The claimant was delivering beer to a working man’s club. He had never used the cellar before. He was shown to it by a steward.

The cellar was poorly lit and as he opened the hatch he did not see its supporting metal bars. He inadvertently dislodged a bar, which fell and struck him in the face.

The Judge held there was a breach of Reg 18 of the Workplace Regulations:

“This relates to doors and gates and the Regs say ‘upward opening doors should be fitted with an effective device such as a counterbalance or ratchet mechanism to prevent them falling back in a manner likely to cause injury.’ In this case if the bar is capable of being dislodged inadvertently then a breach of Reg.18 is inevitable.”

Judgement for claimant

Newcastle upon Tyne CC, 6 March 2009, DJ Jackson.

Assault by mentally ill patient

Our client, a nurse, was attacked by a patient after telling him his medication was being prepared.

The patient had a long history of mental health treatment – he suffered from paranoid schizophrenia and at the time of the assault was sectioned under section 3 of the Mental Health Act 1983

The attack was at a hospital which was an open unit.

The claimant’s main two arguments were:

  • that the defendant failed to expedite the transfer of the patient to a secure unit, and 
  • that the care of the patient changed from a non-interventionist approach to enforcing medication against his will, in an open unit, without carrying out a new risk assessment, despite the fact that the patient had a known history of attacking staff who were involved in giving medication against his will.

 

The defendants took the stance that they were operating in very difficult circumstances to discharge competing, conflicting duties to the public, the patient and its staff against the backdrop of scarce resources.

On the first point, the assailant’s medical records had correspondence from medical professionals in which it was clear that it was not safe to treat the patient in an open unit, in particular this Hospital.

Although a care plan was in place at the time of the assault, it was that, when the patient was sectioned and taken into the Hospital, he would first of all have to be assessed by a Clinic (which was the local NHS secure unit) and if they considered a secure bed was needed and they were unable to offer this, funding would have to be approved to find and place the patient with a private secure bed.

This process had taken 45 days between admission and finding a secure unit. In the meantime the change of drugs had taken place too. The documents also made clear that the patient had previously attacked staff who had administered treatment against his will.

There was no evidence of a further written risk assessment when treatment of the patient transferred and a decision to enforce medication was taken.

The Judge was not prepared to criticise the consultant who had taken the decision to change the treatment of the patient as the patient’s previous consultant supported this decision.

However, the Judge did find that, in view of the fact that the patient’s health deteriorated sufficiently to the point that a decision was taken to enforce medication against his will. At that point, the need to find a secure bed became urgent and, based on the documentary evidence and witness evidence, this was not done and it was foreseeable that injuries would be sustained.

The Judge, who said he had practised in mental health law, said this delay was negligent and found for the claimant.

Birmingham CC, 2 February 2009