing finding. It has not been one since November 2004.
What went wrong
The evidential findings are not available to this page, so nothing here describes what the court heard about the hold itself. What can be said is the shape of it: a detention under the Mental Health Act, a man restrained prone on the ground, and nearly six years of proceedings before a conclusion stood.
Then the conclusion did not stand. A jury heard the evidence and said unlawful killing. A judge set that aside. The recorded conclusion changed from a finding against the officers to no finding at all.
The record has gaps. There is no duration and no account of positions. A restraint that cannot be described afterwards cannot be reviewed afterwards.
What it teaches
Do not teach this case as an unlawful-killing finding. The verdict was quashed, and a trainer who repeats the headline hands a room a fact that a court has taken away.
Teach it as the case that shows how a restraint death, a section 136 detention and a coroner’s court interact over five years, and why the standing conclusion matters more than the headline. In a training room the standing conclusion is the only one you can defend when somebody checks.
Questions for the room
- A jury of ordinary people heard the evidence and said unlawful killing. A judge then set that aside. What does that tell you about how much weight a verdict can bear?
- You are the officer deciding whether a person in the street needs section 136 or an arrest. What changes about the risk to them once that choice is made?
- The case ran from 1999 to 2004. What does five years of proceedings do to a family, and who is accountable for the delay?
- No source reached for this page states how long he was held down. What should a record contain so that the question can be answered later?
Evidence and limits
Confidence: probable.
One source is filed: the Administrative Court judgment. The vault record states that the judgment was opened in full when the case was built. The précis for this page says the BAILII page returned a bot challenge instead of text, and that the judgment could not be read. Those two notes disagree, and this page does not settle it. The dates, the order quashing the verdict and the substituted conclusion are carried from the record.
The record gives no age, no duration and no account of who held which limb, so none is printed. No officer is named, and no finding is made about any individual.
If your staff may have to hold someone who is unwell rather than resisting arrest, our [vulnerable and volatile persons training](/training-solutions/vulnerable-volatile-persons) covers the decisions that come before hands go on.
Sources
Reviewed 20 October 2026.