An escaped psychiatric patient who collapsed after attacking a walker with a belt was lawfully killed by the man he attacked, an inquest jury has concluded.
Khoung Lam was being treated at Whitchurch Hospital in Cardiff, south Wales, when he ran away from a carer while on escorted leave on June 25 2015 and attacked a stranger on a secluded footpath.
An inquest into his death heard how the 42-year-old from Cardiff was nearly apprehended by police in the cafe of a nearby Asda but escaped again into a wooded area where he met David Owen.
He attacked Mr Owen, asking "what day do you want to die" before putting his belt around the older man's neck, the jury at Cardiff Coroner's Court was told.
Mr Owen, a window fitter, who was 58 at the time, managed to prise the belt off and place it around Mr Lam's neck, who collapsed and was later found to have died.
In response to a questionnaire about the incident, the jury found Mr Owen applied force in the honest and genuine belief that he was defending himself against a genuine, imminent threat.
They said: "David Owen made his best attempt to get away from Khoung.
"He ran through shrubbery off of the path and loses footing ... once David Owen realises that he cannot get away from Khoung he takes steps to disable Khoung ... following David Owen's defensive actions, Khoung became unresponsive and collapsed allowing David Owen to safely leave the area."
In his evidence, Mr Owen said he applied pressure to the ligature with "whatever strength I had left", following the struggle and added: "He had stopped hitting me on the head and I was just thinking is he going unconscious or is he faking it?
"I was just a bit scared of letting go."
Mr Owen let go and started walking towards Asda but looked back and "thought (from) the way he was slumped I feared he may have died".
He called the police and was arrested after the incident but not charged.
Mr Owen told the jury he wished he had not been there that day and had to stop work afterwards and have counselling.
The jury heard Mr Lam, who suffered from paranoid persecutory delusions, had a history of mental health problems starting in 2004, resulting in him twice being treated as an inpatient at Whitchurch Hospital, which closed last year.
He was admitted on June 11 as a voluntary patient after a fight with his brother but was detained under the Mental Health Act on June 15 after saying he only planned to stay for two days.
The inquest heard Mr Lam was "irritable, confrontational and sexually inappropriate" during his stay and was assessed as "a risk of harm to others, particularly his family" who featured in his paranoid delusions.
He was granted escorted leave and one of those occasions was on June 25 when he went to the shops with a carer.
Coroner Christopher Woolley said: "Khoung had, in fact, done this before without any incident .. he then suddenly said 'I'm off' and ran away from his carer."
Mr Lam escaped a second time from officers of South Wales Police when they escorted him from the supermarket cafe.
The jury said the initial response to the missing person report by the police was "appropriate and adequate" and officers "acted on the most important information by visiting the family home and ensuring the family's safety".
They also praised the approach to Mr Lam in Asda as being "appropriate, respectful and considered" but criticised how they left the building.
The jury said: "Police failed to apply sufficient restraint in a timely manner, which created the opportunity in which Khoung was able to leave the care of South Wales Police."
Pathologist Nick James said Mr Lam's cause of death was "a sudden collapse" in a man with schizophrenia who had been taking Quetiapine following a prolonged struggle and pressure to the neck.
Mr Woolley said he commended the work done by Cardiff and Vale Health Board following Mr Lam's death but would write to the health minister and the chief medical officer about the circumstances of the case.
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