Jury Inquest Returns Narrative Verdict On Death Of Psychiatric Patient

11/01/2011

The family of a Birmingham man who was found dead 24 hours after he had absconded from a mental health hospital has today welcomed an inquest’s narrative verdict, which found the man would not have died had a door been properly secured.

Steven Karl Murray, 26, from Erdington had a long history of mental health problems and suffered from schizophrenia. He was being cared for at Highcroft Hospital, after his condition deteriorated and he was sectioned for his own safety on 7th October 2009.

A jury and HM Coroner for Birmingham, Mr Aidan Cotter, heard that during this time Mr Murray had managed to walk out of the mental health unit on a number of occasions. The lock on a security door was known to be faulty.

Mr Murray walked out for the last time on 30th November 2009 but his family was only informed when he was seen on Erdington High Street by a relative, who informed his parents. The court heard that when his mother, Mrs Theresa Smith, phoned the ward to confirm the news, a member of staff admitted they were aware of his disappearance but that they expected him “to come back of his own accord”.

Following a desperate wait for news, Mrs Smith and Steven’s community care nurse visited his flat in Erdington on December 1 2010, where they found a window wide open. On entering the flat, they discovered his body alongside some empty bottles of alcohol.  A post mortem investigation later confirmed that Steven died as a result of acute alcohol intoxication and hypothermia.
 
Steven’s mother, Theresa Smith, said: “Steven meant the world to us. Although he had a lot of problems to deal with during his lifetime and had been schizophrenic since the age of 16, he was a very loving son and we were extremely close. His death at such a young age has had a devastating effect on the entire family and we still miss him so much.

“We put our trust in health professionals who we felt were able to best look after Steven, but we feel at a time when he was at his most vulnerable he was badly let down and we remain very angry about what happened.”

Christopher Hurlston, a medical law solicitor with law firm Irwin Mitchell, who is representing the family, said: “Steven’s parents believe that a note which he wrote just days before his death show the very confused and distressed state of Steven’s mind and should have rung alarm bells with staff that he needed to be more closely monitored.

“Having been sectioned for his own safety, his family are at a loss to understand why Steven was simply able to walk out of a mental health ward at a psychiatric hospital on a number of occasions, through a door, which the jury heard, had a faulty lock.

“They are also hugely concerned by the apparent lack of concern shown by hospital staff when they were notified that he had absconded and feel that more should have been done to locate him sooner.
 
“The jury heard that after Steven’s mother had phoned George Ward at the hospital, it was decided to wait two hours before beginning the Missing Patient Process.  In fact it took them three hours.
 
“Steven’s care coordinator and outreach team were not told of Steven’s absconsion until 09:00 on 1st December.  The care co-ordinator attended Steven’s flat around 10:30 but, receiving no answer contacted Steven’s mother and agreed to meet at the flat at 3:30pm that afternoon, where they found him dead on his bed.
 
“Today’s narrative verdict also found that if the outreach team had been correctly informed of Steven’s absconsion they would have had an opportunity to support Steven.
 
“The family is now calling for the hospital to prove that it has learned lessons from the appalling lack of care they feel Steven received, to ensure that other vulnerable people in their care do not come to harm, as a result of lax security and ineffective care procedures. Following today’s inquest the family will be considering its options, including the possibility of civil proceedings against the Trust.”

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