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Cardiff hit-and-runs 'could not have been prevented' Cardiff hit-and-runs 'would have been difficult to prevent'
(about 2 hours later)
A series of hit-and-runs in Cardiff which killed a mother and injured 20 others could not have been prevented, a report finds. A series of hit-and-runs in Cardiff which killed a mother and injured 20 others would have been difficult to prevent, a report finds.
Matthew Tvrdon, 33, was psychotic and hallucinating when he went on a "journey of mayhem" on 19 October 2012, at five locations.Matthew Tvrdon, 33, was psychotic and hallucinating when he went on a "journey of mayhem" on 19 October 2012, at five locations.
He had stopped taking his medication, Health Inspectorate Wales (HIW) said.He had stopped taking his medication, Health Inspectorate Wales (HIW) said.
It identified shortcomings in his care and a lack of monitoring of his condition.It identified shortcomings in his care and a lack of monitoring of his condition.
Ms Menzies, 32, from the Ely area, was struck while walking with two of her children outside Ely fire station. She pushed them out of the way before the van hit her. Karina Menzies, 32, from the Ely area, was struck while walking with two of her children outside Ely fire station. She pushed them out of the way before the van driven by Tvrdon hit her.
Tvrdon later admitted her manslaughter on the grounds of diminished responsibility.Tvrdon later admitted her manslaughter on the grounds of diminished responsibility.
He also pleaded guilty to seven counts of attempted murder and other charges including three counts of grievous bodily harm with intent during the incident which took place over eight miles of the city as parents were on the school run.He also pleaded guilty to seven counts of attempted murder and other charges including three counts of grievous bodily harm with intent during the incident which took place over eight miles of the city as parents were on the school run.
On Thursday a report by HIW said that given the circumstances ,it was difficult to see how Ms Menzies' death could have been prevented. On Thursday a report by HIW said that given the circumstances, it was difficult to see how Ms Menzies' death could have been prevented and it could not have been predicted.
"Whilst evidence reviewed indicates that a relapse of his psychosis could have been predicted following cessation of medication, and was indeed recognised to be a risk by the clinical staff, the subsequent homicide could not have been predicted," the report said. The review said Tvrdon came from a stable and "very caring" family from Roath in Cardiff and only developed behavioural concerns while at university in 2002. He was forced to drop out and in 2003 was sectioned at Whitchurch Hospital, Cardiff.
It said mental health teams and GPs did not monitor Tvrdon's condition fully, particularly after he was sectioned under the Mental Health Act, and subsequently discharged, in 2007. It said he was psychotic and was under the care of Cardiff and Vale University Health Board from 2003 until 2012.
Despite the report's conclusion, Ms Menzies' sister Samantha believes more could have been done to prevent the incident. During that time he was sectioned in hospital four time, the final time in 2007, but he had never made any threats against members of the public.
The report said Tvrdon appeared to be "well and in the phase of recovery" and was working full time at Her Majesty's Revenue and Customs (HMRC) when he was seen for what was to be the final time by a consultant psychiatrist in October 2011 - a year before the tragedy.
He was advised to continue to take his medication for another year before gradually cutting it down until he stopped.
But it later emerged Tvrdon had stopped taking his medication almost immediately and had not been seen by any mental health services in the year before he went on the rampage in Cardiff.
The report said he had a history of not taking his medication and was reluctant to work with mental health services because he felt there was the stigma attached to it.
It said that when he did take his medication, he responded well and was able to have normal relationships and a job - but a relapse was likely if he stopped.
However, the severity of his condition was not properly communicated with his GP surgery, the report found.
It also said mental health teams and GPs did not monitor Tvrdon's condition fully, particularly after he was sectioned and subsequently discharged in 2007.
The report made eight recommendations, including:
Despite the report's conclusion, Ms Menzies' sister Samantha said she believed more could have been done to prevent the incident.
She said the family and Tvrdon were let down by mental health services who should have done more to manage his condition.She said the family and Tvrdon were let down by mental health services who should have done more to manage his condition.
The report recommended: "The report shows the consistency between him not taking medication and him relapsing," she said.
The review said Tvrdon came from a stable and "very caring" family and only developed behavioural concerns while at university in 2002. He was forced to drop out and in 2003 he was sectioned at Whitchurch Hospital, Cardiff. "If this was monitored I truly believe that he wouldn't have done it."
The report said Tvrdon, who was under the care of Cardiff and Vale health board from 2003 until 2012, was psychotic and misusing substances.
Mental health teams said he was difficult to engage with, lacked "insight" into his condition and was reluctant to take his medication especially when he was "acutely unwell".
Tvrdon had a "serious episode" in April 2007 and was sectioned three times in the same year. However, he was later "successfully" treated, the report said.
In total he was sectioned four times, and repeatedly had issues with taking his medication because he felt his condition stigmatised him.
He had not been taking his medication in the year before the hit-and-runs.
"It is clear that at the time (Tvrdon) had tragically killed (Ms Menzies), and injured 20 other individuals, his mental health had deteriorated significantly," the report said.
"The history of (Tvrdon's) contact with mental health services indicated that a relapse of his condition was likely should he stop taking his medication."
It was said Tvrdon would have benefited from having an assigned care coordinator to help build a better relationship between him and the mental health services available.
That person would also have been better placed to monitor whether he took his medication.
The agencies involved have accepted the report's recommendations.The agencies involved have accepted the report's recommendations.
Adam Cairns, chief executive of the health board, said: "While the review has acknowledged that it was difficult to see how this tragedy could have been prevented we do accept that, with hindsight, there were things that all agencies involved could have done better."Adam Cairns, chief executive of the health board, said: "While the review has acknowledged that it was difficult to see how this tragedy could have been prevented we do accept that, with hindsight, there were things that all agencies involved could have done better."