A patient at a mental health hospital died after swallowing an 8in table knife - even though she told staff what she had done, an inquest heard.
Suzanne Johnston alerted staff that she had swallowed a knife on January 4 but her risk level remained low because she showed "no signs of pain or discomfort".
The 41-year-old, who had a history of self-harm, was a patient at the Sturdee Community Hospital in Eyres Monsell, Leicester, at the time of the incident.
The blade had been in her stomach too long for surgery to be successful and she eventually died on March 9.
A meeting held at the hospital a day after the complaint concluded that the hospital may not have been "the best place" for Ms Johnston.
After telling staff what she had done, Ms Johnston then changed her story to say that she did not actually swallow a knife.
Despite being sectioned and complaining about swallowing a knife, she was still allowed to temporarily leave the premises - going out for "pizza" with others from the hospital.
Scottish-born Ms Johnston complained that she was feeling "wheezy" and that she had a cough which led the hospital to send her to a GP.
After going alone to see the GP she was handed a referral note to say she should have an X-ray.
The Leicester coroner said Ms Johnston had "ample opportunity" to tell people about the note, but she failed to do so, and subsequently did not have one.
The consultant surgeon, Dr Robert Williams, said in his evidence that the way the knife was lodged in her stomach meant that it could have been in there for "weeks".
A jury of nine women and two men concluded that Ms Johnston died of misadventure.
The medical cause of death was given as multi-organ failure caused by sepsis due to a perforated gastric wall and emotionally unstable personality disorder.
Coroner Dianne Hocking described Ms Johnston as a "vulnerable person" and said to Ms Johnston's friend, who was present at the hearing: "I know Suzanne's friend Tracey is here today - you have my condolences on the loss of your friend."
The jury had heard evidence suggesting Ms Johnston's behaviour was "exaggerated", "sensationalist" and "attention-seeking".
Dr Albert Chelliah, the group operations director for Inmind Healthcare, who run the hospital, said: "We have devised new systems and protocols so that anything like this doesn't happen again".
He added that the group will ensure that anyone who ingests a foreign body is taken for an X-ray.