A non-verbal boy with autism and an intellectual disability has been detained in a windowless hospital room on an adult ward for 12 weeks because there is no suitable placement for him, the High Court has heard. Judge Mark Heslin heard on Thursday the boy had lost part of his right index finger in an incident involving a door in the hospital on Wednesday. While his continued detention in the hospital vindicated his right to life, it prejudiced other rights, the judge said. He described it as “one of the most complex cases” the Health Service Executive (HSE) had “ever” had to resolve. The young teenager was placed in the hospital’s care on March 31st after two residential placements broke down. While at home he frequently ran away, threw himself from heights, ran into lakes and engaged in “self-injurious behaviour including head banging and biting”. In the hospital he has no access to the outdoors. Despite the best efforts of staff to care for him the situation was “dire” said Niall McGrath, solicitor for the boy’s guardian ad litem (Gal). Separate counsel for each of the boy’s parents said they wanted him moved from the hospital to a suitable placement “immediately”. Tabitha Wood, barrister for the father, said fears expressed by the mother in early June that “something truly awful is going to happen as the situation continues to deteriorate” had come to pass. The boy, who is right-handed, had “lost the top of his first finger on his right hand”. It was “simply unacceptable” that the HSE could not provide a comprehensive report to the court on how it happened, said Wood. The boy’s finger part was “on ice” the court heard with surgery scheduled for Friday to reattach it. Ciaran Craven, for the mother, said she was in a “chasm of despair” that there were no “near prospects of [the situation] being remedied”. A residential placement for the boy would require up to 25 highly trained staff, said the HSE. He would need three-to-one staffing initially, on a 24-hour basis. One provider had been identified, counsel for the HSE said. This placement could begin in July but no details were available. The “shock and distress” the “devoted parents” must be feeling on hearing of the “very serious injury” their son had sustained “can only be imagined”, said Heslin. “One would want to be made of stone not to be moved by the distress of these devoted parents,” he said. An investigation into how the incident happened was “very obviously needed as matter of extreme urgency” and the outcome provided as soon as possible to parents and the Gal. If there was anywhere else the boy could be kept safe the judge would “have no hesitation” in ordering he be moved there, said the judge. But he was “faced with a situation where there is as things stand no alternative where [the boy] would be safer”. It was “beyond concerning that this is the best, in other words the least-worst, alternative available for our fellow citizen,” he said.Listing the case for an update on Monday he said: “I have no alternative on the evidence before me but to authorise, with the heaviest of hearts [the boy’s] detention and restriction in a hospital ... there simply is no alternative where his very right to life can be vindicated.”