Hospital not liable for woman's death

A husband whose wife is presumed to have committed suicide after she walked out of St Patrick's Psychiatric Hospital, Dublin, …

A husband whose wife is presumed to have committed suicide after she walked out of St Patrick's Psychiatric Hospital, Dublin, where she was a voluntary patient, has lost his High Court action for damages against the hospital.

Catherine Madigan (37), a mother of one, left the hospital about 2pm on May 14th, 1998. Her clothes were found at Bray Head on May 20th, 1998. Her body was never recovered but she is presumed dead and a court order has been secured to that effect.

Ms Madigan had a history of depression, had been suicidal in the early months of 1998 and was admitted to the hospital as a voluntary patient on February 5th, 1998, the court heard.

Mr Justice Richard Johnson yesterday dismissed the action by her husband, Joseph Madigan, and his son, Conor, against the hospital. Mr Madigan, a stock controller, Bridge Street, Callan, Co Kilkenny, had attended each day of the four-week action.

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The court will decide later who will pay the substantial costs of the case. The hospital, which had denied any negligence in its observation of Ms Madigan and argued that a more custodial approach to her care was not warranted, is seeking its costs of the case.

In his reserved judgment, Mr Justice Johnson held that Mr Madigan had failed to establish any negligence by the hospital in relation to the observation accorded by it to his wife. There had been no claim of negligence regarding her actual treatment, he noted.

While the hospital was criticised by Mr Madigan's legal team for failing to observe on CCTV Ms Madigan leaving the hospital, the hospital's evidence was that the CCTV was for the purpose of observing intruders to the hospital and not for watching the patients, the judge said.

He found a regime had been put in place for Ms Madigan and that she was monitored by medical staff for a number of months before May 14th when she disappeared. Specialist witnesses called by the hospital had said the level of monitoring and the treatment afforded to her was quite satisfactory, as far as they were concerned.

Outlining the background, the judge noted Ms Madigan married in 1995 and gave birth to her son three years later.

She had suffered depression in 1986 and 1987. She appeared to have made a complete recovery but continued to remain on Prozac until the time of her pregnancy in 1998 when she stopped taking the medication in consultation with her doctor.

After the birth of her son, she developed significant depression which also manifested itself in the form of suicidal intent, the judge said. She was admitted to St Patrick's Hospital and remained there until May 14th, 1998.

She was subjected to a number of drug therapies, her condition fluctuated dramatically and she was admitted at one stage to a ward reserved for the more serious patients showing suicidal tendencies. A nursing plan was set up for her and she had some weekend visits home.

There was continuing variation in her treatment relating to drugs administered and observation in accordance with the view of the nursing and medical staff who kept her under continuous observation, the judge said.

On May 10th, 1998, Ms Madigan went to a beach in Dungarvan, Co Waterford, drank a half bottle of brandy and contemplated drowning herself.

On her return to hospital she was placed in a more secure ward and deprived of having her own clothes and the freedom to be able to move around the hospital.

Those privileges were later restored and this meant she was free to move in accordance with the protocols of the hospital. The degree to which she was entitled to move was a clinical decision taken by the doctors.

On May 14th, Ms Madigan got up at the usual time and walked in the gardens and was seen by a doctor. She left her ward at 1.55pm indicating she was going to occupational therapy but did not do so. She left the hospital about 2.05pm, as recorded on the CCTV, and had not been seen since. Her clothes were found on Bray Head and it was presumed she committed suicide.

Mr Madigan had claimed this was due to the failure of the defendants to keep her safe and secure, the judge said.

He found the regime chosen for Ms Madigan was considered appropriate at the time by the medical and nursing staff.