A hospital nurse has described the moment a patient shouted and swore at her hours before he was found unconscious on a train with a fatal brain injury.

Warsame Warsame, 24, died on March 4, 2013, two days after being found comatose on board a train traveling between Wimbledon and Raynes Park.

Rhys Stacey Parchment, 25, is standing trial at Blackfriars Crown Court accused of killing Mr Warsame by punching him twice in the head during a confrontation on board a different train hours earlier, causing a bleed on the brain.

Mr Stacey Parchment, from New Barnes Avenue in Mitcham, denies manslaughter.

Previously the court had heard how Mr Warsame, who was living at the YMCA in Surbiton, was taking anti-psychotic medication, but had not been taking the drugs in the days before his death.

The court heard how, on the evening of March 1, Mr Warsame left the YMCA returning just after 3am and started complaining his heart was beating very fast.

Zoe Johnson, prosecuting, said: “He kept saying: ‘Sorry, sorry.’ He began to cry and complain that nobody liked him.”

Paramedics found Mr Warsame’s heart rate was 146 beats per minute – a regular heart beat is between 60 and 100.

Mr Warsame admitted he had stopped taking some of his medication, including Resperidone, an antipsychotic drug used to treat schizophrenia.

A YMCA staff member offered to accompany him back to his room to get a coat.

Miss Johnson said: “They both got in the lift but as soon as Warsame pressed the button, he said ‘Come on then’ and clenched his fists.

“He then punched him [the worker] three times in the face.”

After the pair emerged from the lift, Mr Warsame falsely claimed the worker “hits women”, and staff called the police.

Mr Warsame was taken to Kingston Hospital by ambulance where he was said to have told a nurse: “I’ve not slept for four days because I’m overthinking how I’m going to die.

He then repeatedly said: “I want to die, I want to die,” Miss Johnson claimed.

Mr Warsame then absconded from the hospital. He turned up at St Helier Hospital in Carshalton later that morning for his dialysis treatment.

There, he shouted at Geraldine Marchesi, a nurse he knew, telling her to “stop messing with my f***ing head” after she said she would not be the person administering his dialysis.

Ms Marchesi was in the witness box today (Monday) and told the jury: “He came right into my face, his eyes were very glazed, and he pointed to his head and said I was messing with his effing head.

“He was pointing and very agitated. Just very tense.

“He was shouting. [It was] very intimidating, very aggressive.

"He flew out the door, shouting about the YMCA. I thought he was going round to the dialysis unit.

“I rang security because they were aware of Warsame, and I rang the dialysis unit to say he was on his way and he had been aggressive towards me.

“I went round about 10 minutes later to see if he had arrived for his treatment and he hadn’t."

Asked if Mr Warsame had ever behaved that way before, Ms Marchesi replied: “Warsame? No, never.”

Another witness statement read out in court from Patricia Longhurst, a health care assistant at St Helier Hospital, described Mr Warsame as a "likeable and pleasant young man", who liked to entertain hospital staff by showing off his dancing skills.

The trail continues.