The Fayette County coroner's office will not conduct an investigation into the death of a 21-year-old autistic man in police custody.
Roland Campbell, who was severely autistic and could not speak, stopped breathing April 18 while being held down by two Lexington police officers and a caretaker at a group home owned by Adult Day Care Inc. of Lexington.
The cause of death was acute cardiorespiratory failure, a type of heart failure, according to an autopsy performed by the state's associate chief medical examiner. The manner of death — whether the death was an accident, suicide, homicide or from natural causes — is listed as undetermined pending investigation into the events leading up to it.
Campbell's autopsy was completed in July. The Fayette County coroner's office released a copy to the Herald-Leader on Tuesday.
Both the state medical examiner and a state advocacy group for the mentally disabled suggested a coroner's inquest, an investigation into the events surrounding the death.
"One option is to conduct a coroner's inquest, which should include taking sworn testimony and going to the Waco residence to perform the re-enactment," associate chief medical examiner John Hunsaker III said in the autopsy report.
However, Fayette County Coroner Gary Ginn said Wednesday legal counselors advised him not to conduct the inquest.
Ginn said any such investigation should come from the courts if a civil lawsuit is filed. There is no guarantee, he said, an inquest would reveal anything.
"It could become inconclusive, which could put us back to square one," he said. "I don't see using the county's funds for that."
Individual investigations by the Lexington police department and Adult Day Care have been closed.
The police investigation was closed after the autopsy was completed in July, Lexington police spokeswoman Sherelle Roberts said. Police have said responding officers acted appropriately to subdue a man who was "a danger to himself and others."
Police were called after Campbell began destroying items in the home and lashing out at caretakers, reports say.
An attorney for Adult Day Care, Jill Hall Rose, said the company's internal investigation and an investigation by the state Cabinet for Health and Family Services ordered caretakers to be retrained to handle emergency situations, but no further actions were pending.
"The department found the home did nothing that contributed to the death," she said.
Kentucky Protection and Advocacy, a group that supports the mentally disabled, has been investigating the death since May. Director Marsha Hockensmith said the investigations by police and Adult Day Care may not tell the whole story.
"You had so many folks involved in this," Hockensmith said.
"It's like there are pockets of investigation ... being done, but they never meet in the middle," she said.
Campbell's heart failure was brought on by several conditions, including lack of oxygen, dehydration, physical exhaustion, possible medication intoxication and "autism-induced excited delirium during prone restraint," the autopsy said.
Several incident reports from police and witness statements were included in the autopsy report.
According to documents, officers responded to an Adult Day Care group home at 2961 Waco Road after Campbell began destroying furniture and other items.
Campbell, who was breathing heavily and was covered in sweat, had pulled down a refrigerator and destroyed light fixtures, electrical outlets and furniture before jumping out a window, reports said.
Officers were called to take Campbell into emergency protective custody, police have said.
Two officers, Derrick Wallace and Matthew Smith, and Adult Day Care employee Eric Hatter had pinned down the flailing man with a blanket while trying to handcuff him when he "suddenly stopped moving."
Officers performed CPR until an ambulance arrived.
According to reports, pepper spray and Tasers were not used on Campbell. At no point was pressure put on his neck or head, the report said.
However, police reports and witness statements do not say whether pressure was placed on Campbell's back while he was being restrained.
According to the autopsy, "sitting, lying, kneeling, standing or manually pushing on the back needs to be considered because it may cause mechanical interference with breathing."
The report continued, "Death via trunk compression typically (takes) a couple minutes, so establishing duration of such restraint, if any, is crucial to the investigation."
Ginn said he did not see any criminal intent in the case.
"This is a civil litigation," he said. "The courts would handle this rather than me."
It was unclear Wednesday if a civil lawsuit will be filed.