Victoria Police Apologises as Inquest Opens into John Makai's Death in Custody
Victoria Police has apologised to the family of John Makai over his death in custody, as a coronial inquest into the 2023 death opened on Monday, 28 September 2026.
The apology was given in the Victorian coroner's court by lawyer Andrew Imrie, for Chief Commissioner Mike Bush. It concerns Makai, 58, a father of 10, who died from serious head trauma after being held in a Broadmeadows police cell. Earlier reporting noted that he died on September 12 after life support was withdrawn. The Guardian
Police had attended a house in Sunbury, where an ambulance had first been called but was cancelled after one of Makai's sons punched him twice. About 20 minutes after police attendance, Makai arrived at Broadmeadows station. He could not stand. He was dragged from the police van by his legs, with his head striking the van floor and walls. He was then held for five hours in a cell without medical treatment for a significant head injury while unresponsive.
The timeline turns on two ambulance requests five hours apart. Police requested an ambulance at 1.25am, reporting a minor facial injury and saying Makai was in a very deep sleep due to drunkenness. Due to an issue with Triple Zero Victoria, the state emergency call service, that job was not logged as outstanding. No ambulance was dispatched until police re-requested one five hours later. Earlier reporting said Makai had been taken to a police station instead of a hospital because of ambulance delays, and that the inquest is examining those delays. Herald Sun
On the first day, counsel assisting Rachel Ellyard, the lawyer assisting the coroner, outlined failures in custody management and pointed to CCTV footage. She told the court officers twice claimed Makai had responded when the footage showed no physical response. Victoria Police acknowledged the failure to complete a medical checklist when Makai arrived at Broadmeadows. It also acknowledged failures to notice his deteriorating condition, to complete a risk assessment, and to conduct adequate checks.
The footage is central. Custody creates a duty of care, the legal duty of police to keep detained people safe. The questions for the coroner include what was observed, what was recorded, what was asked for, and what was missed during those five hours.
Procedurally, the Coroners Court of Victoria lists the John Makai inquest continuing at 10:00am on Tuesday, 29 September 2026, at Southbank Court 1, 65 Kavanagh Street. Coroners Court of Victoria An inquest is a public hearing into a death or a fire, and hearings are generally open to the public and generally held at the Coroners Court of Victoria in Melbourne unless otherwise noted. Written findings are published when an inquest has been held, recommendations have been made, or a coroner orders publication, and a coroner may make an order or ruling during an investigation or inquest.
The broader context here is the two tracks this case exposes. One concerns police custody decisions for an unresponsive person with a head injury, from initial assessment through monitoring and escalation. A second concerns the emergency medical system, including how a request at 1.25am could go unlogged and undispatched for hours, and how police described the patient's condition when seeking help.
Looking at what this means for the inquest itself, the apology does not settle the factual record. The court will still test the evidence on moving Makai, the accuracy of welfare checks and claims of responsiveness, and the handling of ambulance requests. The findings and any recommendations will matter more than opening statements, because they will allocate responsibility across custody practice and communication with Triple Zero Victoria and indicate what procedural change, if any, the coroner requires.
