Jury in inquest of girl who fatally self-harmed at hospital to consider whether she was unlawfully killed

Independent

a day ago

A jury at the inquest of a teenager who fatally self-harmed while at a mental health hospital should consider whether she was unlawfully killed, a coroner has said.
Ruth Szymankiewicz, 14, died after she was left alone at Huntercombe Hospital, near Maidenhead in Berkshire, also called Taplow Manor, on 12 February 2022, despite requiring constant one-to-one observation.
In the 15 minutes she was left unattended, Ruth, who had an eating disorder, made her way to her room, where she self-harmed. She was found and resuscitated before being transferred to hospital, but died two days later from a brain injury.
Summing up the inquest on Wednesday, assistant coroner for Buckinghamshire Coroner's Court, Ian Wade KC, told the jury they could consider 'unlawful killing', which he said would amount to 'gross negligence manslaughter' on the part of the care worker responsible for her care, if proven.
The jury could also consider conclusions of suicide and or that Ruth's death was a result of neglect.
To come to an unlawful killing conclusion, the jury would have to consider that the worker owed her a duty of care, that the negligence was an act of omission and was a significant cause of her death.
He said the breach of duty of care would have to be 'so reprehensible it amounts to a crime'.
An unlawful killing verdict at an inquest can only be decided on the 'balance of probabilities' rather than beyond a reasonable doubt, as is required in a criminal court.
During her inquest, it was revealed that the ward Ruth was on was 'severely short-staffed' and missing 'at least half' their workers on the day she self-harmed. Two senior workers repeated concerns that had previously been raised with hospital managers over short staffing and the pressure on employees.
In a note written by Ruth before her death, read aloud in court, she said there was a lack of therapy available at the hospital, which she said had an 'unsafe number of staff' and 'should be shut down.'
It was also revealed that the support worker responsible for monitoring Ruth had only gone through a day or a day and a half of online training before his first shift at the children 's psychiatric hospital on 12 February 2022.
He had also been working under a fake identity, Ebo Achempong, and police were not able to question him following her death as he fled the country to Ghana.
CCTV of the day she self-harmed showed the worker left her alone in the TV lounge. During this time, Ruth was able to make her way to her room, close the door and injure herself.
The jury heard evidence that Ruth was able to self-harm just a week before her death after her observation levels were cut. After that, they were increased again, so that she was to be watched constantly.
One staff member said hospital staff knew Ruth would 'take opportunities' to self-harm, the coroner said in his summary.
During her time at the Huntercombe Hospital, Ruth had to undergo force feeding every day through a tube. These 'feeds' caused her distress, and she would have to be restrained by up to staff, according to the evidence.
Dr Gillian Combes, clinical director for Thames Valley Provider Collaborative, which is the NHS body responsible for inpatient mental health care in the area, admitted the NHS did not do enough for Ruth.
Dr Combes admitted the NHS was aware the unit was understaffed daily and 'challenged' but told court there were no other options for a psychiatric intensive unit close to her family and that all other units in the country were struggling.
When asked about Ruth's admission to the hospital, Dr Combe said: 'We had concerns, I was in the [provider collaborative] we had the CQC, we were living and breathing trying to turn this hospital around, but hospitals around the country were facing the same challenges… all the units were really struggling…i t was a really stretched really difficult system.'
Former director for the Huntercombe Hospital, Marc Sycamore, said during his evidence that if the hospital had done enough with clinical care, 'we wouldn't be here',
The Huntercombe Hospital in Maidenhead, also called Taplow Manor, closed in 2023 after joint investigations by The Independent and Sky News. It was part of a group, formerly run by The Huntercombe Group and now taken over by Active Care Group.