The High Court has heard a 19-year-old man stabbed his mother's partner to death two weeks after he had been discharged from an emergency department without follow-up, after presenting with psychotic thoughts and an intention to kill.
The HSE today apologised to the man’s family as it settled a High Court action for €150,000.
The court was told that Fiona Nolan had taken her 19-year-old son Adam to the emergency department of Tallaght University Hospital in January 2018 because he was unwell, and was exhibiting paranoid, violent and psychotic thoughts about killing her partner Bryan Cassidy with a kitchen knife.
She was told these were irrational thoughts and her son should see a counsellor.
Senior Counsel Dr John O’Mahony told the court there was no proper examination and no history taken. He said two weeks later Ms Nolan came home to find her partner in the garden having been stabbed in the eye and six times in the abdomen.
Dr O’Mahony said it should have been clear to the hospital that Mr Nolan was suffering from psychosis which was unrelated to any medication. This he said was "the fundamental flaw".
Mr Nolan, of Buirg an Ri Walk, Balgaddy, Lucan was later found not guilty by reason of insanity of the murder of Mr Cassidy, 52.
In a letter of apology read to the court the HSE unreservedly apologised to Ms Nolan for what it described as the deficits in care given to her son by HSE psychiatric services at Tallaght University Hospital on 25 January 2018 and for the "distress and the grief caused to you by the said deficits in care".
The letter also said the HSE had "reviewed this tragic event and has implemented key learning."
Ms Nolan, 53, had sued the HSE and Tallaght University Hospital, claiming she was advised Mr Nolan should see a counsellor and there was no further follow-up. Mr Nolan continued to suffer from severe psychotic thoughts and behaviour before killing Mr Cassidy on 7 February 2018.
It was claimed there was failure to admit Mr Nolan to the hospital and a failure to diagnose his symptoms which indicated probable paranoid schizophrenia.
It was also claimed there was failure to have regard for the potential risks in failing to admit and detain the young man who had described "clear murderous intentions".
It had been noted in the emergency department that he had expressed a desire to kill people, specifically Mr Cassidy and there was a failure to prevent the killing by either admitting him to hospital, sedating him or referring him to an urgent care psychiatric unit.
A breach of duty of care was admitted in the case.
Mr Justice Paul Coffey noted the settlement and said it was a very sad and tragic case.
