Man guilty of trying to kill five — (BBC News)

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SSRI Stories Summary – Ismail Dogan comes from Turkey to England as a 12-yr-old.  He has language difficulties and suffers several racially motivated attacks at school.  His trouble fitting in is probably why he leaves school, becomes withdrawn, uses soft drugs (cannabis and khat), and is a loner, overly concerned with his physical health.  He first comes to the attention of the NHS at 15.  When he is 22, he is accused of assault.  Two years later he comes to the NHS with a list of physical complaints, despair, and hearing voices.  From this point forward, the NHS makes it their mission to get and keep him on psychiatric drugs, and tells his family he must take them. At various times, they give him olanzapine, Cipramil (Citalopram), thioridazine, Prozac (Fluoxetine), Lustral (sertraline), risperidone, haloperidol, and procylidine. After the Prozac he is not seen by anyone for 5 months until he is arrested for damaging headstones in a cemetery.  He does not react well to the medications, reporting unpleasant physical side effects and becoming paranoid.  He clearly does not want the medication but he is sectioned and coerced to take it.  When his sertraline dose is doubled he becomes aggressive and disoriented, perhaps even psychotic. He is diagnosed with schizophrenia. This leads to the prescription of more neuroleptics.  In the autumn of 2004 he is out of hospital, does not attend appointments and has stopped taking the medications.  His father contacts the NHS 4 times, concerned about his son’s behaviour.  In Nov there is a meeting at which housing is discussed.  In Dec Ismail Dogan stabs five people, killing one.  In sentencing Dogan to be locked up in Broadmoor indefinitely, the judge blames the tragedy on his decision to stop taking  his medication. The BBS reports that Dogan is a paranoid schizophrenic and makes no mention of prescription medications.

BBC News

Last Updated: Thursday, 2 March 2006, 17:10 GMT

Ismail Dogan attacked six people, killing one of them

A paranoid schizophrenic has been found guilty of attempting to kill five people during a stabbing rampage.

Ismail Dogan, 30, of Tottenham, north London, had already admitted the manslaughter of Ernest Meads on the grounds of diminished responsibility.

He denied five attempted murder charges because his lawyers claimed his ill health meant he could not form intent.

An Old Bailey judge committed Dogan to Broadmoor Special Hospital indefinitely over the attacks in December 2004.

Passing sentence, the Common Serjeant of London Brian Barker told Dogan: “I am not in a position to apportion blame, but it is the greatest sadness you stopped taking your medication and the warnings were not quickly heeded.”

The court heard during the trial that Dogan’s mother had asked for her family doctor to visit their home.

This court has illustrated that there are a number of outstanding questions regarding the level of care and treatment that Mr Dogan received

Victoria Cann, Victim

The defendant had stopped taking his medication and in the run-up to the attacks had begun talking to himself and behaving oddly.

But the doctor refused, saying Dogan should visit the surgery.

At an earlier hearing Dogan admitted stabbing Mr Meads, 58, a father-of two, seven times, in Meridian Way, Edmonton.

The other five attacks took place within a six-mile radius between 0800 GMT and 0900 GMT on 23 December 2004.

Inquiry call

After the verdict, two of Dogan’s victims, Roger Levy, 49, and Victoria Cann, 30, said they felt no resentment towards their attacker.

They and another victim David Symes, 31, said in statements that their thoughts were with the families of Mr Meads and the defendant.

Ms Cann and Mr Symes called for an inquiry into how the attacks were able to take place.

Ms Cann said: “What happened to me and five other people on 23rd December 2004 was very shocking and it has certainly changed my life forever.

“What I think this court has illustrated is that there are a number of outstanding questions regarding the level of care and treatment that Mr Dogan and his family received in the run-up to these events.”

Dogan also attacked Raymond Day, 76, and Jeffrey Arthur, 50.

The local mental health trust said it would carry out a review of the case.

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Independent Investigation into the Care and Treatment Provided to Mr. D by the Barnet, Enfield and Haringey Mental Health Trust and the Haringey Teaching Primary Care Trust

A report for NHS London March 2009

(Page 38) 1990:  Mr. D’s first contact with health services was when he registered as a new patient with a General Practice on 7 March 1990.

Mr. D had completed his education in Turkey aged 12; however on arriving in England his schooling resumed, he had difficulty in settling in because of language difficulties. In 1990 Mr. D was hurt in the school playground in what appears to have been a racially motivated attack. As a result he was found a place in another school and recommenced his education there in September 1990.

Mr. D developed a history of truancy at his new school.

1992: When Mr. D was 17 years of age and in the sixth form he was once again assaulted at school. In this assault Mr. D sustained a broken nose. The police were not involved with this incident. As a result Mr. D left school and enrolled in computer classes at his local college. Mr. D left this course after a few months.

Mr. D visited his GP on four occasions with minor physical ailments.

1993-1996 [Mr D / Ismail Dogan] visits the GP a couple of times for physical ailments and starts to smoke cannabis.

1996 20th February 1996. Mr. D’s GP received a letter from the A&E Department at the North Middlesex Hospital regarding an intervention. Clinical records show that Mr. D missed an appointment with his GP on 2nd April 1996.

1997 Mr. D used his father’s car to work as a mini-cab driver… His parents noticed that he was drinking alcohol, taking home bottles of whisky, which he drank on his own in his bedroom. He spent more and more time on his own and hardly ate meals with the family. The mini-cab business was owned by a group of Somalian men and it was at this time that Mr. D started using Khat.

1998 18 December. Whilst Mr. D was driving along the road, he allegedly drove over the foot of a 37 year old male pedestrian. This pedestrian removed one of the car’s wing mirrors. Mr. D stopped his car and chased the man. When he caught up with him, Mr. D assaulted him by hitting his head against a brick wall causing a cut to his forehead. He was charged with Actual Bodily harm (ABH) and was remanded in custody at HMP Pentonville for six weeks18.

1 April 1999. The Police cautioned Mr. D after he had been seen acting in a strange manner and was found to be in possession of a small amount of cannabis. When his car was searched the Police found ‘rice flails” and so he was also cautioned with being in possession of an offensive weapon. (A rice flail constitutes two pieces of wood each joined by a length of metal chain).

9 November 1999. Mr. D attended the GP surgery with his father “to discuss his condition”21.

2000 27 January 2000. Following the incident of 18 December 1998 Mr. D attended Wood Green Crown Court and pleaded guilty to Actual Bodily Harm (ABH), following which Mr. D was subject to a one year Combination Order consisting of a one year Probation Order and 40 hours of community service. He was also expected to attend the ‘Break Free’ project. The Pre-Sentence Report stated that Mr. D did not “accept full culpability” and at one time denied that he had run over the victim’s foot, saying that the victim had stolen the mirror. The Probation Officer, completing the PreSentence Report, recommended the Combination Order as this would enable Mr. D to work with a Probation Officer to explore the events of the offence and any underlying reasons for his aggressive behaviour…

3 February 2000. Mr. D attended his General Practice, complaining of abdominal pain. He was given a prescription and given advice about taking more fluids.

28 March 2000. Mr. D attended his General Practice complaining of a painful shoulder and was given a prescription for Diclofenac 50mgs. He was referred to have an x-ray of his left shoulder and cervical vertebrae.

(Page 42) First Admission

4 June 2000. At 4pm Mr. D attended the A&E department at the North Middlesex Hospital. He was complaining of headaches and a slow heartbeat. Mr. D was referred for a psychiatric opinion and admitted to Downhills Ward, St. Ann’s Hospital for the first time. Mr. D felt that that there was something wrong with his blood. He said that his ‘blood was like water’ and that his ‘body does not feel normal’ and ‘I am dying’. During the interview he confided that he felt that his skin was changing colour and he was hearing voices. An electrocardiograph (ECG) was completed and a letter sent to his GP25.

On admission Mr. D was appropriately dressed, had good eye contact and fairly good rapport during the nursing assessment. The nurse gained the impression that he was preoccupied with vague hypochrondriasis and presented with somatic symptoms… During the medical assessment he said he had smoked cannabis for four years and had started chewing Somalian Grass (Khat) in 1999… He denied having any paranoid feelings but felt that he could no longer live with this ‘sickness’ and said he had had thoughts of killing himself but would not do so out of respect for his parents. Mr. D had worked for two years but was working no longer because of these symptoms. The medical notes stated that Mr. D was probably suffering from a psychotic illness precipitated by Khat. It was noted that Mr. D was distressed by his illness and that he had occasional thoughts of suicide…

Later that evening Mr. D’s sister telephoned the ward to say that her parents wanted to take Mr. D home. His illness was explained to them and that he needed to stay in hospital because he had a mental health problem…

13 June 2000. Mr. D was seen at the ward round. The plan was

1. “to stay in hospital during the day and have leave
2. to have soluble olanzepine 5mg. at 5.30pm and then could go home”

Mr. D agreed to take the medication but left the ward and did not return as planned.

29 June 2000. The CPN visited Mr. D at home… [unspecified] Psychotic symptoms, denies hearing voices and visual hallucinations

19 July 2000. …Mr. D spoke to the CPN on the telephone and told her he was fine and that he did not want to see her anymore. He reassured her that he was no longer taking drugs but just wanted to live his life. She told him that as he had an appointment to see the Consultant Psychiatrist, Dr. 2, she would telephone him again in three weeks time.

19 July 2000. Mr. D was seen in the outpatients department. He was no longer taking the medication… as he said it gave him headaches and made him feel worse. “…..he denied deliberate self harm ideation, expressed no intent or plans but said he was dying anyway. He experienced persecutory delusions…He has depressive symptoms… He also suffers with paranoid delusions… I have decided to start Mr. D on an anti-depressant and have given him two weeks supply of Cipramil 20mg… I have arranged a follow-up appointment for in September 2000, at which stage we would give consideration to increasing the dose of his Cipramil, or the addition of another antipsychotic.