Inquest hears of doctor's "dilemma" in treating “aggressive” patient

Thursday 01 February 2024

A doctor has spoken of the “dilemma” he faced in treating a “tormented and aggressive” schizophrenic patient who later died.

Giving evidence yesterday on the third day of an inquest into the death of Michael Watkins, Dr Olufemi Sanni described some of the considerations before the islander’s death on 16 August 2021 from acute cardiac failure, which followed neuroleptic malignant syndrome.

Dr Sanni acknowledged the difficulty in balancing the risk of neuroleptic malignant syndrome – a rare and life-threatening reaction to anti-psychotic drugs characterised by fever, muscle rigidity and altered mental status – and the opposing risk to Mr Watkins and others if he was not given such drugs.

“It was a difficult decision to make,” Dr Sanni told Sarah Whitby, the relief coroner.

“Mr Watkins was distressed, tormented, aggressive – he was a risk to himself and others,” he said.

Dr Sanni said he had taken the decision to prescribe the anti-psychotic medication olanzapine to “take the edge off” the symptoms of Mr Watkins, who had been described earlier in the inquest as having a history of schizophrenia, and that this appeared to have a “calming effect” on the patient.

In handing over to on-call staff before the weekend of 14-15 August, Dr Sanni said he had recommended that Mr Watkins be transferred from St Saviour’s Hospital to the General Hospital should his condition deteriorate.

On the first day of the inquest, comments from Professor William Roach, a pathologist for Southampton Hospital, were read out.

He said a delay in admitting Mr Watkins to the General Hospital was a “lost opportunity” for five days of monitoring and treatment which may have prevented his death.

The inquest continues today and is expected to conclude tomorrow.

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