A psychiatric patient (30) was left in A&E, awaiting admission, for nearly four hours before he absconded and jumped into the canal, an inquiry into his death heard.

The man’s family had called ahead, and were assured that a team would be waiting for him when they arrived at 3pm on January 4 last.

However, they claimed that apart from an initial assessment by a triage nurse, he received no medication nor care before he left the hospital at 6.45pm.

His wife told the inquest at Galway Courthouse that they were at home with their two children when he began to feel unwell.

“He said he was going back to a paranoid stage,” she recalled.

He knew he needed to be admitted to the psychiatric unit of UHG, where he had been both a voluntary and involuntary in-patient on five occasions in the previous two years.

She rang his care worker, a psychiatric nurse, who said she was not working herself but would ring the hospital to ensure that a team would be waiting for him. She rang back to confirm that this had been done.

The couple arrived at UHG at 3pm, and were required to check-in at A&E, as is the protocol for psychiatric patients. Apart from a 15-20 minute assessment by a triage nurse, he received no medical attention.

“Twice I communicated to the staff about his mental state, the first time they said that someone would be there at 6pm,” his wife recalled.

“At 6.45pm I said it again, and was told the same thing… I’d never seen him that agitated.”

Her husband had last taken his medication at 11.30am that morning, and although his demeanour at the hospital was anxious and agitated, he was administered nothing else during his four-hour stay.

Just before 7pm his wife decided to take him outside for some fresh air. He walked with her to the door, but then said “I can’t be here anymore” and ran off through the car park.

She rang his brother, who immediately made his way into the city centre, hoping to intercept him.

He told the inquiry that he had passed the Cathedral when he saw the lights of emergency services at the canal, and he feared that his brother had been hurt.

Three people were walking together across the bridge near Ward’s Shop on University Road when they heard a splash.

“He seemed to have come from the hospital direction, then stood on the bridge and jumped off,” one of them said.

“He was face down, he wasn’t struggling. We thought he was still alive, as there were air bubbles and some movement.”

He tried to free the nearby life buoy, but was unable to do so. He wanted to jump into the water, but his friends told him not to as it was too cold and the banks were too high to haul him out.

They rang the emergency services at 6.52pm, and the Gardaí were on the scene within 10 minutes. Garda Amanda Brandley said that the man’s body had been carried downstream. It took 12 minutes to pull him ashore and, when he was recovered, he was immediately identifiable by a wristband from UHG.

CRP was commenced, and a cardiac rhythm was established. He did not regain consciousness, however, and died in ICU on January 13.

At the inquiry on Thursday, the man’s family expressed dissatisfaction at the lack of care he had received when they arrived at A&E on January 4. They did not wish to conclude the Inquest until statements were made at an adjourned date by his consultant psychiatrist, his case worker, and the psychiatrist who was on call that day.

Coroner for West Galway, Dr Ciaran MacLoughlin, agreed to call these witnesses, but he also returned a verdict so that the man’s wife could obtain a death certificate, and thereby a widow’s pension.

He found that death was caused by hypoxic ischemic encephalopathy due to drowning.

“When he was in the water, his brain was deprived of air and oxygen, which caused irreversible brain damage, from which he did not recover,” he explained to the man’s family.

The matter was put back until a date in September.