A patient lay dead for three weeks in the grounds of Hackney Hospital, despite intensive searches by nursing and security staff, this week 30 years ago.
Health chiefs demanded a probe into how they had failed to discover the body of 91-year-old Arthur Szczenslive, a long-term mental patient at the psychiatric hospital in Homerton High Street who suffered from senile dementia.
His corpse was eventually found by a works officer lying in an outbuilding near Kenworthy Road.
An inquest revealed he had died of a heart attack, complicated by kidney failure.
The day he disappeared staff searched hospital buildings and grounds without success. A further two searches were carried out. Wards for elderly mentally ill patients were not locked, but were fitted with two-handled "confusion doors", which were designed to make it difficult for patients to leave without help.
All staff were "deeply shocked", said the hospital's manager.
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