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SINGAPORE: After a patient from the Institute of Mental Health (IMH) splashed urine on his colleague, a nurse sprayed hand sanitizer on the vulnerable victim’s face, before striking him during a riot in the dayroom.
Muhammad Ihsan Mahmud, 32, was sentenced to nine weeks in jail on Monday (January 18) on one count each of willfully causing harm to a vulnerable victim and using criminal force against him. A third charge was considered in the sentence.
The court heard that the Malaysian national started working at IMH in April 2016 and was a staff nurse at the time of the incident on December 8, 2019.
Ihsan was on the morning shift with two colleagues that day: 60-year-old health aide Sadasivam Kannan and 24-year-old staff nurse Iylia Muhammad Afiq Nor Effendi.
The IMH patients, including the victim, a long-term patient at IMH since 2005 who suffers from schizophrenia, were scheduled to have their hair cut that morning. At approximately 10:30 a.m., the victim was taken to the day salon after his haircut.
In the living room, he was playing with another patient’s urine container before splashing some urine to a attending nurse, who told Ihsan what happened before going to take a shower.
After hearing what had happened, Ihsan approached the 58-year-old victim and sprayed hand sanitizer on his face while the latter was immobilized in a wheelchair.
The victim raised her arms to protect her face and then wiped off the liquid with her shorts. After this, he picked up the trash from the ground while Ihsan attended to other patients.
A few minutes later, Ihsan walked past the victim and sprayed hand sanitizer on his face, catching him off guard. The victim was unable to protect his face in time and rubbed his eyes as Ihsan walked away to continue with his tasks.
A few minutes later, while securing the restraints for another patient, Ihsan attempted to hit the victim with his elbow, but the latter dodged the blow.
He later sprayed the victim’s face with hand sanitizer for the third time for no apparent reason, with the intention of annoying him. After this, the victim began to create a disturbance in the day room.
Ihsan, Kannan, and Iylia tried to convert the victim’s one-point restriction to a three-point one, but this agitated the victim.
Ihsan struck the victim twice in the eye region before continuing to secure his restraints. The victim remained aggressive and began kicking the nurses, but was eventually subdued after the three men restrained him.
Ihsan kicked the victim while his colleague fixed the restraints around his forearms. His actions were captured on closed-circuit television footage, and Mr. Iylia later discovered bruises around the victim’s right eye.
He administered an ice pack to the victim, while Ihsan reported the injuries to IMH management, prompting IMH to file a police report.
READ: Former IMH nurse is imprisoned and punished for sexual crimes against patients and former colleagues
The victim was taken to Singapore General Hospital with bruises on his face and a broken toe.
Assistant District Attorney Phoebe Tan asked for 10 weeks in jail, saying that Ihsan had violated the trust and duty of care owed to the victim, who was vulnerable due to her psychiatric condition.
Ihsan’s actions also undermine public confidence in the administration of health services in Singapore, he said.
Although he pleaded guilty, all of his actions were captured on CCTV footage, he noted.
DO NOT EXPECT THIS TO HAPPEN: ACCUSED
In mitigation, Ihsan said that he worked as a nurse to earn a living and support his family in Malaysia and did not expect this to happen.
“I don’t want to create any problems while working here,” she said through an interpreter, adding that she has three children, one of whom is a child with special needs.
“My wife has been suffering from depression after the birth of my daughter and her condition is getting worse,” he said. “Since January 8, 2020, I have been unemployed and I am grateful for my friend who has been helping me with my needs and also giving me shelter.”
He apologized and asked for leniency, saying his family was alone as his father-in-law was protected from heart complications and his father was unwell in Penang.
The judge said that nothing in his family situation justifies a lesser sentence, agreeing that the public concern caused was an aggravating factor. However, it gave some weight to the fact that Ihsan reported the victim’s injuries.
For willfully causing harm, Ihsan could have been jailed for up to two years, fined up to S $ 5,000, or both. For using criminal force, he could have been jailed for up to three months, fined up to S $ 1,500, or both.
As the victim was vulnerable and unable to protect herself from abuse due to her mental illness, the maximum penalties for both offenses could have been increased up to one and a half times.
PATIENT SAFETY IS THE TOP PRIORITY: IMH
IMH said in a statement late Monday that it has safety measures and procedures in place to ensure patients recover in a safe environment. Any unexplained injuries are also “thoroughly investigated.”
The rooms are equipped with CCTV cameras and staff members work in teams. These staff members are trained to observe and monitor the patients in their care for any changes in behavior and to be on the lookout for any injuries, as patients can sometimes fall or be injured, IMH said.
Following the incident, IMH said it further reinforced its culture of accountability and reporting to staff members so that steps can be taken to address them early.
More frequent reviews were also conducted to discuss difficult cases in the courtroom. Additionally, members of the nursing administration staff join the ward nurses and patients at their weekly community meetings to understand issues and hear patient feedback directly.
IMH said it apologized to the affected patient and his family after the incident and “provided support.” The patient has also recovered from his bruises and is still being treated at the IMH for his mental health.
Two other staff members were also investigated in connection with this incident, IMH said. The outcome of these investigations is still pending. These staff members are no longer employees of IMH.
“IMH would like to reiterate that the safety and well-being of the patient is a top priority at the hospital. We will not tolerate any act of inappropriate behavior against patients. The perpetrators will be dealt with quickly and reported to the police, ”said the institute.
