A woman who took her own life after a psychiatrist said she was not suicidal was found alone in hospital, where she died just over half an hour before she was reported missing.
Three-year-old Orlaith Quinn committed suicide at the Royal Jubilee Maternity Hospital in Belfast after admitting to family and staff that she had attempted suicide during a heavy pregnancy.
An inquest into her death has revealed that a psychiatrist who examined Ms Quinn after her admission could not rule out postpartum psychosis as she had given birth less than two days earlier.
dr However, Bob Boggs said he thought it was more likely that she was suffering from OCD and did not recommend individual monitoring or transfer to a psychiatric ward.
On the third day of Ms Quinn’s examination, neonatal nurse Kathleen Cardwell testified that she saw her walking down a corridor at the hospital at 2.45am on October 11, 2018.
The encounter took place less than just over 30 minutes before Mr Quinn, who had been staying overnight in hospital with his wife and daughter, woke at 3.20am to find his wife missing.
Ms Cardwell described it as “unusual” to see a patient in the corridor at the time, prompting her to stop and speak to Ms Quinn, who she noted was not wearing a dressing gown.
“She came up to me and I asked her if she was okay,” she said.
“She replied that she was looking for a restroom, I directed her to the nearest restroom which was in the McAfee complex.
“She said thank you and turned towards the toilet.”
Belfast Trust solicitor Jonathan Park asked Ms Cardwell if Ms Quinn appeared distressed, but the nurse described her as “very calm”.
Earlier, the court heard from John Casey, a psychiatric nurse who was present when psychiatrist Dr. Bob Boggs conducted a mental health assessment of Ms Quinn.
Mr Casey told the inquiry that after the assessment he had not carried out a risk assessment in relation to baby Meabh.
Attorney Patrick Mullarkey, representing the Quinn family, asked Mr Casey if this should have happened.
The nurse replied: “I suppose the question would have been whether there was any evidence that Orlaith’s daughter might have been harmed.
“When I asked her about her daughter, I got the impression that she was excited to have a little girl and looking forward to the future.”
However, Mr Mullarkey asked Mr Casey whether, given information from Ms Quinn’s mother and husband about her mental state and the fact that Dr. Boggs said he diagnosed her with OCD if a “risk should have been identified in relation to that, including the baby.”
Mr Casey replied: “Yes.”
Postpartum psychosis is a medical emergency that manifests itself in the hours, days, and weeks after delivery.
Symptoms include major depression or mania, rapid mood swings, restlessness and excitement, trouble sleeping, delusions, unusual behavior, suicidal thoughts, and feeling like you’re in a dream world.
The inquest was told on October 10, 2018, the day after baby Meabh arrived, that Ms Quinn’s behavior had suddenly changed.
Her husband described her as “obsessed” and said she was “manic, uncontrollable, loud, spoke irrationally, wouldn’t listen to reason, was angry, upset and physically shaking”.
She told Mr Quinn, her mother, Siobhan Graham, a midwife and doctor, that five days earlier she had tried to kill herself three times.
She said she lost consciousness on the last attempt.
She also said she harmed her baby with her bad mood during the latter part of her pregnancy and that Meabh had brain damage and would need a wheelchair.
Ms Quinn said police were coming to arrest her and she was going to jail.
On the third day of the investigation, Mr Casey testified that during her mental health assessment, Ms Quinn said she felt better after speaking out about her past suicide attempts.
“Orlaith described life as livable but still had some concerns that she may have harmed her daughter,” he continued.
“She clearly denied any suicidal thoughts, plans or intentions … there was no evidence of psychotic symptoms.”
When asked by Mr Mullarkey about the fact that there had been a number of interruptions during Ms Quinn’s assessment, he agreed that it was “less than satisfactory”.
Mr Mullarkey asked Mr Casey if his patient should have spoken alone, without her husband present.
Mr Casey replied: “In hindsight, yes, absolutely.”
He also agreed that they should have spoken to Ms Quinn’s husband and mother to learn more about their patient.
“That should have happened if there was an opportunity,” he said.
Mr Casey agreed that Ms Quinn’s behavior and comments to her family are “significant” to the information she provided during her assessment.
Mr Casey also said he could not recall being told Mrs Quinn had lost consciousness during the previous attempt on her life.
Coroner’s attorney Mark Reel asked, “If you had been told that, does that affect your thinking or the seriousness of what happened?”
Mr Casey replied: “I suppose yes, it definitely adds a concern.”
He also agreed that “it would have added to the concern” if he had known that she would have given a different account during the investigation than friends and associates on the station did.
“It could indicate that Orlaith was guarded a bit,” he said.
The inquiry was also told that the Belfast Trust has been running a new bespoke training program on postpartum psychosis since Ms Quinn’s death.
However, it has emerged that less than a quarter of midwives have taken part in the training so far, blaming the Covid-19 pandemic and the intention to speed up the roll-out of the training.
The investigation continues.
After the mental health assessment, on the advice of Dr. Boggs, who believed she would benefit from a “low stimulation” environment, moved to an adjoining room.
However, it turned out that the room was closer to the station’s exit and people leaving or entering the room could not be seen from the nurses’ station.
Mr Quinn stayed with his wife overnight to support her, but woke up in the early hours of October 11 to find her missing.
She was subsequently found dead at the end of the corridor of the station she had disappeared from.
The inquiry continues today in Laganside courts.
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https://www.independent.ie/irish-news/health/tragic-mum-orlaith-quinn-found-wandering-hospital-shortly-before-she-went-missing-inquest-told-41641923.html Tragic mother Orlaith Quinn found a wandering hospital shortly before she disappeared, the inquest said