The Chief Constable asked the Police Ombudsman's Office to investigate after a 15-year-old boy died in the presence of two police officers on a building site in the Greater Belfast area.
The officers had attended the scene after a member of the public called to say he believed youths were sniffing solvents and had been trying to start the engine of a digger.
During their investigation, Police Ombudsman investigators spoke to the officers involved, a number of youths who had been with the deceased, and two civilian witnesses.
The officers said they had gone to the building site, which was surrounded by perimeter fencing, at about 7.25pm. A number of youths were seen within the enclosed construction area. When challenged the youths ran off, but having run some distance through the site, one suddenly collapsed and fell over a piece of scaffolding and onto rough ground some three to four feet below. He then seemed to make a couple of sudden movements, as if he was having a fit.
The officers, who were 10 to 15 feet away at the time behind the perimeter fencing, went to assist him. They reported placing him in the recovery position, and trying to reassure him as they summoned an ambulance. The youth was subsequently taken to the Accident and Emergency Department of a nearby hospital, but was declared dead at 8.15pm.
Police Ombudsman investigators interviewed a number of youths who had been with the deceased earlier that evening. They offered corroborating statements about his movements prior to his death. These indicated that before going to the building site, the group had been at a petrol station where they had bought crisps and sweets. Two of the group said that, after leaving the garage, the deceased had produced a tin of deodorant. Once at the building site, they stated that he began to spray the deodorant into a plastic bag and inhale it.
One of the youths who was standing close to the deceased when police arrived, reported seeing him begin to shake before falling forward onto the ground, where he continued shaking for a further 10 seconds.
Investigators also spoke to two civilian witnesses, one of whom had called the police after seeing the youths at the building site. Both witnesses recalled seeing one of the youths with a plastic bag placed over his mouth. They later saw one of the youths being taken on a stretcher to an ambulance, but saw nothing of the incidents leading up to this event.
A subsequent post mortem on the deceased revealed significant quantities of butane, isobutene and propane within his blood and brain. The Police Ombudsman's report noted that these were constituents within aerosol propellants, and that their use as intoxicants was extremely dangerous potentially leading to a fatal outcome as a result of respiratory depression or disturbance of the rhythm of the heart.
There was no evidence to suggest the deceased had been the subject of an assault.
The post mortem concluded that the death had been due to inhalation of volatile substances.
Outcome of investigation:
The Police Ombudsman Mrs Nuala O'Loan concluded: "There are a number of witnesses who give evidence of the actions of the deceased immediately before his death, in that he was on a building site with friends and was abusing solvents.
"In taking into account all the circumstances of this case, there is no evidence that police officers acted inappropriately. The deceased's family have expressed their gratitude at the efforts the officers made to assist their son."
Mrs O'Loan therefore concluded that there was no evidence to support any criminal offence or justify any disciplinary proceedings.