REPORT OF AN INDEPENDENT INQUIRY ... - Hundred Families

20
10. The differential diagnoses for Chandran’s condition were hypomania, schizo-affective illness,
schizophrenic illness and drug abuse (although it seems that there was no evidence which was
sufficient to confirm the abuse of drugs). Having apparently initially been prescribed
Chlorpromazine on a p.r.n. basis, this prescription was changed to 150mgs orally q.d.s.. Dr Feldman
told the Inquiry she had no clear recollection of Chandran, that she had several Indian patients with
fathers and that she could not remember which couple this was. She added that it was “quite a
common scenario of fathers and sons who lived together and fighting”.
11. Chandran remained an in-patient at Goodmayes Hospital until 16th July 1991. On 29th January
1991, he smashed six windows in a television room at the hospital and was assessed and detained
for treatment under Section 3 of the Mental Health Act 1983. On assessment by an approved social
worker, Paul Mahoney, he was described as follows:-
“to be quite deluded in his conversation making very little sense. He repeated in various fashions
that he had discovered the invisible formula which was a cure for aids (sic), prevented glass from
smashing (!), helped him be a genetic engineer; gave him abnormal strength because he was
surrounded by a special magnetic force.
“Talked of the devil being after him and preserving eggs in the fridge. Wanted to be a great
scientist like Da Vinci and have the attributes of Sherlock Holmes. Claimed he could fly through
space though he hasn’t tried this yet.
“Chandran appeared co-operative in taking medication, but was very keen to go home saying he
missed his dad, regretted his behaviour, but he was not ill. Asked about the damage at home
including the destruction of the cooker and fridge, he said he connected all the wires up because
his powers make him resistant to electricity and pain.”
12. His diagnosis on discharge was bipolar affective disorder and hypomanic relapse. The following
description of his mental state and treatment is contained in the Part Two discharge summary dated
19th July 1991which was signed by Dr Levi, Dr Feldman’s then Registrar.
“At the beginning of February he was extremely disinhibited singing “rock and roll”, with the
grandiose delusion that he had the cure for AIDS, he was extremely restless, jumping round the
ward, dancing, and his mood was clearly elated. He exhibited mild pressure of speech and flight
of ideas. Initially he was tranquilised with Haloperidol 20mgs q.d.s. and Lorazepam 4mgs t.d.s.,
both via the intramuscular route, and then switching to the oral route, gradually reducing both
drugs and stopping them.
“Initially he was treated with the mood stabilizer Carbamazepine, but this was gradually phased
out and instead he was put on Lithium Carbonate since he did not appear to respond to
Carbamazepine. In addition he was switched from Haloperidol to Chlorpromazine because the
latter appeared more effective. The combination of Lithium Carbonate with gradually reducing
doses of Chlorpromazine appeared to be the holding combination for him with regard to
pharmacological therapy. Eventually he was established on Lithium Carbonate 800mgs nocte
and his Chlorpromazine was gradually phased out. Unfortunately he was given notice to quit his
flat while an inpatient and his accommodation is somewhat in the air.
“By the time of discharge he was free from any affective or psychotic symptoms and after periods
of gradually increasing leave he was very settled. “