On Monday, an inquest will begin trying to establish why the father of two was allowed to leave the hospital in the first place and how he was able to access a potentially dangerous zone.
Mr McManus’s family say the case raises profound questions about the treatment of diabetic patients in the NHS.
“My father was an extremely vulnerable patient and the nature of his removal from the hospital is inexplicable, Jonathan McManus, his son, told The Telegraph.
“Had he been kept in hospital he would no doubt be alive today.”
Originally from Belfast, Mr McManus had lived with diabetes for more than 40 years.
In the year prior to his death the avid cricket fan and Fulham Football Club season ticket holder had suffered recurrent hypoglycemic episodes, where a person’s blood sugar level becomes dangerously low.
On September 4 2018 he was taken by ambulance to Charing Cross Hospital in Fulham.
He was given glucose, nevertheless a consultant twice declared him unfit to be discharged.
However, a junior doctor subsequently decided that Mr McManus had sufficient mental capacity to self-discharge. This was despite colleagues expressing concerns about the patient’s erratic behaviour.
The doctor asked the hospital security team to remove Mr McManus from the premises.
The inquest, at West London Coroner’s Court, will see CCTV of him leaving at 5.48pm, just four hours after he arrived in the ambulance.
Mr McManus’s family claim that when he left his diabetic monitoring devices had not been restarted and that he was in a confused state.
He was soon reported missing by his family and the Metropolitan Police launched a search.
Type 1 diabetes occurs when a person’s blood sugar level is too high because their body cannot make the hormone insulin.
Around eight per cent of the approximately 4.9 million people in the UK with diabetes have type 1, with almost all the remainder suffering from type 2, which is more often associated with an unhealthy lifestyle.
Theresa May heightened awareness of the disease when she revealed she had been diagnosed in 2012 while Home Secretary.
Paul McNeil, head of medical negligence at Fieldfisher, the law firm acting for the family, said that the inquest would likely run for four days because of the number of potentially responsible parties involved.
“Type 1 diabetes is a complex disease which Mr McManus dealt with his entire adult life,” he said.
“Given the prevalence of diabetes, one would expect any Accident and Emergency ward to be able to safeguard and properly manage diabetic patients suffering from hypoglycaemia.”
“The Coroner has made it clear he will ask those responsible what they should have done differently to have prevented Mr McManus’s tragic death.”
Jonathan McManus said his father’s premature death left a “huge hole” in the family.
“While I have great affection for the NHS, there appear to have been failings that led to my father’s death that could have been avoided,” he said.
“Had the hospital properly secured an onsite construction area he would also likely have been found in time for life-saving treatment.
“Instead, he died alone. His family can only hope that lessons are learned, improvements made and that this tragedy is not repeated.”
Professor Julian Redhead, medical director at Imperial College Healthcare NHS Trust said: “We have accepted the significant shortcomings in our care and treatment of Mr McManus and have expressed our sincere regret and condolences to his family.
“We have undertaken our own review of what happened to help prevent similar incidents in the future and we are engaging fully in the inquest.”
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