WARNING: The video above contains graphic images.

BUFFALO, N.Y. (WIVB) — The last time local media reported on Richard Metcalf’s violent death was more than two years ago, when it was believed he had a heart attack — the result of a pre-existing heart condition — after being roughed up by corrections officers at the Erie County Holding Center.

But a new report from the state released Sept. 26 sheds new light on the 2012 case.

It states Metcalf was beaten severely and strangled by county corrections officers while he was shackled at the hands and feet.

Attorney Thomas Casey and attorneys from Brown Chiari, who are both working the criminal and civil case, said the Erie County District Attorney’s Office, charged with overseeing such matters, turned a blind eye in 2012 and 2013 by failing to investigate the case. Family notices strange behavior

The family of Richard Metcalf said their son started acting strangely in November of 2012. He grew paranoid, thinking that someone, or some thing, was after him.

At around 2 a.m. on Nov. 27, he suddenly ran out of the home he shared with his girlfriend. Snow covered the ground. He was wearing only shorts and a T-shirt.

Depew police said they caught up with Metcalf breaking into the catering business where he worked. He initially resisted, and was Tazed twice. He eventually complied, was taken back to the holding cell in Depew and held for arraignment.

After his arraignment, Metcalf was transported to the Erie County Holding Center, pending a mental health evaluation ordered by the local judge.Metcalf’s injuries disputed

Before he was transported downtown, Metcalf had soiled himself, and required a shower upon arriving at the holding center.

He had no other significant injuries at the time, according to Depew police and what medical personnel told state officials in their investigation.

But Erie County jail authorities told News 4 reporters in 2012, Metcalf came to them with visible injuries.

“Their (jail medical staff) documentation indicated that he had several contusions and abrasions, and he had suffered a little bit of knocking around,” David Marciniak, director of correctional health, said in 2012.

Again, that’s disputed by Depew police, medical staff at the holding center and the state. Metcalf’s booking photo shows small cuts on his left eye, and a small abrasion near his right eye, both likely sustained when he fell after being Tazed.

The state report shows corrections officers told Depew detectives when they dropped Metcalf off that he “freaked out” after he was taken to the showers; and that they had to “take him down” in order to control him.

Because of his injuries, Metcalf was then taken to ECMC, where medical staff observed cuts and bruises all over his face.

Another doctor found Metcalf to have multiple skin abrasions and lesions to his hands and feet, and new and worsening bruises on his face, arms and legs.

Metcalf told doctors “he got beat up in jail,” according to the report.

He’s eventually taken back to the holding center, where his behavior worsened, as did the beatings, according to the state report.

Metcalf began having hallucinations several hours after he’s brought back to the holding center. Officers reported to the state he was acting irrational in his cell, that he was biting and punching himself, and scraping and stabbing himself with an utensil. He was also reportedly banging his head on the cell bars.

The report states Metcalf told officers he was radioactive, and repeatedly yelled the word “slaughterhouse.” Several inmate witnesses corroborated this report to state investigators.

After being restrained, and shackled at the hands and ankles, a bleeding Metcalf began to spit at officers.

He was taken to the infirmary, and continued to resist, despite the fact at least four of them were holding him down, the report states.

Officers placed a spit mask on Metcalf, and he eventually chewed through it, according to the report.

Surveillance video then showed an officer leaving the room and returning with a pillow case, which was then loosely tied over Metcalf’s head, according to the report.

EMTs were eventually summoned. But upon arriving, they’re prohibited from assessing Metcalf, according to the report. Medical staff said deputies told them safety was an issue. At the time, Metcalf’s head was covered, and he was being held down on his chest on a medical table, the report states.

A full 30 minutes after EMTs are called, Metcalf was lifted into the ambulance and turned onto his back for the first time since being ripped from his cell.

An EMT told state investigators he found the chewed through spit mask still tied around Metcalf’s neck. It was so tight, it required scissors to remove, the report states. Metcalf was no longer resisting, but he was also no longer breathing, and his heart had stopped, according to the report.

Emergency room doctors brought him back to life. In addition to new, visible bruising all over his body, Metcalf’s organs were failing, and he had four broken ribs.

He never regained consciousness, his family signed an order for him not to be resuscitated and he died two days later.

Metcalf’s death is disputed

The county medical examiner ruled Metcalf’s death a homicide as a result of acute and subacute myocardial infarction, meaning he died of a heart attack caused by an outside force. It also suggests he had a pre-existing heart condition.

State investigators disagreed with this. In their report, the Medical Review Board rejected the medical examiner’s ruling, saying instead Metcalf died because of the restraint methods used by the Erie County Deputies.

The Medical Review Board said its forensic pathologist reviewed the findings and tissue samples collected during Metcalf’s autopsy, and found “no evidence of acute myocardial infarction.”

It added: “Significantly, the results of Metcalf’s autopsy did not demonstrate that he had any coronary artery disease or atherosclerosis heart disease that would support the pathological diagnosis of acute myocardial infarction,” according to the state investigation.

The state recommended the county medical examiner correct its autopsy findings to reflect Metcalf’s actual cause of death, and that an independent review be conducted.

This will not happen, according to Erie County Executive’s Office, which said it, too, has received and reviewed the report.

“The autopsy, review of records and other supporting materials, autopsy report and death certificate for this individual were conducted and prepared by a pathologist who is no longer employed at the Erie County Medical Examiner’s Office,” the statement read. “The Medical Review Board’s dissenting opinion with respect to the cause of death in this case is noted. As cause and manner of death determinations represent the certifier’s medical opinion, however, and as no new or additional information that was not available to the original certifier has been advanced, the cause of death listed on the death certificate will not be amended.”State recommends multiple investigations

State police were called to investigate the case in 2012, by former Erie DA Frank Sedita.

Sedita said at the time he believed state police would do the best job as an independent and respected agency. He said they did good work and he agreed with their findings that corrections officers acted appropriately. The case was never brought before a grand jury. No charges have ever been filed.

The Commission of Corrections issued eight recommendations to the sheriff’s office, including that it investigate the sergeant who violated the county policy for his “dangerous use” of a pillow case around Metcalf’s head. It also recommended the sheriff’s office investigate another sergeant for failing to properly supervise the staff during its use of force against Metcalf.

Because the case is being litigated, the Erie County Sheriff’s Office declined to comment specifically on the commission’s report. However, officials reviewed the report and dispute its findings, according to a statement.

“In preparing the report, we believe the COC mischaracterized and misinterpreted critical evidence, and the failure to accurately take account of that evidence led to flawed conclusions. The Erie County Sheriff’s Office looks forward to defending itself and the actions of its deputies in court,” the statement read.

The state report recommended acting Erie County DA Michael Flaherty conduct a full criminal investigation. That’s still to be decided, Flaherty said in a statement released Tuesday.

“I offer my sympathies to the family of Richard Metcalf,” Flaherty wrote. “I have received the report from the NYS Commission of Correction, and I am in the process of discussing with my colleagues our next course of action. It would be inappropriate for me to offer any further comment at this time.”

A meeting between Flaherty and Metcalf’s attorneys was scheduled for 3 p.m. Wednesday.

The state also recommended to the county legislature it review the findings of the report and review “the continued service of the current appointee.” That process is underway.

“I just recently became aware of the report and I am still examining it,” said Erie County Legislator Patrick Burke, D-South Buffalo. “Trust between law enforcement and the community is at an all time low and we must do better to rebuild that relationship. I am currently working on legislation to improve the internal affairs process of local police agencies.

“We need transparency and accountability so that the community can have confidence in the police but also so good police officers are not unfairly maligned because of the actions of a few bad apples,” Burke added. “It is about creating an objective process that protects the community and the officers. I will speak more to the report when I have had an opportunity to fully analyze it.”