A CONSULTANT psychiatrist has told a jury that after a patient stabbed him in the abdomen with a four-inch knife he could smell gut contents and saw that the blade was "smeared right up to the hilt".
Gavin Francis (26), who had been diagnosed with schizophrenia, was attending Dr Michael McDonagh as an outpatient at St Patrick's Hospital.
The consultation had just ended when Mr Francis shook hands with Dr McDonagh and handed him a box of chocolates before stabbing him in the stomach.
Dr McDonagh had to undergo three hours of emergency surgery after it was discovered that the knife had entered through the front of his stomach, left through the back of it and pierced the head of his pancreas. He required 13 units of blood and spent some time in intensive care before he was released from hospital.
Dr Patrick Plunkett said in a statement read to the jury at Dublin Circuit Criminal Court by prosecuting counsel Shane Costelloe, that in his opinion, prior to emergency surgery, Dr McDonagh's wounds indicated a substantial risk of death.
Mr Francis, of Earls Cliff, Ceannchor Road, Howth, who is currently a patient at the Central Mental Hospital, has pleaded not guilty to intentionally or recklessly causing Dr McDonagh serious harm at St Patrick's Hospital, St Stephen's Lane, on September 19th, 2006.
Mr Costelloe said there was a possibility that a special verdict would arise in which the jury would have to consider whether Mr Francis was "not guilty by reason of insanity".
He said that he anticipated that most, if not all of the facts in the case, would be agreed between the State and the defence teams and the jury would be left to determine only one issue: if Mr Francis was suffering from a mental disorder when he stabbed Dr McDonagh.
Defence counsel Luan Ó Braonain told the jury that he wanted to make a number of admissions on behalf of his client.
He said his client was correctly identified as the man who stabbed Dr McDonagh, leaving him with a wound that resulted in surgery and that the attack "gave rise to a substantial risk of death".
Dr McDonagh told Mr Costelloe that he and Mr Francis had been discussing the hallucinating voices the accused had been experiencing over previous weeks.
He said he altered the dosage of the medication he had been prescribing and ended the session earlier than he normally would have had after he noticed that Mr Francis seemed quite distressed.
He said when Mr Francis took the box of chocolates from his rucksack he said something along the lines of "that's for two years" in reference to the amount of time he had been treating him.
He then felt a thrust to his abdomen and when he grabbed hold of Mr Francis's wrists he noticed that he was carrying a knife. Dr McDonagh said he managed to get the knife off the accused but that there had been no struggle. He said Mr Francis then became passive and offered his assistance in calling the emergency services.