Middlemore staff failed to ‘follow best practice’ in restraining mental health patient – inquest

The Tiaho Mai Acute Mental Health Inpatient Unit at Middlemore Hospital.
Photo: LDR / Life Network

Te Whatu Ora has published the findings of an internal investigation into the alleged assault of a patient by a member of staff at the Tiaho Mai Mental Health Unit at Middlemore Hospital last month.

The unit provides 24-hour treatment services to people with serious or complicated mental health issues.

The family of the 24-year-old patient from Tiaho Mai alleged that he was assaulted on October 22 after refusing to take medication and was later punched in the face and then kicked by a member of staff while he was on the ground.

His brother said he had bruises on his legs and ribs. The patient has bipolar disorder and was admitted to the unit a few days before the incident.

In two reports on the events, Te Whatu Ora Counties Manukau said that although the patient was not assaulted, staff did not follow proper procedures to restrain him.

“All staff are trained in the application of safety holds by working in a three-person team,” he said. “However, in this incident, two staff members were forced to apply safety holds without a third staff member in the room.”

The investigation found that this was a departure from best practice as a three person crew was not used to restrain the patient and the panic alarm system was activated to alert the other event staff.

“A team of three members of staff ensures that while the upper two members are held in a level four safety position by two members of staff on either side of the service user, the third member of staff supports the part upper shoulder, neck and face in case the service user is brought down to the ground, thus preventing head and face injuries.

“As the two staff members attempted to hold the patient’s arms, they all fell to the ground causing a minor injury to the patient’s inner lip. This injury was immediately reported and later examined by a house officer in the night.”

The patient was ‘re-examined’ the following morning by another member of staff who found no ‘signs of assault’ and no further medical diagnosis was requested.

Te Whatu Ora Counties Manukau said he was sorry the incident had “caused significant distress and concern” for the patient’s family.

The family has been approached for comment.

The incident is still the subject of a complaint to the Health and Disability Commissioner.

Local Democracy Reporting is public interest journalism funded by NZ On Air.

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