Prisoner not assessed as a suicide risk despite previous incident of self harm, inquest hears

A prison nurse has told an inquest that she did not believe a 29-year-old man was a suicide risk even though she was aware he had tried to kill himself two years earlier.

Anna Lyons told the inquest into the death of Andrew Gearns that he told her that he had no suicide ideation and had twice guaranteed he would not self-harm when she interviewed him on his committal to Cork Prison on September 22nd, 2020.

“When I spoke to Andrew in 2020, he denied any suicide ideation, any plan to harm himself and he guaranteed his safety to me,” Ms Lyons told the inquest at Cork City Coroner’s Court into the death of the father of two who was found unresponsive on September 28th, 2020.

Mr Gearns from Model Farm Road in Bishopstown was treated by prison medical staff before he was taken by ambulance to Cork University Hospital. He spent over a week in intensive care before dying on October 7th, 2020.

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The inquest heard how Mr Gearns’ mother, Aideen told gardaí her son was in “a bad place” when they arrested him on a warrant on September 22nd. The hearing heard he became addicted to drugs when was prescribed benzodiazepines for back pain following an accident in 2016

Ms Lyons told Cork City Coroner, Philip Comyn and a jury how she went out to assess Mr Gearns in a garda van at the main gates of the prison as Covid-19 restrictions prevented medical staff assessing new committals in the surgery where she would have access to computer records.

She explained that up to 2019, all new committal prisoners were placed in special observation cells where they were checked by prison officers every 15 minutes, and they would remain in such cells until they were seen by a GP, but that policy changed in 2019 because of the pandemic.

Quarantine

She said she recommended that Mr Gearns be accommodated in a double cell on the normal landing, where inmates were not subject to as many checks as those deemed at risk. Mr Gearns was put in the cell on his own because he had to quarantine until prison staff were satisfied that he did not have Covid-19

Ms Lyons said that when she checked on the Prison Health Management System, she noted and recalled she had carried out a previous committal assessment on him in 2018 in which he told her he had suicidal thoughts and revealed he had tried to kill himself two days earlier in a Garda station.

Questioned by counsel for the Gearns family, Elizabeth O’Connell SC, Ms Lyons agreed a previous history of psychiatric difficulties could be a factor in assessing a patient for suicide risk but on this occasion in 2020, Mr Gearns presented in such a manner she did not believe he would self-harm.

“If I felt someone was a suicide risk and not guaranteeing their safety at the committal interview, I would place them on special obs (observations) and I would inform the medical officer – I do not decide what cell they go into unless I am putting them in special obs,” she said.

“He did not appear agitated or anxious, he did not appear distressed in any way that alerted me that he might be a suicide risk …. He guaranteed his safety to me on two occasions during the interview so I had to go on the basis of what he told me – that he had no suicide ideation,” she said.

Ms O’Connell asked Ms Lyons if she was aware that the Irish Prison Services identifies factors such as being male, unemployed, having a low level of education and a history of mental health issues and substance abuse were all factors that increase the risk of self-harm.

Ms Lyons said that she had not asked Mr Gearns at the committal interview if he was unemployed or what level of education he had attained as she was simply asking medical questions and on the basis of his answers and how he presented, she believed he was not at risk of self-harm.

She said Mr Gearns did not disclose his history of drug treatment, though he did tell her he had smoked heroin earlier that day and that he was buying methadone on the street. She did not think he had withdrawals symptoms.

The inquest heard that the following day that Mr Gearns, who said he was on Anxicalm and Halcion, was assessed by a GP in the prison and prescribed Seroquel, which Ms O’Connell described as an anti-psychotic. Ms Lyons said could also be prescribed to help people sleep.

Hallucinating

Ms Lyons said that Mr Gearns reported a week later on September 27th that he had been attacked the previous night in Blackpool and had been stabbed and slashed. He asked for a GP to examine his wounds but there were no wounds on his abdomen, and it was concluded he was hallucinating.

She said she reassured him he had not been attacked as he was oriented as to time and place and knew he was in Cork Prison so she scheduled for him to see a GP the following day and to see a psychiatrist at the next available opportunity on September 29th.

Prison officer Anthony O’Brien told the inquest he checked on Mr Gearns at about 4.30pm on September 28th when he lifted the observation flap on his cell door and saw that he was walking about the cell and did not look distressed or in any need of medical intervention.

However, fellow prison officer Paul Cleary said that when he checked on Mr Gearns at around midday that day and entered the cell in PPE gear, Mr Gearns said “I do not want to fight, I do not want to fight anymore” and he told him there were people at the window wanting to fight him.

Mr Cleary said that he later checked on Mr Gearns in the afternoon and asked him why he hadn’t eaten his dinner and Mr Gearns replied “How can I eat it when my jaw is broken in five places?”. He contacted one of the nurses and asked them to speak with Mr Gearns.

He said that he again went to check on Mr Gearns at 4.50pm and he lifted the observation flap and although the cell was dark, he could see that Mr Gearns was unconscious so he entered the cell and radioed for help as colleagues raced to assist him treat Mr Gearns.

Mr Cleary said that throughout his interaction with Mr Gearns on the day in question, it appeared to him that “he was suffering from withdrawal symptoms, but he never appeared a threat to himself for anyone else”.

The inquest continues on Thursday.