[On] 29 April 2021 C climbed an electricity pylon and suffered a significant electric shock. He was immediately rendered unconscious and fell approximately 20 feet to the ground. He survived but received severe electrical burns, fractures to two vertebrae, and subsequently underwent an above-knee amputation of the right leg. He continues to suffer back pain, phantom limb pain and nerve damage to three limbs, with physical disability and restricted mobility from having to use a wheel-chair. [1]
In the days preceding this incident C had had extensive contact with D’s mental health support services due to his depression and suicidal thoughts. That contact included a face-to-face assessment on 27 April 2021 with a locum Community Mental Health Team (‘CMHT’). [2]
At that assessment D concluded that C was suffering from Depressive Disorder, Post-Traumatic Stress Disorder (‘PTSD’) and Generalised Anxiety Disorder, all of which he assessed as “moderate”. He also assessed the current level of risk of self-harm as “moderate”. D increased C’s dosage of anti-depressant medication (Mirtazapine) from 30mg to 45mg, and prescribed Zolpidem sleeping tablets to aid his night-time sleep. D also arranged a further face-to-face appointment with C for 30 April. He did not refer C to D’s Home Treatment Team (‘HTT’) for an assessment as to his suitability for admission as a hospital inpatient. [3]
C brings his claim against D on the basis that D’s assessment of both his degree of depression and the risk of self-harm as ‘moderate’ fell below the standard reasonably to be expected of a competent psychiatrist in possession of the relevant facts. He argues that, had D exercised the appropriate degree of skill and care, he would have assessed both issues as ‘severe’. Such an assessment ought to have resulted in C being referred to the HTT for assessment of his suitability to be admitted as an inpatient. [4]
C says that had such a referral been made, whether on 27 or 28 April 2021, the HTT would have assessed him as being in need of immediate admission to a hospital and that he would in fact have been immediately admitted as such. Had that happened as it should have done, he argues, he would have been unable to climb the pylon early on 29 April with the consequent lasting effects on his physical and mental health. [5]
D denies that D’s assessment of the risk of self-harm was negligent; it says that assessing both C’s level of depressive illness and his risk of inflicting significant self-harm as ‘moderate’ rather than ‘severe’ was within the range of reasonable and respectable psychiatric opinion. [6]
D does accept that, given the information available to D on 27 April, and the assessments that he in fact made, he ought to have referred C to the HTT for an assessment of the most appropriate treatment pathway. However, D submits that even if D had referred C to the HTT for further assessment, his symptoms and presentation were not so acute that C would have been admitted as an inpatient. [7]
D submits that even if C had been assessed as suitable for admission as an inpatient, because of the demand for such places it is highly unlikely that a suitable bed would have been found for him before the 29th April 2021. Therefore, says D on 29 April C would still have been living at home and thus in a position to injure himself in the way that he did. [8]
C’s case cannot succeed. [103]
medicalnegligencenow.com 