Mum ‘medically cleared’ to leave hospital, inquest hears
A LISMORE Base Hospital doctor has explained the reasoning behind the decision to discharge Carley Metcalfe, who was found dead in the Brunswick River three weeks after she left hospital.
Doctor Alexander Pullen, a consultant who works in the LBH emergency department, told the inquest into Carley's death about the events of November 1 and 2, 2017, when Carley was in hospital seeking treatment.
She had been brought to hospital by ambulance after she was found to be disorientated outside of Lismore Courthouse.
Carley was admitted into the emergency department in the afternoon of November 1 before being medically cleared by ED staff.
"The conclusion had been drawn there was no medical reason this patient needed to be kept in hospital," Dr Pullen told the inquest at Ballina Court.
The inquest heard that Carley was also assessed by the on-call psychiatric registrar Dr Robert Byrne, who assessed she was not showing any signs of psychosis.
But Dr Pullen said he was left feeling uncertain about Carley's care plan because Dr Byrne had indicated he would support a further mental health assessment on November 2 but did not require her to be admitted to the mental health ward.
"I was unhappy because of the lack of clarity for the actual plan for this patient, specifically what I was handing over to the night team in case she tried to leave," Dr Pullen said.
"We needed to know if she was to be admitted under the mental health act or if she could leave.
"Dr Byrne could not give me a confident plan and failed to do so.
"They were happy to review the patient if they were still in the ED the next day.
"I asked if she could be discharged at 9pm and they said yes."
The inquest heard that Carley, while technically medically allowed to be discharged, continued to stay overnight in the emergency ward before leaving after 6am on November 2.
"It would be generally bad practice to allow an isolated female leave the hospital and wander around town in Lismore, which is not a safe town," Dr Pullen said.
"She had been cleared by mental health, we had not right to detain her if she wished to leave."
The inquest will resume at 10am Thursday.