You bring me... JOKES. Does this report look like the same meeting.. and that is why people get away with medical murder

 The reality https://www.youtube.com/watch?v=mTZtPsWjJhQ&t=150s and the fabrication!

ASSOCIATE HOSPITAL MANAGERS’ REVIEW OF DETENTION
RECORD OF HEARING Section 3/37

VENUE:                                                         
Teleconference
   DATE:                                  
1
0
0
5
2
1
    TIME:
1
4

3
0






RELEVANT PARTIES

Name
Attending
Person deputizing (if relevant)


Yes
No
Name
Role
Patient
Edward Moss
x



Responsible Clinician
Dr Stewart  0207 561 4010
x



Nurse
Beata, Jade Ward 0207 561 4010/12
x



Care Co-ordinator
Roman Wyper 0203 317 6590
x



Nearest Relative
Mary Moss
x



Patient’s Legal Rep
Fernanda Stefani of Reece Thomas Watson
x







CURRENT DETENTION:

REASON FOR REVIEW:
Please Tick
Section:
3
Patient’s Appeal

Start Date:
30/03/2021
Renewal (Sec.20)

Expiry Date
29/09/2021
RC barring discharge – s25(1A)
x



RELEVANT SECTION HISTORY

Section Type
Start date
End date
Section Type
Start date
End date
2
06/03/2021
30/03/2021
3
10/12/2019
07/01/2020
2
03/08/2020
12/08/2020
2
13/11/2019
11/12/2019
136
03/08/2020
03/08/2020



2
01/07/2020
15/07/2020



5(2)
07/01/2020
08/01/2020



5(2)
11/12/2019
10/12/2019









Patient Hearing History of Adjournments and Postponements
Date
Outcome
Reason









CHECKLIST FOR CONDUCT OF REVIEW
N/A
YES
NO
    •    Chair welcomes/introduces all present

X

    •    Explain purpose of the review and propose procedure to be used.

X

    •    Ask if patient/representative has copies of reports (see CP 23.14 regarding discretion on disclosure)

X

    •    Has patient had opportunity to be accompanied by friend or representative of own choosing to help in putting his/her point of view to Panel? (CP26.16).

X

    •    Ask if the patient's relatives or point of view are to be represented.

X

    •    Ask if patient, (if willing):



    •    To be present throughout interviews with medical and other advisors?

X

    •    Ask for patient's reasons for wanting discharge
 
   X
 
Summary of patient's reasons:

He does not accept that he is ill and therefore wishes to be discharged.
    •    RC’s Report discussed with RC

X

    •    Social Circumstances Report discussed with Community Representative

X

    •    Advocate and other professional view heard? (write in)

X

    •    Has the Mental Capacity Act been considered?


X
    •    Has the carers views been considered?
Summary of carers views:
Ms Mary Moss who is the Nearest Relative under the Act, had applied for his discharge, which was the subject of the Barring Order this hearing had been convened to consider. After behaving in a way sufficiently disruptive to prevent the hearing from proceeding and failing to respond to caution, and indeed being called to order with great difficulty, she  had to be informed she could continue to attend the hearing only if she remained as an observer.  This action was taken with regret but the hearing could not otherwise have continued.

Prior to this she had stated in evidence that the reports were full of errors, and that she had several handwritten pages of corrections she wished to make;  she was requested several times to submit these detailed corrections to the MHA in writing outside the hearing, as the panel were not in a position to make any decisions regarding the accuracy of the content of reports.  In any case  as she became  excluded from active participation, she was unable to make these points, which by her own account, to do fully, would have taken a substantial period of time. time. It also seemed that she wished to contest the evidence strongly, taking the view (before being brought to order) that the RC was probably in breach of the Mental Health Act, and so her brother’s detention would be in breach of that Act, and disagreeing with the RC’s clinical judgements, in particular regarding the size of the Sodium Valporate dosage which she thought excessive. It would appear there were other aspects of the patient's  medication that she would have wished to disagree with had her comments not been curtailed. (She also particularly contested the report of a “near miss “, a car accident in which her brother was involved, which it was stated could have been very serious, saying that her brother had been improperly treated by a policeman who had a personal dislike of him). She appeared to support her Brother’s view that he was not really ill.

The panel's considered view was that as the patient was in attendance, and had legal representation, it was appropriate for the hearing to continue in the best interests of the patient, even if only with limited participation by the Nearest Relative.








CONDITIONS NECESSARY TO CONTINUING DETENTION
Section 3/37 appeal

    •    Is the patient still suffering from mental disorder? If so, is the disorder of a nature or degree which makes it appropriate for the patient to receive medical treatment?

YES

Evidence and reasons for decision:

Mr. Moss has a dual diagnosis of:-

a.) Paranoid schizophrenia

b.) Mental and behavioural disorder due to the  harmful use of multiple substances.

His disorder has both nature and degree.

It is reported that he first showed symptoms of psychosis when he was 19, had a diagnosis of Schizophrenia when he was 20 (1990) and since then has had over five hospital admissions, including admissions under the Mental Health Act and on a PICU, becoming first known to C&I in 2019.





AND
 (b) Is continued detention for medical treatment necessary for the patient’s health or safety or for the protection of other persons?


YES

Evidence and reasons for decision:

Risk to health

When unwell he has a history of severe self neglect including rough sleeping.

Risk to self

His affective symptoms and likelihood of drug use are described as putting him “ at a risk of misadventure.” There is a history of two suicide attempts. .One was  by electrocution in 1993, after his son’s death, and a record of another suicide attempt in 2005.

There is also a risk of retaliation from others provoked by intrusive and aggressive behaviour.

Risk to others

He has a history of dangerous driving when unwell and reportedly nearly ran someone over in 2019. He has also been known to be physically aggressive when unwell.







    
AND
(c)  Is appropriate medical treatment available for the patient?


YES

Evidence and reasons for decision:

He is  on medication, (which is under review ) and is encouraged to take part in activities provided on Jade ward, to which he has only recently been transferred. It should be noted that while it was reported that his current engagement in activities is poor, Mr. Moss responded in evidence, that the range of activities provided was, in his view, limited. Psychology will be offered when it will be helpful to Mr Moss.

His accommodation needs are being assessed, as it was thought that high support mental health accommodation might be appropriate, particularly to assist with his medication.







FOR SECTION 25  (RC barring discharge by nearest relative) ONLY
AND
    •    Would the patient, if discharged, be likely to act in a manner dangerous to  other persons or to him or herself?
The Managers may still exercise their residual power not to discharge even if they override the RC’s report but  only if the grounds for detention are satisfied and there is evidence to suggest that the patient’s health would be significantly compromised if he/she were to be discharged

YES

X

Evidence and reasons for decision:

His dangerousness to others  is reported as taking the form of verbal abuse, property damage and threats. In Coral Ward he has been repeatedly aggressive towards staff and patients. (He broke a heavy door in a rage approximately ten days ago). He is dangerous to himself putting  himself in very vulnerable situations by provoking others, who then threaten him.. In addition, Mr Moss endangers himself by profoundly neglecting himself.  He is also at risk financial exploitation, an example of which was given in evidence. (Staff had held 100 pounds in cash in the safe; issuing him with 20 pounds a day, which sum other patients had then sought to take from him, which had required staff intervention)


Are there reasons why the panel considers the patient should be discharged even if the criteria for continued detention are met?


NO.
DECISION OF REVIEW PANEL (give any further reasons below)

 

Patient not discharged from section   





Hearing Re-arranged for:    Date                        

Signed     (1)Adeola Akande  ………………………………………………: ()

                 (2) Penny Mellor ……………………………………………….: (  )

                 (3) David Barry ……………………………………….……...: ()
       
Date
                        
Any further reasons:
…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

DECISION COMMUNICATED TO PATIENT BY:  ……………………………………………………………………
                             
(and reminded of right to apply to First Tier Tribunal – Mental Health (if applicable)


Signed:        
Date:                    
                                                                                                 
REASONS FOR ADJOURNMENT

…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..
RECOMMENDATIONS/ COMMENTS

1 .Whether the nearest relatives views have been properly considered/whether the reports refer to the nearest relative correctly or any other term is used in reference the nearest relative?

The Nearest Relative is correctly identified. Her views were heard up to the point at which, in order to enable the hearing to continue, she was asked to remain as an observer only. It should be noted that she stated she had a number of detailed criticisms of the reports: she was invited to submit these in writing to the mental Health Act  Law Office.

2. Other Comments/Recommendations…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
ACTION BY …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………