A court has directed immigration authorities to “seriously consider” removing two carers from Malta after their professional negligence resulted in the death of a 101-year old resident at St Vincent de Paul home.

The court also called upon the Health Minister and authorities at the care home to conduct an investigation into the type of lifters, hoists, hammocks and slings used in the handling of patients, to ensure that they are tailored to each patient’s particular needs.

The judgment stemmed from proceedings against a doctor and two carers who were accused of the involuntary homicide of an elderly woman through negligence in August 2019.

The woman was being transferred from a seat to her bed when she slipped off a hammock-like lifter, landing on the floor in pain.

The two carers lifted her onto the bed and alerted their superiors.

A doctor examined her without delay, confirming she was “fully engaged” at the time.

But some six hours later, around 10pm, he was called back because she was in pain. He prescribed painkillers and booked her for an X-ray in hospital the following day.

At the time, her condition did not fall within the parameters of ‘red alert.’

A few hours later, she passed away.

An autopsy confirmed that the woman died “from acute myocardial infarction following fracture of the right neck of humerus and fracture of the cervical spine.”

The doctor who examined the patient and the two carers were prosecuted.

The court heard that according to standard professional procedures, in case of such a fall, the patient “must not be moved from the floor.”

An occupational therapist testified that the victim lacked mobility and had to be lifted.

The type of lifter was selected by the in-house physiotherapist who testified that the hammock-style equipment made it impossible for the patient to fall when properly hooked.

Yet, one of the carers testified that “all of a sudden [the patient] slipped from the front curve.”

After considering all evidence Magistrate Monica Vella concluded that there was no doubt that the death was caused by the fall.  

The patient’s age and a heart attack, triggered by the painful neck and arm fractures she suffered, led to her death.

When assessing the context of the tragic death, the court observed that there were three doctors on duty that day, working long 12-hour shifts.

They worked under pressure, dealing with some 1300 patients.

The doctor who examined the victim answered the carers’ call immediately and followed the proper procedure.

The woman was given all the treatment she would have received at Mater Dei Hospital. Only the X-ray was missing and that would not likely have affected her condition.

It was not ideal for the patient, given her age and condition, to be kept waiting for an X-ray at Mater Dei’s crowded emergency unit.

And moreover, such injuries were very difficult to treat in patients over 80 years of age.

The court found no negligence on the part of the doctor.

But not so the carers.

As semi-professionals they knew that they should not have touched the patient after the fall until a doctor arrived, the court said.

They could have easily pressed the emergency buzzer so as not to leave the patient unattended.

“Our instinct told us to put her on the bed,” one of them testified.

But the court observed that they should not have followed instinct but professional procedure.

The court said it could not understand how such a fall could have happened right under the nose of the two semi-professionals one of whom claimed to be a nurse in her homeland and also worked as a nurse in Malta.

The lifter was functioning well and the hammock sling was not defective.

Most probably, the patient was being pushed in the lifter by one carer from behind and so when she slipped forward there was no one and nothing to block the fall.

The link between the carers’ actions and the fall was “amply proved.”

Whilst declaring the carers guilty and condemning them to one year imprisonment suspended for four years each, the court ordered the judgment to be notified to the Police Commissioner for possible prosecution of the physiotherapist who was also negligent in choosing the type of sling for the patient.

A T-harness would have been more secure and could have avoided the fall, the court said.

The court directed the immigration authorities to “seriously consider” removing the two carers (from Malta) since patients under their care could be at risk.