DR ADELEY: There are countless factors that can lead to your death.
As Senior Coroner, I deal with nearly 4,500 fatalities a year.
NARRATOR: The coroner can make any inquiries necessary
to find a cause of death.
The police act on behalf of the coroner.
If the coroner asks, then we do it.
We need to be alert to the fact that
there could be something more sinister in this.
With unprecedented access,
we follow the coroner's full investigation.
It does make you realise how fragile life is.
Let's start and just work our way up.
Forensic medicine is all about being very suspicious.
From the moment of arrival in the mortuary
to the final conclusion of the inquest.
All rise.
I'm sorry that you're attending court under these circumstances,
and I appreciate that the evidence that you will hear today
may be distressing.
I never thought I'd ever find myself in a coroners court.
You shouldn't have to organise a funeral for your children.
If you die here, if it's violent, unnatural,
or of an unknown cause, it's my job to find out how.
Detective Inspector Paul Price has just returned
from the scene in countryside north of Bolton.
It's a male who's been found face down at the side of a wall.
It looks as though he's been there for a couple of day, I'd say.
When we searched him, there was no phone, there was no wallet on him
to give us any indication who he is.
It is very strange.
His jacket had been taken off and placed over the top of him,
almost like a quilt or a cover.
He's got a pair of wellington boots underneath him,
which were no longer on his feet.
Worryingly, his pants had been pulled down slightly.
And when we've rolled him over, he's got an injury to his cheek.
He's also got quite a significant injury to his ear.
There was a pair of pliers which were found next to him,
so you've gotta look for torture injuries.
The body was lay against the wall,
and the wall itself is at the side of a single-track road.
It's not far from a carpark.
So, you're asking yourself,
"Has someone taken him there in a vehicle
"and effectively placed him over the wall to hide him?"
So... it's strange.
The weather today is absolutely awful.
It's lashing down with rain, sideways wind,
so we've had to forensically recover him
and take him through to the mortuary.
It's absolutely awful to think that someone's been up there
on their own for two days, so it's our job now
to try and identify him as quickly as we can
and establish what's happened to him.
PHONE RINGS
DI PRICE ON PHONE: 'Hi, Dr Adeley, you OK?'
I'm fine, thanks. 'I'm coming to you with a query.
'Basically, we've had a man pass away,
'and he's been found in quite suspicious circumstances.
'He was in a field, his wellington boots were at the side of him,
'and his coat was over his head.'
Do we have any idea who he is?
'No, we're really struggling at the minute.
'He didn't have any ID on him at all, he didn't have a phone.
'We've ran him through the fingerprint machine,
'and that's come back as negative.'
Nothing on missing persons?
'No, I've reached out to the neighbouring forces as well.
'There's nothing on at this present time.'
OK, do we have any idea how long he's been there?
'I'd say he's been there for at least a couple of days.
'There's slight decomposition which has already started.
'He had a little bit of his ear missing and an injury to his face,
'and I'm not happy with it, so I'm coming to you
'just to request a Home Office, if that's OK?'
I agree entirely, I think you need a Home Office.
'Yeah, no worries, and I'll keep you in the loop.'
Thanks a lot, Paul, take care. 'Thank you, bye-bye.'
Home Office post-mortems are used
either where there are suspicious circumstances
or the circumstances are simply unknown or strange.
Home Office pathologists have additional training
in detecting criminal action to determine whether or not
any third party has been involved in the death.
DI Paul Price must look for any CCTV cameras in the area
that may reveal how the man ended up in the field.
This is a map of Rivington.
It's a very, very rural area.
The male was found here,
which is not far from the actual reservoir itself.
So I've tasked officers to blitz that area predominantly.
CCTV is proving really difficult for us,
just because of how rural the area is.
We've got a few cameras along here,
but we've then expanded that out a good mile away up this way,
a mile away that way as well,
and all the entry points from the west and the east as well.
We've not been able to find anyone
who matches the male's description on the cameras.
It is really difficult because we don't know what day,
what time, how he got there. Did he come in a vehicle?
And with it being the middle of winter as well,
it gets dark very, very quickly,
so we've not got much daylight hours to work with.
In the modern world, you've got so many investigative opportunities,
but this case doesn't really have any of them.
We've not really got the CCTV, we've not got a phone,
we've not got a vehicle.
You need to know who your victim is, really,
in order to concentrate your inquiry, so it is frustrating.
Cases like this are extremely unusual.
If you think about the ID that you have on you
if you were out and suddenly died,
you'd have your phone on you, you'd have bank cards on you,
you might have a driving license on you.
You could have receipts as to where you've been shopping.
This is a man who's found alongside a wall in a field in Rivington,
in terrible weather,
and we have no idea at all who he is.
NARRATOR: In Preston,
Detective Inspector Paul Price is trying to identify a man
found dead in a field north of Bolton.
I've checked the current outstanding missing persons on our systems,
and I've also sent that out to neighbouring forces
and there's no-one that matches that description at the moment.
So we need to go bigger, effectively,
and we need to send that out on a social media appeal.
The description for the male that I've put out is
a 40- to 50-year-old male, a dark goatee-style beard,
wearing a green Foxy jacket and green-coloured wellington boots.
The thing that really stands out more than anything
is he's got an orange Casio digital watch, quite distinctive.
I think if any member of your family had that, you'd notice it.
So that's gonna be the focus of our appeal.
As well as posting on social media,
DI Paul Price is sending a photograph of the man's face
to the police facial recognition database.
The photograph goes through to headquarters,
they will then run that photograph through the system
to see if there's any matches which do come back.
With suspicion of third party involvement in the man's death,
the coroner has ordered a Home Office post-mortem.
Having the pathologist come and do an intrusive post-mortem,
they can assess what could potentially be
injuries beneath the skin a little bit better.
We do need to be alert
to the fact that there could be something more sinister in this.
Forensic pathologist Dr Matthew Lyall has been assigned to the case.
OK, if you just say white adult male,
appears middle aged, 80 kilograms in the bag,
and 167 centimetres in height.
And so body generally damp with some adherent vegetation.
A Crime Scene Investigator will photograph the process.
OK, and a new paragraph,
you'd say the eyes are softened and discoloured.
Nose intact.
Matt, would you be able to tell us what colour his eyes are?
I'm just thinking for the appeal and stuff like that.
They're all discoloured due to post-mortem changes, really.
As well as looking for identifying features,
Dr Lyall is searching for any evidence of third party involvement.
OK, faint bruise, three by two.
Inner surface knee.
Small bruise. Top front thigh.
The main problem with him, at the moment,
is just that he's starting to decompose,
and that becomes a much more challenging...
It's usually pretty easy
to determine if something's a bruise or not.
But the process of decomposition also affects blood vessels,
so blood vessels can start to leak and it will just simulate bruising.
And then next...
ragged loss of... left ear lobe
and lower helix, exposing soft tissue,
which is slightly blood stained.
Are you able to tell if that's healing at all
or if it's old or new or...?
I don't think it's healing, looks recent. Recent.
But there's clearly a piece of the ear missing, though.
OK, so next is outer left cheek.
Gaping, irregular injury
which is approximately 5.5 centimetres in length.
Quite peculiar-looking injuries, really.
You've literally had no-one say who they think he is?
Not at all. Even like other forces and stuff like that haven't...
Nothing?
Contacted all of them, put it on the NCA website. Nothing.
Weird that he has no phone on him, though, or anything.
We've done a full search
of all the fields as well around it, nothing there.
47-year-old Jane Hubberstey has been transported
to Royal Preston Hospital.
She was found unconscious at home by a relative,
hadn't been seen for a day or two, which was out of character for Jane.
I rang her on Friday morning...
because I was going to take her shopping.
When she didn't answer the phone,
that was when I really thought something seriously was wrong.
And I went in, and she was just lying there, her eyes open.
There were a number of things of concern,
the main thing being that her conscious level was quite low.
She was known to be diabetic,
and there was a feeling that she hadn't been taking her insulin.
So with that complexity of situation,
the most appropriate place for her to come
was to the intensive care unit.
She'd had a lot of episodes
of various sorts of self-harming over a long, long time...
..so possibly it was just one more, I don't know.
She was kept there for quite a few weeks,
and then they transferred her upstairs
to enhanced care for about 13 weeks.
Jane had developed a brain injury as a result of being unconscious
and unable to breathe by herself.
So it became apparent that she wasn't going to come out of it.
They were talking about just letting her go,
you know, fade away.
And then I got a call...
about nine o'clock, to say she'd actually died.
Yeah, so that was the actual end.
Any deaths that occur in hospital
are reviewed by the medical examiners.
Hi, Amy. Hi, Alice, thanks for coming down.
It's a lady called Jane Hubberstey, she's 47.
She's come in, and there seems to be quite a few admissions previously,
four or five,
where she didn't take her insulin for a prolonged period of time,
and that was with an intention.
Is there anything on record about the levels of insulin?
Were there any bloods taken on admission to look at...?
I would probably have to run that past a diabetic clinician
if you wanted further details.
So, it's a combination of overdosing and not taking. Yeah.
And all those times, they've brought her into hospital?
They have.
According to records, she does have depression
and she's under the mental health team.
I'll go have a chat with the family, try and get a more information
about the days leading up to her admission. Yeah.
Once I've got that information, I'll give the coroner a call
and see what they want to do. Perfect.
Thank you. Cheers. Thanks, Alice.
She came into the world backwards in 1976,
weighing two pounds, ten ounces, and she was feisty, you know.
She had that bit of spirit that she survived.
All through her life,
she's faced a lot of things to do with illness.
She's been quite tough in that way,
but very, very vulnerable in other ways.
She loved animals, she always did.
Her favourite friend was a little Jack Russell terrier
who she had for 14 years.
When he had to be put down, that was terribly dramatic,
you know, she was very...
very, very sad to lose Patch.
Patch was her mate, her best friend.
She trained, when she left school, as a nursery nurse,
but she never really had chance to do it
because by then she was getting quite... disturbed, really.
Er, she had anxiety... and the self-harming.
She never actually worked.
Jane had Type 1 diabetes
that she managed with insulin.
Because we don't have the levels of the insulin on her admission bloods,
we don't know whether she's done an intentional overdose
or not taken enough of her insulin.
She knows that too much of it can cause her harm,
she also knows that too little can cause her harm.
What we need to look at is whether this was actually
an attempt to take her own life.
Jane Hubberstey is a 47-year-old lady.
She is the type of diabetic that requires insulin on a daily basis.
She is in a situation where her blood sugar is much too high.
This indicates she hasn't taken enough insulin.
She also has a long-term history of mental health complaints,
this has resulted in self-harm
and some suicide attempts resulting in hospital admission.
The question here is whether she's deliberately not taken her insulin,
or alternatively, there's another process going on
that is causing her to lose her diabetic control.
What is going on is very unclear.
This case will definitely go to inquest.
You find yourself thinking about it.
It's at the back your mind all the time, how sudden it was.
Whatever the episode was...
..I'm interested to hear the evidence
of what happened on that day
because there've been so many episodes before.
I'd like to know the actual cause of death.
NARRATOR: In Preston, Detective Inspector Paul Price
is attending a Home Office post-mortem
on an unidentified man found in a field.
He had a bit of his ear that was missing.
He also had a large gash to the side of his face.
Difficult to say what could have caused that at the minute,
but we've also gotta keep our options open.
It could be the result of an assault,
so that's something else we've gotta keep considered,
just cos it's such a strange death.
OK, heart valves are normal.
The pulmonary arteries are clear.
The coronaries have normal anatomy,
there's no sign of a heart attack.
And then next, this is the structures in the neck.
Is there any chance that he's been strangled?
Well, that's one of the things we're sort of looking for at the minute,
just to see if there's injury to them.
And they're intact in this one, so...
The brain is 13-92.
OK, I'll have a little look at the brain further.
There's some blood on it which shouldn't be there,
and it can be a sign of injury to the head.
Well, is that significant or not?
The most common explanation for that is blunt head trauma.
And so what you normally find in a subdural haemorrhage that is fatal
is a large mass of blood that is sort of compressing the brain.
Now, we don't know if that picture here,
but it could still represent a blunt impact of some kind
to the head or face.
In a way, we're sort of operating in the dark for a lot of this
because we do not know who he is, we know nothing about him,
we know nothing of his medical history,
so no cause of death at this stage.
I think we put the brain in fixative for a period of time
so it then can be examined in much more detail
than it would be if we were to just examine it now. OK.
These samples will be sent to the laboratory, made into slides.
I'll examine those to get an idea of what diseases are present,
and we need to do the toxicology.
And I think that will hopefully allow us
to come to some sort of resolution as to why he's died, if possible.
OK.
It's a really tragic set of circumstances.
I mean, this gentleman will have friends, family somewhere
that we've not managed to identify yet.
And to think that he's going through this process today
and none of his friends and family are aware.
The joint investigation by the coroner and police
into the man's death
is now dependant on the forensic pathologist's report.
Meanwhile, DI Price needs to continue his police search
to find out who the man is.
We've had a potential match come back
from the facial recognition check.
In terms of his nose, in terms of his eyes,
I can see, certainly see, why this has come back as a match
cos they are very similar.
So really hopeful that it could be the male.
We have identified family members who are still local in Preston.
Hopefully, this gives us that lead to identify this male.
47-year-old Jane Hubberstey died in hospital
after being in a coma for 13 weeks.
She had consented to become a tissue donor.
Investigations into Jane's death are ongoing.
However, the coroner has agreed that the donation can go ahead.
We looked into her medical history
and she has suitability for corneal donation only.
NURSE: Everyone ready? Yeah.
Ready, steady, slide.
And ready, steady, roll.
Our coroner is really supportive of donation.
He feels that this very much wouldn't interfere
with his investigation work.
'The coroner can then investigate and look at the cause of death.'
So, first, Cecily's gonna gently dissect the very fine layer
of membrane and connective tissue that surrounds the eye.
So, we have a lot more flexibility than an organ.
They don't have to match it to blood type.
So these can go in for anyone who needs corneal transplants.
Time? 17:30.
This set of eyes will go into the tissue bank to be prepared,
and then they'll send them out to an ophthalmic surgeon.
We're so low on corneas.
I think a lot of the time when people realise
that this can help restore the sight of up to ten people
is when they think, "That's a huge thing to do
"for someone else, and such a lifechanging thing."
Her next of kin was really pleased
that this is something she'd be able to do.
If some good can come out of this situation,
you know, power to their elbow, let them do it.
If it can do somebody else some good, then all the better.
The Coroner's team are investigating
the circumstances around Jane's death.
JEAN ON PHONE:
Hi, is that Jean?
I've spoken with the medical examiners here at the hospital.
And they've talked about the previous admissions
in January and March.
OK, so were those intentional overdoses of insulin
or she's intentionally not taken enough insulin,
are you aware of those?
All those episodes where she's been brought in to hospital,
she's rung the ambulance herself and got admitted,
it wasn't that somebody's found her?
Yeah.
I believe she was found collapsed at the home address.
Was she on the floor?
She was on her bed, OK. That's fine.
Have you found any notes, were there any notes or anything like that?
No notes, OK.
Do you know if she expressed any suicidal thoughts
or anything about mental health, about self-harming?
Mm-hm.
OK.
She's got an history of self-harming right going back a long time.
I first became aware of it when she was in her early teens,
but she told me not that long ago that she started when she was eight.
You would sense her mood, that she was down.
She would sometimes be very quiet.
And I knew that she was feeling, you know, particularly depressed.
And that she was, in moods like that,
she was liable to self-harm.
She just built up...
..to a crisis...
where to hurt herself physically was a substitute for mental pain.
You know, she'd been cutting herself or overdosing,
or she'd had an overnight in hospital
because she overdosed or something.
She would tell me. It would sort of come out.
And I think, to that extent, she trusted me.
She knew I was there for her.
I hope I gave her enough of my time.
This is probably a difficult case
because we're not quite sure what's happened.
We don't know whether she's intentionally tried
to take her own life, cos there's no note left.
We don't know whether she's just had a natural medical event.
It's really hard because if somebody doesn't leave a suicide note,
depending on how they've died...
it can make it quite difficult for us to understand
whether there was an intention there to take their own life.
The identity of a man found dead
in a rural area of Lancashire is still unknown.
His face has been matched with that of a man on the police database,
so DI Paul Price is heading to meet the man's family.
We're going to the address of a family member,
which is the male's mother.
It's a bit of a strange feeling to have to make this journey
because you're kind of in two minds with it.
Whilst I'm keen to identify the male,
the family that we're going to see, that's a loved one,
that's someone in their life.
So I have to be really sensitive in how I conduct this inquiry.
KNOCKING
Hiya, sorry to bother you, I'm from the police, nothing to worry about.
Am I all right stepping in for a second?
Thank you.
On the seventh of December,
there was a male who was found deceased up at Rivington.
And what makes you say that?
OK, if you're saying you've seen him, then...
Thank you, cheers. Bye-bye.
Spoken to mother of this male,
and the chances of it being him are highly unlikely.
You want to be able to give people answers.
You wanna get answers for yourself as well.
Every avenue we're going down, we're just hitting dead-ends.
Hi, Amy. Morning, Alice.
I just wondered if you've got an update on Jane Hubberstey?
Ah, yes, so we spoke to the diabetic clinician,
who was a registrar. OK.
His sort of conclusion on events that have happened
is there were no admission bloods taken or insulin levels.
And this was purely because it wouldn't have changed
the outcome or the treatment Jane would have received. OK.
It's really difficult to try and pinpoint what her intentions were.
OK. That's great.
OK. Brilliant, thanks, Alice. Thanks for your help, thank you.
It's the day of Jane Hubberstey's funeral,
and her family is still searching for answers.
I shall remember Jane fondly.
I think the whole thing, you know,
in some ways an accident waiting to happen.
And it may have been an accident.
My feeling is that she didn't actually, deep down, want to die.
In the case of the unknown man found in a field,
Lancashire Police have commissioned a portrait artist
to create the most accurate image possible
in a last attempt to identify him.
I need to work from post-mortem photographs.
My job is to make drawings presenting him
as much like he might have looked in life.
You just have to hope that somebody will recognise
and say "Hang on, that's my neighbour,"
or "I know him, I've seen him in the shop."
This is just about done. I think so.
And then I'm going to try and pack it very carefully
ready for its journey to Lancashire.
DI PRICE: I've only ever seen him at his worst,
so seeing him how you would expect him to look
when he was alive and well,
it's a bit of a strange feeling, to be honest.
So, my plan now is I'm gonna take some photographs,
get that out to Interpol, get it out to the NCA.
He might not be local to Lancashire. He might be from another country.
So, this image,
I'm pinning quite a lot on getting me an answer
for this man and for his family.
NARRATOR: The police and the coroner
have been working alongside each other
to try and establish both the identity
and the cause of death of a man found in a field north of Bolton.
The Home Office post-mortem report has been returned.
At the moment,
there is no third party suspected of being involved in his death.
That does not mean that a third party did not take him
to that location and leave him there.
Toxicology in this man was negative
for any compounds that might have caused or contributed to his death.
There are three possible causes raised by the post-mortem report.
Heart disease, fatty liver or possible hyperthermia.
But there is no way to determine,
without the information, as to how he got them,
what his past medical history is,
as to which one is his cause of death.
If the family were found, we have a name.
With a name, we may have a chance of contacting his GP.
Therefore, his cause of death is unascertained.
It's the day of 47-year-old Jane Hubberstey's inquest.
For the first time,
all those involved in Jane's case before her death
will come together to present their evidence.
JEAN: I don't know what I'm expecting.
I hope it's a verdict of misadventure.
One of the strongest pieces of evidence here
is the repeated assertion by Jane
that she's going to take her own life.
But this does not mean that she would do so.
People will say this quite often,
but not actually intend to take their own life.
The difficulty here is working out what Jane's intentions were
at the time, if indeed she had any.
We have the physical healthcare trust coming
with their clinicians to talk about the hospital admission.
We have the mental healthcare trust coming to talk
about Jane's mental health conditions and how she was behaving.
With any case, you do not pre-judge the outcome.
Is it Jean? It is.
Alice Swarbrick, coroner's office manager.
How are you feeling?
OK. OK.
So, the coroner's provided a witness list,
each individual witness will give their evidence one by one,
and at the end of each witness,
we'll then ask you, "Do you have any questions for that witness?"
This is one of these inquests where you're walking into court
with information
but no idea of which way the case is going to develop.
OK? All rise.
DR ADELEY: I'm very sorry that you're attending court
under these circumstances.
Could you tell me the position that you hold?
I'm a respiratory consultant at the Royal Preston Hospital
working on the respiratory high care unit.
In terms of precipitating factors for a diabetic ketoacidosis,
one of these, I believe, is infection.
Were there any signs of infection when she was admitted to hospital?
So when she was admitted,
she did have raised inflammatory markers in the white cell count,
which did rise quite rapidly.
There was some evidence of chest infection.
What were her inflammatory markers on admission, please?
Her white cell count was 9.92,
and it went up to 23 within a matter of hours.
What would your interpretation of that be?
For me, that would indicate there was probable underlying infection.
Taking the picture as a whole,
it looks like she has developed an infection
leading towards a diabetic ketoacidosis,
not the other way around. Yes.
I agree with that looking at the blood markers at that time.
Jane is losing diabetic control
because she has got a serious and underlying infection.
So, consequently, the conclusion that I propose to return
in this case is that Jane Elizabeth Hubberstey died of natural causes.
This was not on my horizon when I walked into court.
The inquest unfolded in a very unexpected manner.
On questioning the hospital consultant,
it rapidly started to become apparent
that Jane had an underlying pneumonia,
a significant lung infection,
and this has destroyed her diabetic control.
And she's collapsed before she can give herself more insulin.
Because the evidence given by the clinician developed so quickly
and so comprehensively,
there is then no need to consider the mental health team's,
"Was she trying to take her own life?
"Was she crying for help?"
Because that's now irrelevant.
This is a physical illness
that is driving the entire process and causing her death.
JEAN: I, er...
I used to take her shopping every week.
We often had pub lunch afterwards.
As you reflect on it,
I think you'll always think, "Could have I done more?
"Should I have done more?"
I think that's just generally part of the grieving process.
It does seem...
..less tragic that...
..that she died of natural causes.
Still very sad, of course.
But deep down, I don't think she wanted to die.
Jane liked it here,
and she always ordered gammon, egg and chips...
..with garden peas.
Woe betide me if I ordered mushy peas.
With no official cause of death, identity, or next of kin,
the unknown man found in a field remains in the mortuary
at Royal Preston Hospital.
MORTUARY WORKER: Right. Everything's locked up.
Heater's put out. We're done.
I've never been in this situation before
where we have no idea who this person is.
We can't trace relatives because of this.
We're starting to get to the point where we will have to do something
with his body, and we will have to look at options of do we bury him?
Does he remain in the mortuary fridge?
Does he need freezing?
It's just sad that someone out there hasn't noticed he's missing.
DI PRICE: Failing to identify him, I'm absolutely gutted to be honest.
I really thought, after three months' time,
we'd have got that name.
I will continue to do what I can locally.
I'll keep linking him with the NCA, I'll keep linking him with Interpol
just because all it takes is that one call.
I received an email from a gentleman in Poland
stating that he's not seen or heard from his brother
since November last year,
which obviously fits in with the timeline.
He said that there was a similarity between his brother
and the artist's impression.
The key thing as well really was the orange Casio watch
that, he believes, is his brother's watch.
He last physically saw his brother 20 years ago.
So the next step is try and tie the male via his DNA.
We're gonna have to look at family members and familial DNA.
This is massively important for me.
It's a case which I've really taken to heart over the past few months,
because there's a family, someone's lost a brother,
someone's lost a relative.
So for me, it's vital that we're able to identify this male.
Received a referral from the police for a young lady,
and sadly, she was found unresponsive and cold in bed.
I've not found anything which explains her sudden death.
There has to be a reason why a 34-year-old has died.
The family need an answer
as to what happened in this sudden and unexpected death.
There's an article appealing
to trace the family of a man found dead.
The thing I want to know is
what could have contributed towards his death?
We are running out of time.