The High Court dismissed a negligence action brought by Ellen Anne Orpen on behalf of the statutory dependants of her son, Michael Orpen, who died by suicide in November 2006. Mr Justice O’Neill concluded that the plaintiff had not established a breach of duty by the Health Service Executive or the doctors involved in his care.
Michael Orpen attended Letterkenny General Hospital on 14 November 2006 after taking an overdose. He told staff he had recently felt depressed, had left an IT course and regretted the attempt. A psychiatric assessment followed. The judgment records that he said he did not then intend to harm himself and did not need hospital admission. He was discharged to the care of his sister, Mary Ellen, with a plan for urgent assessment at Parkview the next day.
The plaintiff’s expert psychiatrist, Dr Cookson, criticised the care in several respects. He argued that the doctors should have taken a fuller family history, more actively sought admission, given clearer advice about suicide risk and the means of the attempt, arranged closer supervision, and considered starting antidepressant medication. The judgment records that the expert accepted involuntary detention was not justified.
The court considered the disputed evidence about what was said to Mary Ellen at the hospital, the risk assessment and the discharge plan. It found that the doctors recognised Michael was depressed and at risk, and had appropriately weighed the recent attempt against his repeated statements that he did not intend to harm himself, his regret, his engagement with treatment and the availability of care from his sister overnight. The judge concluded that discharging him to her care, with a return to psychiatric services planned for the following day, was consistent with good psychiatric practice.
The judgment also found the advice given before discharge appropriate in the circumstances, including the short period before the planned follow-up. It rejected the criticisms about supervision, driving and access to tablets, and found no breach in not starting antidepressants that night.
Michael attended Parkview on 15 November for a lengthy assessment and was scheduled for further review. The following day, his death was confirmed after his car was found at Bruckless pier. The court’s ruling addressed whether the defendant had breached its duty of care; it did not find such a breach and dismissed the action.