By Evan Schwarten
Staff at a Townsville mental health unit violated guidelines by injecting an agitated schizophrenic Aboriginal man with powerful antipsychotic drugs twice in 17 minutes, an inquest into his death has been told.
Lyji Vaggs, 27, died in the Townsville Hospital in April last year, two days after he stopped breathing while being restrained on the floor of the foyer of the mental health unit.
The inquest heard no psychiatrists or senior doctors were on duty when Mr Vaggs arrived at the unit on April 13 and it fell to junior doctors and interns to deal with him.
It also heard that after his death, staff at the unit complained to hospital bosses about a lack of supervision and training from senior doctors at the facility.
Dr Rene Cescon, an intern who had been working at the unit for only three weeks, said Mr Vaggs was agitated and aggressive when he arrived at the unit and refused to take sedatives or antipsychotics.
"He was agitated, he was combative, he was quite aggressive, he was screaming," he told the inquest in Townsville.
"He was yelling at the staff, he was dancing, he was pointing at people, calling them sorcerers, prime ministers, and (saying) that his arm was a magic wand."
Dr Cescon said more than six staff were involved in trying to restrain Mr Vaggs, and he ended up on the floor with people holding his limbs and at least one person sitting on top of him.
He said he tried to get hold of a psychiatrist but was unable to contact one.
"We needed help," he told the inquest.
Dr Cescon ordered Mr Vaggs be injected with the antipsychotic drug Olanzapine twice within 17 minutes, although he said the second dose was given in consultation with a more experienced, albeit still junior, doctor.
Under questioning from counsel assisting the coroner Jennifer Rosengren, Dr Cescon admitted the injections were "completely contrary" to hospital guidelines, under which a second dose should not have been administered until at least two hours later.
The inquest heard a nurse then injected Mr Vaggs with a sedative, although it was unclear who authorised the dose, which Dr Cescon also agreed was against hospital guidelines.
A few minutes later, Dr Cescon said staff tried to stand Mr Vaggs up but the patient collapsed and he and a colleague rushed to try to revive him.
He died in the hospital's intensive care unit.
Another junior doctor at the facility, Dr Elizabeth Nicholas, told the inquest the unit's roster meant psychiatrists and registrars were not on duty between 2.30pm and 10.30pm.
She said she had approached the unit's clinical director about her concerns at having to work unsupervised night shifts and was unhappy with his response.
After Mr Vaggs' death, she said the unit's junior doctors had taken their concerns directly to hospital bosses.