Two elderly patients died after they were attacked with a walking stick by another pensioner on a hospital ward, an inquest has heard.
Ken Godward, 76, and Roger Lamb, 79, died after they were beaten by 70-year-old Harry Bosomworth, who had schizophrenia, at St James's University Hospital in Leeds in February 2015.
An inquest in Wakefield, West Yorkshire, heard Mr Lamb may have been trying to help Mr Godward when he was injured.
Both men suffered multiple health problems and died days later.
Daniela Loeb, a friend of Mr Lamb, told the coroner she was in "utter shock" when she saw his battered face after the incident.
She said: "All I was aware of was his face, the blood on his face."
Miss Loeb said: "I was not just in shock, I was angry. How could something like this happen?"
She agreed that she said in her witness statement that she thought "both gentlemen were failed by the hospital" and that was because the ward - J19 - "was either mismanaged or understaffed".
In emotional evidence, she said she had known former civil servant Mr Lamb since they were at university and later rented the top floor of her Leeds house to him.
Miss Loeb described how she cared for him in the last years of his life.
She told coroner Kevin McLoughlin she had not realised until recently that Mr Bosomworth's behaviour had been deteriorating before the attack and "that he had to be sedated because of his deteriorating behaviour and aggression".
Earlier this year, a leaked investigation report detailed how Mr Bosomworth was admitted to the hospital suffering from oesophageal cancer.
It explained how a decision was taken to stop an anti-psychotic drug despite warnings from his family.
The inquest heard Mr Bosomworth was given a sedative on the night of February 28 but, the following morning, he was found with his walking stick standing close to the injured Mr Godward and Mr Lamb.
Nurses on the ward said his behaviour was unexpected and they had never experienced anything like it before.
One told the inquest Mr Lamb told her he got out of bed to help Mr Godward when he was attacked.
Giving evidence on Monday, pathologist Kirsten Hope said that the blunt force trauma suffered by both men contributed to their deaths.
But Dr Hope said Mr Godward's immediate cause of death was a chest infection caused by Alzheimer's.
She said Mr Lamb also died from a chest infection, in his case caused by a fractured hip.
The inquest is due to last six days.
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