Coroner rules death of COVID-19 patient a suicide, notes increased welfare measures by hospital

SINGAPORE: The state coroner on Friday (Sep 25) ruled the death of a COVID-19 patient, who was found on the third floor of Khoo Teck Puat Hospital in April, a deliberate act of suicide.

In her findings, the coroner also noted the increased measures taken by the hospital for the welfare of foreign patients.

Indian construction worker Alagu Periyakaruppan was found lying motionless on an open-air staircase landing on the third floor of the hospital on Apr 23, after he went missing from his ward on the seventh floor.

The 46-year-old man was admitted to hospital on Apr 19 with complaints of fever and later diagnosed with COVID-19. He shared a ward with another COVID-19 patient and had no complaints during his stay other than a mild headache on Apr 21, which was resolved with paracetamol.

His attending consultant spoke to him in Tamil, and while Mr Periyakaruppan expressed concerns about his children in India and his financial position, he did not voice any suicidal intentions, said State Coroner Kamala Ponnampalam.

Mr Periyakaruppan's nephew, who worked under the same employer and lived in the same dormitory, said he was not aware of any personal troubles his uncle had.

However, he said that on Apr 21, Mr Periyakaruppan asked him to help take care of his family and to ensure that his children received a good education.

His nephew felt something was amiss as his uncle had never spoken about such matters before. But the older man did not say more when probed, except that everything would be alright and he would recover soon.

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On the morning of Apr 23, a staff nurse preparing for her rounds heard a thud from inside Mr Periyakaruppan's ward. She discovered he was missing and a window pane next to his bed had been removed and placed on the floor.

A search for him uncovered his body on the third-floor staircase below his window. Attempts at resuscitating him failed and he was declared dead at 7.15am. His cause of death was certified as multiple injuries consistent with a fall from height.

Investigators found two video clips in his phone, which he had filmed of himself in the ward toilet at about 5.30am that day. He said in one of the videos he did not want to live after the doctors told him he had the coronavirus.

The police concluded he had likely used a metal hook to dislodge the window pane and create a gap large enough to fit through.

READ: COVID 19: No spike in number of migrant worker suicides, says MOM

After the incident, Khoo Teck Puat Hospital formed a work group to review what had happened and introduced additional measures for foreign patients with COVID-19.

ADDITIONAL MEASURES BY HOSPITAL

The hospital noted that many such patients did not have a good understanding of COVID-19, and additional resources were provided for them such as video recordings about the disease. A voluntary welfare organisation that cared for foreign workers was also engaged.

The hospital focused particularly on minimising the patients' sense of isolation. The chairman of the hospital group said that even though so many people were involved and sick, the experience was one that could make the patients feel frightened and alone.

Another step was to ensure the patients stayed connected, helping them link to Wi-Fi and top up their phone cards. The nurses also identified themselves, wearing name tags and making a point to connect with the patients.

To tackle misconceptions of COVID-19, the hospital prepared videos and print-outs in the patients' native languages.

There were no lapses in Mr Periyakaruppan's clinical care, and the incident was not predictable nor preventable, a hospital review found.

The coroner ruled the death as a deliberate act of suicide, acknowledging that assessment of suicide risk is extremely difficult. She said it would be "a matter of speculation" as to whether the outcome would have been different if Mr Periyakaruppan did not have the silver hook, whose origin was not identified.

She conveyed her condolences to Mr Periyakaruppan's family for their loss.

Where to get help: Samaritans of Singapore operates a 24-hour hotline at 1800 221 4444, or you can email pat [at] sos.org.sg. If someone you know is at immediate risk, call 24-hour emergency medical services.

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