An 89-year-old pensioner died after a violent hospital bust-up with another elderly patient, an inquest heard.

Reginald Homewood, 89, was found lying unconscious on the floor of an unlocked store room in Nevill Hospital, Laburnum Avenue, Hove, where he had been admitted four days earlier.

Staff did not see the incident but were alerted by a thump and shouts at 5.30am on September 27 and found Mr Homewood with a cut to his head and blood on his pyjamas. A 73-year-old patient, referred to only as RJ, was seen running away and later admitted to punching him.

Mr Homewood was taken to the Royal Sussex County Hospital, Brighton where his condition was said to be inoperable and he died later that day.

Police were not alerted to the incident for two days which was yesterday called "appalling" by Brighton and Hove coroner Veronica Hamilton-Deeley as it meant valuable evidence had been lost.

Three weeks before the death, South Downs Health NHS Trust had been fined £25,000 for negligence after another Nevill Hospital patient, John Tilling, fell through a badly-fitted hoist and died.

Both Mr Homewood and RJ suffered from advanced dementia and were too confused for staff to be sure what happened. It is not known why they were in the store room, which was full of bathroom furniture and was referred to by Miss Hamilton-Deeley as an "unlocked trap".

RJ had shown "random, unpredictable and aggressive behaviour" towards fellow patients before. A female patient know as MW had been found lying face down on the floor at the entrance to his room and crying just the afternoon before the incident.

Staff were again alerted by shouts and did not see what happened but said RJ had a "look on his face like a naughty, sheepish child" when they rushed in. It is believed he pushed her after she wandered into his room.

RJ also pushed a female patient to the ground and a male patient against a wall in July after which he was given calming drugs to control his behaviour. The medication was stopped when he suffered urinal infection, which the drugs aggravated, in August, and were not started again until October. A policy of checking on him every 10 minutes was also stopped at an unrecorded, unspecified date.

Mr Homewood had been unsettled since he had been transferred to the Brunswick ward at the hospital, which looks after up to 20 patients aged over 65 and suffering from severe dementia, from the Royal Sussex County Hospital on September 23. He fell over in the corridor just half an hour after he arrived and when a nurse tried to help him up he punched her.

Joan, Mr Homewoods wife of 48 years, of Ryde Road, Brighton, said in a statement read out at an inquest yesterday that she had been worried about RJ's behaviour when she visited her husband the day before he died.

She said he had blocked the corridor where they were trying to pass and had a very aggressive expression. She said Mr Homewood had been visibly distressed.

She said: "He barred our way in a threatening manner and I felt he could be trouble.

"I feel very upset that this has happened so soon after he moved to Nevill Hospital."

Dr Carol Skerry, consultant psychiatrist at Nevill Hospital, said: "In this ward there are patients who are highly volatile. In a fairly small space there are a number of highly disturbed patients who can be very challenging for the nurses to handle."

She admitted the store room, full of unused bathroom furniture, was not somewhere patients should be able to go and she did not know why it had been left unlocked.

The inquest continues.