multiple injuries from deliberate fall from pedestrian bridge onto Mitchell Freeway
AI-generated summary
Sarah Jane Rutherford, a 28-year-old woman with bipolar affective disorder and schizophrenia, died on 27 December 2009 after falling from a pedestrian bridge onto the Mitchell Freeway in Perth. She was an involuntary patient at Graylands Hospital at the time, admitted on 3 December 2009 following a relapse triggered by non-compliance with antipsychotic medication. After initial stabilisation on a secure ward with 30-minute observations, she progressed to an open rehabilitation ward and was granted overnight and weekend leave. During weekend leave her mental state deteriorated, but she denied suicidal ideation at her 23 December review and was discharged home on a 7-day prescription for risperidone. She left home early on 27 December and fell from the bridge approximately 11pm on 26 December. Evidence suggests she had not taken her medication for at least one day before death, possibly contributing to suicidality. The coroner found the quality of treatment and care at Graylands was reasonable and appropriate, and concluded the manner of death was suicide.
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Specialties
psychiatryintensive caregeneral medicineemergency medicine
Drugs involved
risperidonelorazepam
Clinical conditions
paranoid schizophrenia with catatonic featuresbipolar affective disorder with psychotic featurespsychotic relapsemedication non-compliance
Contributing factors
non-compliance with antipsychotic medication (risperidone)
deterioration in mental state during weekend leave
possible medication non-compliance in days before death
patient's ability to mask symptoms effectively to family and clinicians
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