Overview

• The jury at Teesside Coroners’ Court concluded on July 29 that Mrs. Levin’s death was suicide due to mental illness after seven hours of deliberation
• Jurors highlighted flaws in care, including incomplete handovers that omitted details of her suicidal thoughts and the family’s discovery of a farewell note
• Witnesses testified that hourly observation checks were sometimes missed or falsely recorded and that risk assessments were not updated after her sectioning
• A delay in administering CPR arose when staff lacked a working alarm device and paramedics were slowed by locked hospital gates
• Senior Coroner Clare Bailey extended condolences to the Levin family and acknowledged ongoing scrutiny of patient safety in mental health services