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Tragic Buncrana suicide recalled 30.09.08

Father-of-three took his own life as he awaited rehab, inquest hears

A CORONER has called for more "joined up thinking" between the hospital, primary healthcare and voluntary sectors in relation to alcoholic patients following the suicide earlier this year of a man in Buncrana.
Donegal coroner Dr John Madden made his comments on Friday at the inquest into the tragic death of Paudie Taylor, a 54-year old Dubliner who had lived for many years in the seaside town.
Mr Taylor, an alcoholic described as well-read and well-liked, was found with fatal stab wounds to his chest and cuts to his neck on January 24, 2008 in the Buncrana home of his friend, Don McNeill. Mr McNeill, a Newfoundlander, had invited the father-of-three to stay at his Pairc na hAluine home for support until he could be admitted for rehabilitation.
Mr McNeill described how he fled to neighbours in shock after discovering his friend's fully-clothed body in the kitchen of his home around 4.45pm on January 24. He described seeing one of his large chef's knives protruding from the dead man's chest with two large knives lying on a folded blood-soaked towel nearby.
The inquest in Carndonagh also heard about the events leading up to Mr Taylor's death starting on the night of Christmas Eve, 2007 when he was discovered shivering on Lisfannon beach by a search party including his son and friends. He later told his ex wife Miriam Killeney he had intended going into the sea. Ms Killeney testified how on Christmas Day she brought her ex partner to Letterkenny General Hospital's A&E unit. Later she spoke to the psychiatrist on call and outlined a previous Taylor-family suicide and the escalation of her ex-husband's drinking in the previous six months, during which he gave up his job as a taxi driver.
It was agreed that the patient would begin detox for a few days in the medical ward before being moved to the psychiatric ward. But on December 28, the hospital discharged him. Following an urgent request from the family he was transferred to the hospital's psychiatric unit where he remained for ten days before discharging himself. Ms Killeney said during his time in the unit, a doctor told him that if he continued to drink he would develop early Alzheimer's and brain damage. She said he became “fixated on the possibility that this had already happened. The late Paudie Taylor.
In a lengthy deposition, his wife outlined how she took him to White Oaks Rehabilitation Centre in Muff for a one-hour screening interview on January 15. He was told he would be admitted the following week but when he arrived on January 23, the centre said he could not be admitted because he was hearing voices and was on Xanax, a drug not acceptable to the centre's policy. They were "shocked" and following a visit to his GP, Dr Seamus O Domhnaill, the patient was prescribed Librium. But this too was unacceptable to the White Oaks programme, the inquest was told. Ms Killeney was then advised to return to his GP and seek a change of prescription and a referral letter for Paudie to be assessed the following day when the psychiatrist visited Buncrana. She said while her husband was in withdrawal awaiting addiction support, he remained remorseful, agitated, was having hallucinations and thought he was "losing his mind". Ms Killeney was told that on the basis that his medication got sorted, he could be readmitted to White Oaks in a "couple of weeks". The night before he died, she and their youngest son visited him as he prepared to light a fire and watch a Western on TV before attending an AA meeting at 8.30pm. He agreed he would keep the appointments she arranged for him with the psychiatrist and addiction counsellor the following day. It was the last time they saw him alive.
Ms Killeney, a social worker with the HSE, said the family would like to know if Paudie would still be alive if there had been a "shared and accepted policy" between his GP, White Oaks and the HSE in relation to his medication and the community care response to patients between screening and admission to treatment programmes. A visibly upset Dr O Domhnaill, a personal friend of the deceased, admitted that Paudie had been let down by the current system. He said the health agencies needed to be "more streamlined" in relation to patients with addiction problems. The jury returned a verdict of death by suicide in line with the medical evidence including that contained in a nine-page report from State Pathologist Dr Marie Cassidy. Her report stated that the large knife had penetrated the victim’s heart and that this was the cause of death. She found no defensive wounds and concluded that the injuries were self-inflicted. Dr Madden said he would send all the depositions to the HSE in the hope that such a “horrible” tragedy could be prevented in future. He said if health professionals such as Ms Killeney and Dr O Domhnaill could “not work the system” there was “no hope for the rest of us”.
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