The brother of a mentally-ill Suffolk man feared his sibling was “about to deteriorate into a crisis” in the days before his death, an inquest heard.
David Martin was found by a friend “foaming from the mouth and unresponsive” at his Ipswich flat on September 11, 2014 – four days after his 52nd birthday. The cause of death has been identified as pneumonia.
The inquest, which opened yesterday, heard David suffered from a range of mental and physical health issues throughout his adult life, including bipolar manic depression and schizo-affective disorder, as well as problems with drugs and alcohol.
His younger brother, Steve Martin, told the inquest his sibling’s condition had worsened over time, with every episode of mental ill-health “stripping away a little more reality” as he became increasingly delusional.
In a statement, read out by Suffolk Coroner Peter Dean, Steve said that although his brother “dearly loved those that were close to him” he was incapable of looking after himself.
After seeing his brother for the last time, four days before his death, Steve said he was “concerned” David’s mental health was “about to deteriorate into crisis”. He said his filthy flat was of particular concern, as this was often “the precursor to a mental health crisis”.
Steve has previously criticised the care his brother received from the Norfolk and Suffolk NHS Foundation Trust (NSFT). His statement to the inquest repeated concerns the NSFT had allowed his brother to live in cold, damp and squalid conditions, failed to ensure he was taking his medication, and did not take action when he was known to be using illicit drugs, namely amphetamines.
However NSFT staff involved in David’s care told yesterday’s inquest at The Coroner’s Court, Ipswich, that his condition was within “normal parameters” and did not warrant extra action.
Lee Peryer, David’s support worker, who last visited him three days before his death, said he “came away confident it was a routine visit”.
Although he noted David appeared to have taken amphetamines in recent days, saying his “conversation was wilder than usual”, he did not, and does not, believe that David was in a state of crisis.
Mr Peryer also acknowledged David’s flat looked “more dishevelled” after he had chosen to stop paying for a cleaner, but claimed it was usual for it to be untidy. He described the flat as “organised chaos” but said it was how David chose to live and should not be considered a reason to intervene. “There’s no doubt that David had significant long-term mental health problems, however it does not follow that individuals with mental health issues do not have the capacity to make decisions relating to their day to day life,” he added.
Psychiatric nurse Deogracias Lapena also claimed David’s condition was normal. He said: “During the time that I visited, there was no indication that his mental state warranted concern.”
He said David was taking his medication as prescribed, despite his brother claiming to have found “two shopping bags” filled with prescribed drugs, after his death.
David’s GP Lynne James gave the inquest details of his prescriptions as well as the physical and mental problems from which he suffered.
In addition to his psychiatric conditions, David suffered ongoing complications from a number of serious injuries, as well as issues related to his poor lifestyle, such as high cholesterol.
Dr Dean noted there was a “considerable raft” of health conditions.
Pathologist John Chapman highlighted several “significant findings” from his post-mortem investigation, which he said could be connected with poor diet, heavy drinking and drug-taking.
David’s heart was found to be almost twice its normal size and his liver was also enlarged and fatty. A toxicology test revealed high levels of amphetamine and codeine, though neither were considered to be fatal.
The most likely cause of death, Dr Chapman said, was pneumonia relating to a “very significant infection involving a lot of the lung tissue”.
When questioned as to the cause of pneumonia, Dr Chapman acknowledged it could have been related a cold, damp flat, but said it was more likely to be linked to David’s poor unhealthy lifestyle.
Dr Chapman said David would have been showing symptoms for “at least several days” but could not specify how many.
The inquest is set to continue today.