Northern NSW Local Health District has acknowledged the pain felt by Carley Metcalfe’s family during the inquest into her 2017 death near Mullumbimby.

An inquest has heard “shortfalls” in the hospital had been addressed with changes already made in the system.

Missing woman Carley Metcalf.

Legal counsel for the local health district has extended its condolences to the family of a woman whose body was found near Mullumbimby after she was missing for three weeks.

Carley Metcalfe, 41, was taken by ambulance to Lismore Base Hospital about 12pm on November 1, 2017.

She left the hospital the following day and was missing for weeks until her body was tragically discovered on the banks of the Brunswick River later that month.

An inquest into the circumstances surrounding her death, which began more than a year ago and was put on hold due to COVID-19 concerns, has resumed this week.

Counsel for the Northern NSW Local Health District, Patrick Rooney, acknowledged the pain of Carley Metcalfe's family when the inquest began again on Tuesday.

"The local health district does pass on its full condolences to all of Carley's family and friends," Mr Rooney said.

He told the inquest of changes which had been implemented in the time since Ms Metcalfe's passing, and said "shortfalls" or "gaps" in their operations had been mitigated by those changes.

He said the health district would also consider any further recommendations from the coroner.

"(The LHD) treats all incidents of this nature very seriously and would be pleased to meet with the family to discuss these issues or any relevant issue," he said.

Dr Robert Byrne, a psychiatric registrar at the hospital at the time, has told the inquest Ms Metcalfe appeared in a disoriented state when he saw her.

Counsel assisting the coroner, Kirsten Edwards, asked whether he was able to confidently exclude psychosis from Ms Metcalfe's situation after his brief attempt to assess her.

The inquest has heard he was unable to complete a full mental health assessment on the night of November 1.

"No, I don't think I could definitively exclude that at that point," Dr Byrne said.

"But my primary diagnosis at that point was much further leaning toward intoxication.

Carley Metcalfe was taken by ambulance to Lismore Base Hospital about midday on November 1, 2017 and spent the night in the emergency department before her disappearance.

 

"I felt at that point, she was not appropriate for admission to the mental health unit at that specific time, but that doesn't preclude reassessment further down the line."

This, Dr Byrne said, was what he hoped would happen if Ms Metcalfe was kept in the ED overnight.

Ms Edwards asked him if he "favoured" this approach because any intoxication would be "significantly resolved by the morning" and "it would have been an opportunity to test" whether her manner was "the result of an underlying condition".

Again, Dr Byrne agreed.

When asked if there should not have been an "abeyance" in any intoxication by the time he saw her about 6pm, he said this was not necessarily the case.

Dr Byrne said while intoxication should subside in that time, "confusional states" could "last much longer".

"When I saw her at that point …. she was clearly confused," Dr Byrne said.

"It was my opinion at that time (substances) were still having an effect or the cognitive effect of those substances were still with Ms Metcalfe."

Further medical witnesses are to be called as the inquest continues before Byron Bay Coroners Court today.

Originally published as Northern NSW Local Health District has acknowledged the pain felt by Carley Metcalfe’s family during the inquest into her 2017 death near Mullumbimby.