Psychiatric patient died after ’55 minutes’ of restraint

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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