Psychiatrist guilty of misconduct after freeing dangerous patient

From a Report out of Plymouth, England

A Plymouth psychiatrist who released a dangerous schizophrenic from a mental health ward hours before he tried to kill his mother was today found guilty of 'recklessly' putting the public at risk.

Dr Andrea Tocca described the 39-year-old as 'no danger to himself or others' and discharged him from Derriford Hospital in Plymouth, Devon, a day after he assaulted a female patient.

Soon after arriving home, the man, referred to as GA, told his mother: 'I know what I have to do to you' and battered her repeatedly over the head with a spade.

Dr Tocca was found guilty of misconduct after the GMC panel decided that he had 'recklessly put the public at risk' in releasing GA from the ward.

Panel chair Ralph Bergmann said: 'This panel is particularly concerned by your decision to discharge GA on April 25, 2006.

'You had been responsible for the care and treatment of GA for some three months prior to discharging him.'

Mr Bergmann said during this time he had been informed by the patient's previous doctor in Torquay that 'if GA became acutely psychotic, his mother may be at risk.

'He (the doctor) had also informed you that GA had made two very serious suicide attempts.

'The panel accepts the proposition put forward by your counsel that your conduct in discharging GA amounted to a single episode of significant error.

'However, you had access to GA's medical history, you had become very familiar with his condition and you ought to have been very alert to the risks and potential consequences of discharging him.

'Your decision to do so leaves the panel in no doubt that this was serious misconduct on your part.

'As the consultant psychiatrist responsible foe the care and treatment of a vulnerable patient, you behaved irresponsibly and recklessly in allowing GA to be returned to the community.

'You thereby put at risk not only the patient but also his mother and the public.

'Taking all these matters into account, the panel has determined that your fitness to practise is impaired because of your misconduct.'

The GMC panel will now consider whether to kick Dr Tocca out of the medical profession.

The hearing was told that Dr Tocca did not read GA's medical notes and decided to 'make up his own mind' about the patient.

On April 24, GA assaulted a female patient on the unit by holding her in a headlock and punching her.

His medical records show that he had also threatened other patients and believed that the staff on the unit were trying to kill him.

Marios Lambis, for the GMC, said: 'At 9.55am on April 25, Dr Tocca made an entry in GA's notes stating that in his view, that assault on the female patient was not a product of his mental state but rather a result of the high level of stress he was experiencing on the unit.

'He recorded that once the police had completed their investigation into the assault, he would discharge GA, and twenty minutes later he recorded: ''In my clinical opinion, GA is not detainable under the Mental Health Act and he is not really a danger to himself or to others.'''

In a statement read to the panel GA's mother, referred to as Mrs A, told the hearing that Dr Tocca telephoned on April 25 to say her son had assaulted a patient but he was sending him home.

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The GMC heard that GA had developed brain damage after falling from a tree swing at the age of 12 and became 'passive and apathetic.'

In 1991, at the age of 22, he was admitted to hospital in Manchester with paranoid psychotic symptoms, the hearing was told.

Mr Lambis said: 'He would not let anyone into his flat, his furniture was broken and he was talking in an incomprehensible manner.

'He had become suspicious and withdrawn.'

In 1993, he was diagnosed with paranoid schizophrenia and was admitted to acute mental health units nine times over the following three years.

Two years later he made threats to kill his grandmother.

GA took an overdose in 2003 and was later sectioned.

On August 8 2005, he set fire to his mattress five times before lying on it and burning himself in a suicide attempt.

He spent 11 weeks in the burns unit at Frenchay Hospital in Bristol.

Dr Tocca admitted being told by GA's doctor that he became acutely psychotic his mother may be at risk.

He also admitted that he ought to have known that GA had made threats to kill his grandmother and had shown previous incidents of violence, and he discharged GH when he ought to have known he should not have been discharged.