Triple killer Alexander Lewis-Ranwell set fire to hospital furniture and held fellow patients hostage.
Mental health care failings saw a man released from custody before he killed three people, a report has found.
The review, jointly commissioned by NHS England and the Torbay and Devon Safeguarding Adults Partnership , was released on Tuesday. Six weeks later a consultant contacted police claiming the incident was "pre-meditated and calculated", despite Mr A suffering from psychotic symptoms at the time. When Lewis-Ranwell moved to France in 2017 Devon NHS Partnership Trust discharged him from mental health after care - without evidence he no longer needed after care and against the Mental Health Act Code of Practice.
In Devon and Cornwall, custody healthcare is delivered by G4S, which includes a healthcare professional who may be a registered nurse or paramedic and forensic medical examiners, who are available on-call.
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