If You Think There is a Risk Then Why on Earth Are You Releasing Him?

By ed hill

A Transcript reveals how a doctor was warned by a police inspector about the risk of releasing a patient who threatened to torch his house – 24 hours before he set himself on fire and died.

It shows Inspector Alison Dando telling psychiatrist Dr Raj Sinha that, if anything happened to Andrew Whetton, “it would look bad on the health authority”.

The 48-year-old begged to be kept in hospital and threatened to set fire to his house but was released from the mental health unit.

The next day, he covered his clothes in petrol and set them alight while in a car with his partner of 25 years, Julie Croft, in Marston Lane, Hatton.

Coroner Dr Robert Hunter recorded a verdict of suicide at the end of a two-day inquest yesterday.

However, he said the fact Mr Whetton was not given a mental health examination by a senior psychiatrist after the suicide threat was a “contributing factor in his death”.

Dr Sinha rang police to let them know Mr Whetton was being released.

After a recording of the call Dr Sinha made to police was played in court, he said: “Too much pressure was coming to me at that time. It was not an ideal situation.

“We do not have a machine to say what this patient will do.”

Mr Whetton, of Sydney Street, Burton, was first admitted to the Margaret Stanhope Centre, the mental health unit at the town’s Queen’s Hospital, on February 15 last year.

He was an inpatient for three weeks before being allowed periods of home leave, which meant he was still under the hospital’s care.

Mr Whetton was deemed to be severely depressed with “possible psychotic features” when first examined.

He was convinced he had stomach cancer after a bout of gastroenteritis, although tests disproved that. He also felt guilty after having an affair. He expressed suicidal ideas, saying he could not cope at home, Dr Sinha told the inquest.

But the doctor felt Mr Whetton showed significant signs of improvement in the weeks after his admission.

Dr Sinha and consultant psychiatrist Dr Nitin Gupta – who had the final word on when Mr Whetton was discharged – changed their diagnosis to acute stress reaction with anxiety.

“He had depression but we treated him and his symptoms were improving,” said Dr Sinha.

But he said the self-employed window cleaner became agitated during periods of home leave.

He was on home leave at the time of his final review meeting on April 2, the day he was due to be discharged, but asked to stay in hospital.

“He said ‘do not send me on leave, I do not feel safe’,” said Dr Sinha. “He was more anxious – he had never been like that before.”

It was then that Mr Whetton got down on his knees and begged for help, the inquest heard, and said that he would burn his house down if he was released.

Dr Sinha said: “He wanted to stay on the ward. We thought that might not be appropriate. We thought we could give him some more leave and he could see me on a daily basis.”

As a result of the threat, Dr Sinha and mental health nurse Robert Guest had a 20-minute meeting with Dr Gupta, the senior psychiatrist, where they told him about the fire threat.

Dr Gupta was asked by the coroner whether, if he had given Mr Whetton a full mental health assessment, his decision to send him on home leave would have been altered.

“No sir,” Dr Gupta replied.

Dr Gupta said Mr Whetton had never previously made a serious attempt to kill himself.

Dr Robert Rowlands, an independent psychiatrist asked to look at Mr Whetton’s medical notes, also questioned the decision not to carry out an assessment.

He said: “People being agitated to the point of pleading on their knees – that’s an unusual level of agitation. If you have ended up on a psychiatric ward, you are a high risk.

“Dr Gupta did not actually review the patient himself. That would have been the prudent thing to do.”

The inquest heard how Mr Whetton could not be sectioned under the Mental Health Act as he wanted to stay in hospital.

Summing up, the coroner said: “Mr Whetton was agitated, he fell to his knees pleading with staff not to discharge him. The team were collectively concerned to inform the psychiatrist, but no formal examination was made. The consultant psychiatrist did not see him. As a result of that decision, it was agreed he should be sent on home leave. I find that this was a contributing factor in Mr Whetton’s death.”

(c) 2008 Derby Evening Telegraph. Provided by ProQuest Information and Learning. All rights Reserved.