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Guilty plea over hanged patient Guilty plea over hanged patient
(20 minutes later)
A health board has admitted breaching health and safety laws following the death of a mental health patient who hanged herself in a hospital.A health board has admitted breaching health and safety laws following the death of a mental health patient who hanged herself in a hospital.
Sylvan Money, 26, from Presteigne, Powys, had been on suicide watch when she died using a nightgown cord at Bronllys hospital near Brecon in 2004.Sylvan Money, 26, from Presteigne, Powys, had been on suicide watch when she died using a nightgown cord at Bronllys hospital near Brecon in 2004.
Powys Local Health Board (LHB) was accused of of failing to ensure she was not exposed to risks to her health.Powys Local Health Board (LHB) was accused of of failing to ensure she was not exposed to risks to her health.
It will be sentenced on 18 September by Merthyr Crown Court.It will be sentenced on 18 September by Merthyr Crown Court.
Richard Tyrrell, representing Powys Local Health Board (LHB), pleaded guilty on its behalf before Llandrindod Wells magistrates..Richard Tyrrell, representing Powys Local Health Board (LHB), pleaded guilty on its behalf before Llandrindod Wells magistrates..
A maximum fine of £20,000 could be imposed when the case goes to crown court.A maximum fine of £20,000 could be imposed when the case goes to crown court.
The LHB has already agreed to pay £40,000 towards the cost of the Health and Safety Executive (HSE) investigation and court costs.The LHB has already agreed to pay £40,000 towards the cost of the Health and Safety Executive (HSE) investigation and court costs.
The prosecution, which was brought under the Health and Safety at Work Act, accused the LHB of failing to ensure that Ms Money was not exposed to risks to her health.The prosecution, which was brought under the Health and Safety at Work Act, accused the LHB of failing to ensure that Ms Money was not exposed to risks to her health.
Nightgown cord 'Vulnerable young woman'
The court heard she was admitted to the mental health unit of Bronllys Hospital in January 2004 after she used her nightgown cord to hang herself on a curtain rail.The court heard she was admitted to the mental health unit of Bronllys Hospital in January 2004 after she used her nightgown cord to hang herself on a curtain rail.
The LHB admitted failing to provide a safe environment and failing to act on warnings about the risks.The LHB admitted failing to provide a safe environment and failing to act on warnings about the risks.
A coroner at the 2006 inquest into Ms Money's death found 36 errors had contributed to her death.A coroner at the 2006 inquest into Ms Money's death found 36 errors had contributed to her death.
Geraint Williams recorded a narrative verdict contributed to by neglect.Geraint Williams recorded a narrative verdict contributed to by neglect.
This hearing was told that Ms Money was on 15-minute suicide watch when she was first admitted to hospital, but was downgraded to half-hourly checks within days.This hearing was told that Ms Money was on 15-minute suicide watch when she was first admitted to hospital, but was downgraded to half-hourly checks within days.
At the time of her death she was not checked for more than an hour following a breakdown in the rota system.At the time of her death she was not checked for more than an hour following a breakdown in the rota system.
Four members of staff at the psychiatric unit were sacked after she died.Four members of staff at the psychiatric unit were sacked after she died.
The failure for which the HSE prosecuted the health board was the presence of ligature points in the psychiatric unit at the time of Ms Money's death.
Dale Collins, prosecuting, told the court this was despite a risk assessment carried out three years earlier in 2001 which identified a "high likelihood of injury to patients" through such ligature points.
The solicitor said the risk assessment concluded that existing controls at the hospital were "not acceptable" and recommended the replacement of the ligature points with "less hazardous alternatives".
Mr Collins said that before Ms Money died, the LHB failed to ensure the identified actions of the risk assessment were undertaken.
He added they failed to make sure the results of the risk assessment were circulated to the staff who had day-to-day control of the wards, and failed to ensure hazardous notices were distributed.
Mr Collins said the case involved "the death of a vulnerable young woman in a perceived place of safety".