Deceased
Konstantinos Eleftheriou-Tragakis
Demographics
36y, male
Date of death
2017-06-05
Finding date
2018
Cause of death
Hanging
AI-generated summary
A 36-year-old man with schizoaffective disorder, substance use disorder, and previous psychotic episodes was discharged from psychiatric inpatient care after being absent without leave for 72 hours. On 4 June 2017, he contacted the Crisis Assessment and Treatment Team (CATT) at 5:53pm requesting urgent help, stating 'I need help. I have to come in.' The call was transferred from the triage clinician to CATT staff but was not answered. No record of the contact was documented, and the usual practice of redirecting unanswered calls back to triage for assessment was not followed. The patient died by suicide the following morning. The coroner found Eastern Health's management suboptimal due to failure to record interactions and insufficient triage assessment to determine urgency of response. A formal protocol for handling unanswered CATT calls should have been in place.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Specialties
Error types
Drugs involved
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