In August 2013 C developed his first suicidal ideation and had actively investigated how best to take his own life. He was seen by his GP, referred to the Mental Health Crisis Team and was seen by a Psychiatrist 6 days later. Suicidal ideation was noted, medication was provided and C was discharged from the Crisis Team.
The G.P. continued to record in his notes that C was suffering low mood and suicidal ideation and in mid September 2013 he tried to jump off a bridge and was stopped by a friend. Following that event, C’s wife found a rope and discovered that he was actively planning to hang himself when she left the house. He had written a suicide note. The G.P. was informed and he approached the Crisis Team who advised that C was to be assessed at home. He was not assessed at home and instead was given advice over the telephone by the Crisis Team. A week later C was noted to be coping better and medication was assisting. However shortly thereafter C again started to have suicidal ideation and was hearing voices in his head. The G.P. again contacted the Crisis Team who said that they would assess him. A further telephone call was made to C by the Crisis Team. No home visit was made. Some advice was tendered over the telephone. C was given a telephone number for the out of office Crisis Team Service and a plan was made for him to revisit his G.P. for follow up.
The day after this, C again telephoned the Crisis Team stating that he felt worse. He was anxious and had rung the Samaritans based on the Crisis Team’s earlier advice. No further concerns were raised. On the 30th September the Crisis Team was advised by C’s wife that he had killed himself. The G.P. had correctly diagnosed deterioration in the Deceased’s mental health. The Hospital Trust had not correctly diagnosed the deterioration in the Deceased’s condition. There was a failure to identify red flag signals in such a patient especially having regard to the fact that C had no previous history or diagnosis of a personality disorder. The command hallucinations had been completely missed as a red flag indicator of the development of psychotic symptoms within a setting of clinical depression. A reasonable Mental Health Professional would view the situation as being one in which there was likely to be a diagnosis of psychotic depression and that the risk of completed suicide was high. An immediate face to face assessment was required preferably with a Psychiatrist in case the use of the Mental Health Act was indicated. No such assessment was carried out which represented a failure on the part of the Defendant Trust. Had the assessment been carried out it is likely that the opinion would have been that the Deceased was at such a high risk of completed suicide that an immediate admission to the inpatient unit with constant observation would be needed to keep him safe. No such treatment took place which fell below an acceptable standard of care.
Had the Deceased been admitted it is highly likely that he would have made a full recovery from his psychotic depression as it is known there is a high recovery rate within the general public. As a result of the failures on the part of the Hospital Trust the Deceased passed away on 30th September 2013 and but for those failures he would have survived and had a relatively normal life expectancy. The claim dealt with Article 2 of the European Convention on Human Rights as the Defendant Trust allegedly failed to protect the Deceased’s right to life. The Trust failed to take preventative action where there was a real and immediate risk to life. The Trust’s policies and procedures were said to be inadequate and the Coroner submitted a Regulation 28 report. The Deceased suffered mental anguish from onset of symptoms to the date of his death. The Deceased’s wife made a claim for dependency. A life expectancy report was obtained to establish whether or not the Deceased had other co-morbidities which might have affected his life expectancy. The claim was ultimately settled in the sum of £75,000. Liability was admitted by the Hospital Trust on receipt of the Letter of Claim.
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