Inquest Finds 34-Year-Old Hugo Flint-Cahan Unlawfully Killed by Neglect at NHS Unit
Updated
Updated · bbc.co.uk · Sep 14
Inquest Finds 34-Year-Old Hugo Flint-Cahan Unlawfully Killed by Neglect at NHS Unit
1 articles · Updated · bbc.co.uk · Sep 14
Summary
Coroner Graeme Irvine ruled Hugo Flint-Cahan’s 2023 death at Newham Mental Health Centre was an unlawful killing contributed to by neglect, and urged regulators to review four staff members and police to revisit the case.
CCTV and inquest evidence showed two nurses were in staff areas, one nursing assistant slept for two hours, and ward records falsely logged Hugo as checked at 02:00 after he had likely already been attacked.
Hugo, 34, was strangled by fellow patient Rolando Torres-Pena, 22, who later admitted manslaughter on diminished responsibility grounds and received an indefinite hospital order.
The inquest heard Hugo was found at 03:19, but CPR did not begin until 03:45 after staff failed to raise the alarm promptly, with witnesses describing the emergency response as chaotic.
The ruling adds to at least 29 Prevention of Future Deaths notices sent to East London NHS Trust over 12 years, many warning about missed observations, falsified records and repeated safety failures.