Courier Mail, The (Brisbane), 04/09/2002, pg. 10

A MENTAL health nurse who was told that one of his clients was drinking excessive amounts of liquid did not alert a doctor because the nurse did not believe the claims, an inquest has heard.

The nurse, Jonathon Smith, was giving evidence at the inquest into the deaths of two Toowoomba boarding house residents who died in November 2000 and January 2001.

One of the Ranleigh boarding house residents, Terrence Carty, 43, died of sodium deficiency from drinking too much coffee and orange juice.

Mr Smith said staff at the boarding house had told him on at least two occasions that Carty was drinking excessive amounts of coffee, orange juice and water in the weeks before his death.

“I asked (Terry Carty) if he had been drinking excessive fluids and he denied it,” Mr Smith said.

Mr Smith said he did not believe what the staff had said because he thought they were misinterpreting Carty’s behaviour and he didn’t see any signs of bloating, poor memory or lack of co-ordination.

But if he had known Carty had not been a heavy drinker of coffee he would have been more concerned.

Mr Smith said he did not record staff complaints to him nor ask the staff or other residents to observe Carty’s behaviour because he did not think they would be able to gather reliable information.

Mr Smith said he did not report back to boarding house staff who had raised concerns because he did not believe their concerns were important. “I would communicate it to his treating doctor, not to the cook,” he said.

Carty, who had severe schizophrenia and was being treated with the antipsychotic drug Clozapine, was found dead on November 25, 2000.
The inquest was told Clozapine has been linked with several sudden deaths and patients were monitored with tests for heart conditions and lowered immunity.

Dr Frances Mulholland gave evidence that she had not been told about Carty’s excessive fluid intake and if she had she said she would not have been concerned.

“What is presenting here is a typical response to Clozapine of a person with severe schizophrenia,” she said.

She said a person would have to drink 15 to 20 litres of fluid a day to trigger acute hyponeutremia which in this case had led to heart failure and a venous back-flow of blood into the lungs, brain
and liver, causing death.

The coronial inquest is also inquiring into the death of a second resident of Ranleigh boarding house, John Joseph Jeffery, 52, who died in January 2001, of an overdose of prescription drugs.

The inquest continues.

Copyright 2002 / Courier Mail