Man took his life after leaving hospital
An inquest at Cork City Coroners Court yesterday heard the man had attempted suicide the previous night and was later brought from Cork University Hospital (CUH) to Mercy University Hospital (MUH), but walked out before being assessed for admission.
The hearing was adjourned as coroner Dr Myra Cullinane wants to take further evidence about differing policies on transfer of patients at CUH and St Michael’s Psychiatric Unit in MUH at the time. During evidence, Dr Cullinane was told the 21-year-old agreed to be admitted to St Michael’s and moved from CUH, where he was treated on the night of April 22 last after trying to kill himself.
Following medical clearance, he was assessed at around 4.30am on April 23 by CUH registrar psychiatrist, Dr Femi Banjo.
He said the man was not remorseful about what happened and he felt the patient was at risk of another suicide attempt and should be admitted to a psychiatric ward. He rang the on-call psychiatrist at St Michael’s, where the patient said he had been seen before. Dr Banjo said he understood there was no difficulty about a bed and that the man would be admitted.
Jacinta Carroll, a CUH emergency ward staff nurse who stayed with the patient since he woke at 3am, said he had been anxious to leave but she convinced him to stay and was concerned because of his ambivalence about having tried to kill himself. She arrived with him around 6am by ambulance at St Michael’s, where she gave staff medical notes and related her concerns and about him being a flight risk.
St Michael’s staff nurse Marie O’Neill said that she met Ms Carroll and the man at the unit’s entrance around 6.10am and asked them to wait in an assessment area for the on-call psychiatrist to arrive. Ms Carroll had said it was CUH policy that staff should return after bringing a patient to another hospital, so she waited with the patient until a taxi arrived and she then went back to CUH.
Ms O’Neill said it was policy at St Michael’s that patients are not admitted before being assessed and sometimes somebody accompanying a patient would wait with them. She said the exit door to the unit was locked until 7am but she asked the security guard in the corridor to alert staff in the psychiatric ward if the man went to leave.
She checked on him a few times and when he said he wanted to leave, she asked him to wait for the psychiatrist, which he agreed to do. She told him his family had been notified of his transfer and were on their way in.
Ms O’Neill said he was in the assessment room as she left at 7.10am at the end of her shift but she later heard that CCTV footage showed him walking out at 7.18am.
In earlier evidence, the patient’s mother said she arrived at St Michael’s at around 7.20am but the security guard said her son had walked out.
She and his father drove around and found him about 15 minutes later calling to a friend’s house.
Later that day, his family was very concerned as he had told a sister he didn’t want to live any longer. His mother kept regular checks on him but 10 minutes after last checking his room, she found him unconscious at around 4.45pm after another suicide attempt, and he died in hospital on April 25.
The family’s solicitor, Dominic Creedon, questioned the medical and nursing witnesses about the transfer of the patient and what concerns had been made known to each other.
Dr Cullinane said it was clear there were differences in the two hospitals’ policies on the transfer of patients and she wished to hear evidence about those in operation at the time and now.
Diarmuid Cunningham, solicitor for the Health Service Executive, said that since the tragic death and the introduction of guidelines from the Mental Health Commission last September, those policies had changed and a witness could outline them at a further hearing. The inquest was adjourned until March 11, and Dr Cullinane offered her sympathy to the family for their tragic loss.
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