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SINGAPORE: On Friday (September 25) the state coroner 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 his findings, the coroner also noted the increase in measures taken by the hospital for the welfare of foreign patients.
Indian construction worker Alagu Periyakaruppan was found immobile on an outdoor staircase on the third floor of the hospital on April 23, after he disappeared from his ward on the seventh floor.
The 46-year-old man was admitted to hospital on April 19 with complaints of fever and was later diagnosed with COVID-19. He shared a room with another COVID-19 patient and had no complaints during his stay other than a mild headache on April 21, which was resolved with acetaminophen.
The counselor who treated him spoke to him in Tamil, and while Periyakaruppan expressed concern for his children in India and their financial situation, he did not express any suicidal intent, state coroner Kamala Ponnampalam said.
Mr. Periyakaruppan’s nephew, who worked for the same employer and lived in the same bedroom, said he was not aware of his uncle’s personal problems.
However, he said that on April 21, Mr. Periyakaruppan asked him to help him take care of his family and to make sure his children received a good education.
His nephew sensed that something was wrong as his uncle had never discussed such matters before. But the older man said nothing more when questioned, except that everything would be fine and he would recover soon.
FOCUS: The long and challenging journey to control COVID-19 in the dormitories of migrant workers
On the morning of April 23, a staff nurse preparing for her rounds heard a thud from inside Mr. Periyakaruppan’s room. She discovered that it had disappeared and that a window pane next to her bed had been removed and placed on the floor.
A search for him discovered his body on the third floor staircase below his window. Attempts to resuscitate him failed and he was pronounced dead at 7.15 in the morning. His cause of death was certified as multiple injuries consistent with a fall from a height.
Investigators found two video clips on his phone, which he himself had filmed in the living room bathroom at around 5.30am that day. He said in one of the videos that he did not want to live after doctors told him that he had the coronavirus.
Police concluded that he had likely used a metal hook to dislodge the window pane and create a space large enough to pass through.
READ: COVID 19: No increase in number of migrant worker suicides, says MOM
After the incident, Khoo Teck Puat Hospital formed a task force to review what happened and introduced additional measures for foreign patients with COVID-19.
ADDITIONAL MEASURES BY HOSPITAL
The hospital noted that many of these patients did not have a good understanding of COVID-19 and were provided additional resources, such as video recordings of the disease. A voluntary social assistance organization that cared for foreign workers was also contracted.
The hospital especially focused on minimizing patients’ feelings of isolation. The hospital group president said that even though there were so many people involved and sick, the experience could leave patients feeling scared and alone.
Another step was ensuring patients stayed connected, helping them connect to Wi-Fi and recharge their calling cards. The nurses also identified themselves, wore name tags, and went out of their way to connect with patients.
To address the misconceptions of COVID-19, the hospital prepared videos and prints in the native languages of the patients.
There were no lapses in Mr. Periyakaruppan’s clinical care, and the incident was neither predictable nor preventable, a hospital review found.
The coroner ruled the death a deliberate act of suicide, acknowledging that suicide risk assessment is extremely difficult. He said it would be “a matter of speculation” as to whether the result would have been different if Periyakaruppan had not had the silver hook, whose origin was not identified.
He conveyed his condolences to Mr. Periyakaruppan’s family for his loss.
Where to get help: Samaritans of Singapore operates a 24-hour hotline at 1800 221 4444, or you can send an email to [email protected]. If someone you know is at immediate risk, call 24-hour emergency medical services.
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