To view original article click here
SSRI Stories Summary: A homeless Iraqi man with language barrier and employment challenges goes to his GP complaining of physical problems. The GP prescribes citalopram. The GP does not ask about SM’s experience with the medication when he was on it for one month in the past. Nor does he explain what the drug is for, or the side effects. Seven months later Muhamed stabs a pensioner to death in a motiveless crime at the flats where he had previously lived. The press reports the murder but makes no mention of the SSRI. The Independent investigation report notes the medication but ignores it completely as a potential contributor to the tragedy.
A 29-year-old Iraqi Kurd has been found guilty of murdering a pensioner in a frenzied knife attack in Maidstone.
Sherzad Muhamed had denied being responsible for the death of 67-year-old Richard Cromarty in July last year.
Mr Cromerty died from more than 20 knife wounds that had been inflicted on him at flats at 67 Kingsley Road. The attack was so ferocious that ribs were fractured. The fatal wound was 10-12cm deep and penetrated Mr Cromerty’s heart.
Muhamed, who denied murder, was discovered asleep on the step of a nearby post office after the street was cordoned off by police.
He later claimed during his trial at Maidstone Crown Court that he was sleeping rough at the time and that another Iraqi had once brandished a knife at the flats.
He said he had lived at the flats for a year but left shortly before Mr Cromerty was murdered and had never returned.
But Muhamed, of no fixed address, was found guilty by the jury after hearing evidence that a mixture of Muhamed’s blood and Mr Cromerty’s was found on cars parked nearby.
The court heard during the trial that there was no apparent motive for the killing. Mr Cromerty had lived at the flats for several years and, said Alan Kent, prosecuting, had led a “solitary and lonely life”.
Mr Cromerty’s dying words were captured on a security film. Indicating a large carving knife he said: “Help me, help me. Been stabbed. Help. It’s that Iraqi – just stabbed me with this.”
The court heard that as well as the blood on parked cars, Mr Cromerty’s blood was also found on Muhamed’s trouser pocket. When arrested and interviewed by the police Muhamed was told of the DNA evidence. He claimed he was being set up.
He added that he was walking about in the area on the night of the murder but did not go to the flats.
After the verdict, Judge Warwick McKinnon told Muhamed he faced a mandatory life sentence but was adjourning for psychiatric reports on the basis that they may affect the minimum term he will have to serve before being considered for parole.
To view complete original report click here
Report of the independent review of the care and treatment of Sherzad Muhamed – Verita
In July 2003, Sherzad Muhamed, a Maidstone resident who was receiving NHS outpatient treatment for anxiety and depression, committed a murder for which he was convicted in September 2004.
Prior to his move to Maidstone and registration with the Holland Road Surgery (Dr. Patel) on 27th June 2002, SM had been registered successfully with GP practices in Birmingham (from 19th July 2001) and Gravesend (from 27th October 2001).
The computer record at the Birmingham practice (Victoria Road Surgery) indicates that SM attended twice for essentially routine purposes and then on a final occasion, on 11th Sept 2001, consulted the GP with concerns about his weightm, which the GP recorded was normal.
During the eight months with the practice in Gravesend (Gravesend Medical Centre) SM consulted twice. On 30th October 2001 he was treated for symptoms of conjuctivitis, but the notes also record some stress-related symptoms (palpitations and sleeplessness), and SM mentioned his father having died 3 weeks previously. SM returned to the GP on 22nd January 2002m with the same stress-related symptoms (again mention was made of his father’s death). He was prescribed a 28-day course of citalopram and asked to return if he did not feel any better after the treatment. According to the practice records he did not return.
After registering in June 2002, SM consulted his GP feeling himself to be physically ill on several occasions. He ceased work for reasons of ill health and Dr Patel ratified his claim for sickness benefit. On 23rd August 2002, Dr PAtel referred SM to the Maidstone Hospital for cardiology investigations and then after a further consultation in November 2002 Dr Patel referred SM for a mental hearl assessment. Feeling that language difficulties were obstructing communication, Dr Patel arranged an interpreter to be present for the consultation with SM on two occasions.
Dr Patel told the team that he was not convinced that SM had genuine physical symptoms warranting specialist acrdiology investigatioon nor was his mental ill-health at the time such that if could not be managed within primary care. During this period Dr Patel initiated medication for depression. This was citalopram, the same drug prescribed earlier by the Gravesend practice which by implication had helped SM previously (since he did not return with symptoms after the initial course of treatment). This medication was continuted while SM was being seen as an outpatient.
No reason was found why the non-medical aspects of SM’s situation that might have had a bearing on his mental health – housing, employment, social contacts, family and personal relationships, use of alcohol or drugs – should have suggested to the GP the need for other agencies to be brought into the picture at this time…
In Maidstone…SM expressed dissatisfaction with his relationship with Dr PAtel; he had begun to feel that his treatment was not effective (he believed that the medication was simply to help him sleep) and he felt that Dr Patel did not show him and his problems sufficient consideration…
3.1.2. Secondary Care
The Trust received SM’s referral on 28th November 2002. Dr Patel referred SM to a named consultant, Dr. Sigakumar, which the review team understands was usual practice at the time. Dr Patel referred in his letter to SM’s “symptoms if severe anxiety and underlying depression…
…on 29th January…It was decided to continue current medication.
At the third consultation, on 9th April…SM [reported] feeling fearful, depressed, tearful …somewhat hopeless.” The notes record that “the interpreter feels that it may have something to do with his father’s death”. At this consultation SM had no thoughts of self-harm or suicide..