HSE apologises to woman whose son killed her partner after being discharged

High Court reporters

The HSE has apologised to the family of a man who stabbed his mother’s partner to death two weeks after he was discharged from a hospital emergency department.

Fiona Nolan had brought her 19-year-old son Adam to the emergency department of Tallaght University Hospital because he was unwell and had psychotic thoughts about killing her partner of 10 years Bryan Cassidy.

It was claimed that Ms Nolan was advised these were irrational thoughts and Adam should see a counsellor. It was alleged that Adam was discharged without further follow up.

The family’s counsel, Dr John O’Mahony SC, told the High Court that there was no proper examination and no history taken while Adam was in the emergency department, and his mother was told he should go to counselling.

“Two weeks later Fiona Nolan came home to her partner in the garden and he was pumping blood. He had been stabbed in the eye and six times in the abdomen,” Dr O'Mahony said.

Dr O’Mahony said it ought to have been clear in the hospital that the 19-year-old student was suffering from a psychosis, which was unrelated to any mediction. This “was the fundamental flaw,” Dr O'Mahony said.

Adam Nolan, of Buirg an Ri Walk, Balgaddy, Lucan, was later found not guilty by reason of insanity of the murder of 52-year-old Bryan Cassidy, of the same address, on February 7th, 2018.

Dr O’Mahony read a letter of apology from the HSE to the court.

The apology was read out as Adam Nolan’s mother, Fiona, settled for €150,000 her High Court nervous shock action over the death of her partner Bryan Cassidy.

It read: “On behalf of the HSE, I wish to unreservedly apologise to you for the deficits in the care given to your son Adam Nolan by HSE psychiatric services at Tallaght University Hospital on January 25th, 2018, and for the distress and the grief caused to you by the said deficits in care.”

The letter from Orlagh Claffey Integrated Health Area manager Dublin South West also said the HSE had “reviewed this tragic event and has implemented key learning.”.

It concluded: “I would like to offer my sincere condolences for the distress and grief suffered by you due to the deficits in your son’s care.”

Fiona Nolan (53), of Buirg an Ri Walk, Balgaddy, Lucan, Dublin, had sued the HSE and Tallaght University Hospital.

On January 24, 2018, Ms Nolan brought her son Adam Nolan to the emergency department of the hospital when, it was claimed, he was suffering from and exhibiting paranoid, violent and psychotic thoughts and behaviour, including thoughts about him killing Ms Nolan’s partner Bryan Cassidy or someone else.

It was claimed that Ms Nolan was advised that these were irrational thoughts and Adam should see a counsellor.  Adam was allegedly discharged without further follow up.

He then allegedly continued to suffer severe psychotic thoughts and behaviour and on February 7th, 2018, he killed Mr Cassidy.

In the proceedings it was claimed there was a failure to admit Adam into the hospital on January 24th/25th, 2018, and a failure to diagnose that the symptoms from which he was suffering and describing were acute psychotic symptoms indicative of probable paranoid schizophrenia.

It was further claimed there was a failure to have any or any sufficient regard for the potential risks in failing to admit and detain Adam who had described clear murderous intentions.

Having noted within the emergency department that Adam was expressing a desire to kill people and specifically Mr Cassidy with a kitchen knife, it was claimed there was a failure to take any proper action so as to prevent the killing from occurring by either admitting Adam to hospital immediately, or sedating him or referring him immediately to an urgent care psychiatric unit.

A breach of duty of care was admitted in the case.

Noting the settlement, Mr Justice Paul Coffey said it was a very sad and tragic case.