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Islington Tribune - by CHARTLOTTE CHAMBERS
Published: 27 June 2008

Hospital patient found dead in alley

Procedures reviewed after epileptic sufferer wearing T-shirt wandered off in mid-winter

A GALLERY assistant with epilepsy died in a Barnsbury street after wandering out of hospital unnoticed, an inquest heard this week.
Robert Nwaka was admitted to University College London Hospital (UCLH) in Euston on his 37th birthday in November last year after growing so confused he did not recognise his daughter.
Days later Mr Nwaka, from Kilburn, walked out of hospital dressed in a T-shirt and jeans, despite staff being aware he had absconded from the hospital before. Within just over 24 hours the father-of-one was found dead in an alleyway in Half Moon Crescent.
The hospital is now reviewing its procedures for managing confused and agitated patients in its acute admissions unit.
St Pancras coroner Dr Andrew Reid described Mr Nwaka as being “in limbo” between the psychiatric team and the medical team at UCH. He refused to rule out hypothermia as a contributory cause of death. “The possibility of the cold temperature cannot be excluded,” said Dr Reid.
Professor Michael Hanna, head of neurology at UCLH, said: “The situation when someone has disturbed behaviour with a medical cause is common and medics treat it. It would then be treated by psychiatrists to control that behaviour.”
He admitted the cold weather that Mr Nwaka was exposed to – he was missing for nearly two days – could have prompted an epileptic seizure. But he added: “My best explanation would be that he was having some sort of seizure, perhaps triggered by alcohol. A very small percentage of people with epilepsy can [also suffer] sudden death.”
Expert witnesses gave evidence that “straightforward good nursing” and “very, very close observation” could have saved Mr Nwaka’s life.
When asked what could have kept Mr Nwaka safe, Dr David Ellis said: “[You need to] make sure you know where your patient is and maybe put them in a side room if they’re at risk of wandering off.”
Dr Ellis added that medics had missed a crucial piece of the puzzle when assessing Mr Nwaka because they failed to interview his wife, Suzanna, 37. Instead, medics referred Mr Nwaka to the alcohol dependency team after he told them – wrongly – that he had drinking problems.
At an earlier hearing in April, Mrs Nwaka criticised hospital chiefs. “They made an assumption that he drank too much,” she said. “In the last two years he didn’t drink anything at all.” Heartbreakingly, she described her feelings of relief that he was in “a safe place” when he was admitted to hospital.
Dr Reid could not determine why Mr Nwaka died and recorded an open verdict.
He did not find UCLH’s care had contributed to the death and instead blamed the tragedy on Mr Nwaka’s confused state.

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