Dead man's family question his release from care

The family of a 45-year-old psychiatric patient, who took his life while out on an overnight release from a Dublin hospital, said he should never have been let out.

Ann Patton, a sister of Kevin Pringle, told the Dublin City Coroner’s Court that her brother was extremely agitated on the night of March 23, 2004, when he was out for one night from St Vincent’s Hospital in Dublin.

“I feel extremely strongly that Kevin should have been in hospital on the previous night and not let out given his agitated state,” she said. Ms Patton said she had offered to take him back to St Vincent’s that night but he refused, saying the day care team would pick him up the following day.

However, the inquest heard that when staff nurse Laura Buchanan from the Crannog Day Hospital, a part of St Vincent’s, returned to pick him up on March 24, 2004 he was found hanging in his flat at Killarney Court in Dublin 1.

The family queried why they were not informed that Mr Pringle was being released overnight. The jury, which passed a verdict of death by suicide, recommended the coroner write, without prejudice, to the hospital to consider ways to inform families about temporary releases and other issues raised at the inquest, which included ensuring a patient took their medication.

Ms Buchanan told the court that Mr Pringle was being released for short periods as part of a supervised reintegration programme.

The nurse said they would tell Mr Pringle that he could return to the hospital at any time, as he was a temporary in-patient, committed under the Mental Health Act. She said the staff always ensured he had the hospital phone numbers and money for a taxi to return when they dropped him off at his home.

The court heard there was an assessment carried out on each occasion to ensure someone was fit for a day release.

The inquest heard that Mr Pringle first expressed notions of severe depression and paranoia after an mystery accident in May 2003 – which could have involved a fall from his bike. A neurologist, who treated him, said there were no visible brain damage but it could have resulted from a series of minor accidents and heavy alcohol consumption over the years.

Dr Mona Kilduff, who was the consultant psychiatrist treating Mr Pringle, said he was in an extremely bad condition that December, 2003, and January of last year – around the time she had him committed under the Act.

The inquest heard that he had previously attempted to overdose on pills in December of 2003 – which Mr Pringle said he had accumulated from not taking his prescribed medication.

Dr Kilduff assured the court that the taking of medication was always fully supervised when a patient was in hospital. She also said that Mr Pringle had been started on slow release medication to account for times he failed to take the anti-psychotic drugs while released.

Dublin City Coroner, Dr Brian Farrell, said there had been no traces of the long-term anti-psychotic medication that Mr Pringle was supposed to have been taking in his post mortem blood samples.

The coroner said: “I can’t tell if he was taking the medication in the hospital but I would expect some to have shown up if he was taking the long-term medication.”

The family raised issues over ensuring patients continue taking their essential medicines.

The psychiatrist said he had shown signs of recovery and had told her he had no wish to end his life during interviews relating to his overnight visits in February and March of 2004.

Dr Kilduff said there were privacy issues in relation to informing the family unless a doctor had serious concerns about the patient. However, she said Mr Pringle had always claimed he was telling his family about his overnight stays.

The psychiatrist said he had got no warning signals from Mr Pringle that he was going to harm himself when he was given overnight release.