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Psychiatric
patient died after '55 minutes' of restraint
May
30, 2008
by Staff Reporter
A
psychiatric patient died after almost an hour of being restrained,
an inquest has heard.
Kurt Howard, 32, diagnosed with
schizophrenia and who was detained under the Mental Health Act,
died on June 29,
2002, while being restrained at Swansea's
Cefn Coed Hospital.
Steven Parsons, the
senior nurse in charge on ward five at the hospital,
told the inquest this week that
problems with Mr Howard that day began at around 7.05am, five minutes
after his shift had begun, according to The
Swansea Evening Post newspaper which is covering the inquest.
Mr Parsons said an
agitated Mr Howard was in his room and staff continued to check
on him and that a colleague, Paul Hunt, later found Mr Howard trying
to make his bed.
Soon
after, Mr Parsons said, he heard shouts coming from Mr Howard's
room and found Mr Hunt trying to fend off Mr Howard who was attacking
him.
Two
other staff, Wayne Norman and Neil Owen, also attended.
Mr
Parsons said they restrained him on his bed for around 30 to 35
minutes, before Mr Howard dragged them all to the floor, where he
remained for another 20 minutes - before he died.
But the cross-examining barrister Mr Leslie Thomas said Mr Howard
had two black eyes and "horrific" injuries to his face
at the time of his death, which had gone un-recorded by Mr Parsons.
The
reports of the two incidents had also been changed to show different
times - to rectify a mistake, according to Mr Parsons.
This,
said Mr Thomas, shows that Mr Parsons lied to the police and to
the inquest jury when giving evidence earlier.
Reports
of the injuries Mr Howard had inflicted on Mr Parsons, and other
staff, had also been overblown, he said.
"You
were trying to make Kurt out to be as bad as you could make him.
You were trying to cover your tracks because you were involved in
killing this man," said Mr Thomas.
Mr
Parsons denied the accusations. "Our job is to save life, not
lose it," he said.
Earlier in the inquest, Mr Parsons
had said that, during the first restraint, as soon as the nurses
had tried loosening their hold on Mr Howard, he would begin to struggle
again.
"We turned him over and I started
giving him mouth-to-mouth, one of the boys did compressions on his
chest straight away, within a matter of seconds," said Mr Parsons.
He then described a surge of energy
from Mr Howard, who fell onto his front on the floor, where they
restrained him for the further 20 minutes.
Mr Parsons had told the jury he
was concerned about the patient's breathing because he was on his
front - he said he had not had training to deal with a patient in
that position.
He added they had to adapt the technique
they were taught "as best we could for that situation".
Mr Parsons said they discussed how
to turn him onto his back, but they could not do so while he was
struggling.
He said Mr Howard did not appear
distressed, they kept checking his pulse and was still shouting
and spitting.
He said he was talking to Mr Howard
when "he just went lifeless".
"We thought now that perhaps
he was OK, but no. I took his pulse and it was very faint, checked
his radial pulse - nothing.
"We turned him over and I started
giving him mouth-to-mouth. One of the boys did compressions on his
chest straight away, within a matter of seconds."
Asked by the coroner Philip Rogers
if he felt he had acted appropriately throughout the period of restraint
and he replied: "Under the circumstances, yes. I think so."
He denied using more force than
necessary dealing with Mr Howard.
He said restraining Mr Howard had
been a joint effort, but he was the only qualified nurse involved
in the incident.
Previously this week the jury had
heard the ward manager of Cefn Coed Hospital, Martin Arber, deny
he had failed in his duty of care to Mr Howard.
Although he accepted it was his
duty to assign a key worker to Mr Howard and there was no record
of that being done.
In the weeks before his death, Mr Howard
claimed he was in the SAS, that he was a barrister and a gynaecologist,
the jury heard.
Mr
Howard had a 14-year history with Cefn Coed hospital before he died
there.
The
jury was told that, in 1995, Mr Howard was diagnosed with schizophrenia,
a diagnosis he shared with his father, John, who was also an inpatient
at Cefn Coed Hospital at the time of Mr Howard's death.
But
Mr Howard's mental health problems were exacerbated by an addiction
to drugs, leading to aggressive and often violent episodes, the
jury heard.
After
Mr Howard was admitted to Cefn Coed on June 17, 2002, these episodes
became increasingly frequent, with threats of violence, as well
as actual assaults against other patients and staff.
Consultant
psychiatrist Dr Marilyn Gibbs had told the inquest that Mr Howard
would inject amphetamines, "as much as he could get his hands
on or afford", as well as smoking cannabis and dabbling with
other drugs such as Ecstasy, LSD, opiates and cocaine.
During
his time at Cefn Coed, she said, he was treated with Haloperidol,
for psychotic episodes, and Lorazepam, for anxiety.
She
said Mr Howard was prescribed the two injections every four hours,
and had received a dose at around 7.30am on the day of his death.
"On
each occasion when he had taken Haloperidol and Lorazepam he had
settled, he did not need more medication."
The
inquest, delayed for six years, is conducted in front of a jury,
is expected to last until at least next week.
The
hearing continues.
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