The corpse of a doctor who died in July remains in the morgue as his family fights for a magisterial inquiry and an independent autopsy to be ordered into his death.

The wife and children of Dr Naged Megally want a magisterial inquiry to investigate whether hospital staff were negligent or in any way failed to give their father the best possible treatment during the weeks leading to his death.

Megally, a specialist in foetal medicine who worked at Mater Dei hospital, died on July 5 after developing medical complications. He was admitted to hospital in May in critical condition and was treated in the intensive care unit. After a series of surgeries, doctors repeatedly told his family his chances of survival were “nil”, but he surprisingly began to recover.

The family say just as staff began discussing to transfer him into another ward, his health took a turn for the worse in ways nobody could explain, and he died within three days.

The family suspect hospital staff might have treated him poorly, thinking he was going to die anyway. Upon his death, the hospital authorities said they had no intention of performing a post-mortem on his body, the family said.

The family also claim during the treatment the hospital was not always transparent, at times even refusing to allow Megally himself to see his own medical file.

They are now insisting on an independent autopsy in the hope it would shed light on the cause of death. Hospital authorities deny any wrongdoing and have so far argued against the inquiry in court, insisting staff acted diligently all the way.

Family are insisting on an independent autopsy

A Mater Dei spokesperson said it is standard practice not to order an autopsy when the cause of death is clear to clinicians. However, the medical director might give permission for an autopsy to be carried out in particular instances. Also, internal inquiries are carried out whenever relatives of the deceased file a complaint.

In Megally’s case, “special permission was given to carry out an autopsy, even though according to clinicians the cause of death was clear,” the spokesperson said.

“However, the relatives of the deceased refused this and immediately reported to the police and the inquiring magistrate on duty asking for a magisterial inquiry. Neither accepted this request, given the facts of the case. Nonetheless, the relatives disputed these decisions and proceeded with a written application before another magistrate. The latter case is still ongoing.”

Mater Dei Hospital said it has continued to offer to carry out an autopsy to offer the family peace of mind, yet to date, it has been refused numerous times.

The family insists it wants an independent autopsy they can trust.

The day after Megally died, his family filed a request for an inquiry before the court of magistrates, which would include an autopsy performed by court experts.

Court still to decide about inquiry

Meanwhile, Megally’s corpse has still not been released from the morgue as the family and hospital authorities argue their cases in court, which, four months on is yet to decide whether there are grounds to order the inquiry.

Since the court has not yet decided on the family’s request to hold an inquiry, an autopsy cannot be held by court experts.

The family says the hospital even objected to the release of Megally’s body for a private autopsy.

They believe the hospital is using “delaying tactics”, given that the more time passes, the more the body deteriorates and the less likely it is to retain valuable information.

“This ordeal has had a huge impact on our lives. The delay in having an independent autopsy and proceeding with a befitting funeral has also robbed us from being able to go through our grieving process and is increasing the family’s pain,” Megally’s son Polycarpus said.

I’m unsure which pain is worse: the shock of losing my brother or the ache of all the injustice and bullying before and after his death- Megally's sister, Ireni

“The resistance to, and the delaying of, due process on the part of Mater Dei is also a sign of outright disrespect for their own colleague.”

Megally’s sister, Ireni, said: “I’m unsure which pain is worse: the shock of losing my brother or the ache of all the injustice and bullying before and after his death.

“My heart bleeds every day for what he’s been through and what we as a family are going through, especially our frail mother, whose heartbreak is indescribable.”

A litigious person

Megally was known as a litigious person, taking his cases to court whenever he felt injustices were being levelled at him.

Last year, he won monetary compensation after a court ruled he was discriminated against by the state hospital when he was forcefully carried out of a Mater Dei examination room by senior medical staff and the hospital CEO where he was treating patients.

But last March, an appeals court overturned that decision, clearing Mater Dei staff of manhandling.

After the appeals decision, Megally, who suffered from mitochondrial myopathy and used a wheelchair, had told Times of Malta he would take his case before the European Court of Human Rights.

There is nil humanity, nil respect- Megally’s daughter, Eugenie

But he was admitted to hospital in May and, following a slow but steady six-week recovery, his health deteriorated overnight, and he died three days later.

His family now suspects his disputes with the hospital did not earn him much sympathy from hospital management during his final days, and that, combined with the fact that he had already been on the brink of death, caused them not to bother too much.

They also suspect hospital staff also wrote him off because of his disability and said the hospital told the family life would be too difficult for him at that point, even if he survived.

The family argues his disability should have never been taken into account when considering his quality of life, given he had learned to live with it and led a fulfilling life.

‘A blatant lie’

But hospital authorities vehemently denied ever acting this way.

The hospital spokesperson said these claims are “a blatant lie, slanderous and completely disrespectful towards Mater Dei Hospital’s dedicated ITU staff who treat hundreds of patients, irrespective of their sex, race, age, disability.

“Moreover, it is not prudent for the hospital to disclose the nature of the treatment received by the individual in question, or his medical conditions. The hospital shall hold accountable anyone making such statements, tainting the name of hundreds of dedicated professionals,” the spokesperson said.

The family argues it has no interest to cause an overhaul of hospital procedures or damage its reputation. They praised the “excellent work” of a number of specialists who were able to save Megally’s life and supported his will to live when it seemed he was going to die.

He was the most courageous and resilient man you could ever meet- Megally’s other daughter, Anastasia

The family say the hospital issued a ‘do not resuscitate’ (DNR) order when Megally was in critical condition but never lifted it when he began to recover. They also say the hospital never consulted them on this matter until they discovered this order several weeks later.

But the hospital spokesperson said a DNR is not an order, but “a clinical decision based on the futility of resuscitation” – and is taken following NHS guidelines.

“Despite a DNR, resuscitation may still be carried out when medical professionals feel this may be useful for the patient’s condition,” the spokesperson said.

Other complications

The family also questioned the complications which led to Megally’s admission to intensive care and other complications that developed during the final days of his life. They say doctors told them they had never encountered some of those conditions before.

They also believe staff were not taking into consideration his medical condition when they administered certain medications. They said evidence of any shortcomings or wrongdoing could show up in the autopsy if it is not too late and foreign consultants whom they spoke to feel there appear to be evidence of potential “failings” that merit an in-depth investigation.

The hospital would not comment on these claims, saying “any public comments on the proceedings may prejudice the case, which is being meticulously heard before the magistrate”.

‘Pure torture’

Megally’s daughter, Eugenie, said the hospital authorities’ attitude shows they have “no proof of goodwill and no care whatsoever for the mental health” of his family.

“It is pure torture to be left without answers. Waiting over four months with no end in sight has caused the entire family distress and anxiety,” she said.

“There is nil humanity, nil respect from the hospital’s side. We deserve to have closure and answers.”

Megally’s wife, Margarita accused the hospital of having an “absolute disregard for ethics”.

“We are mourning not only the passing away of a dear husband, father, son and brother, but also the fact that those entrusted with the healthcare of our nation are proving to be heartless and resistant to answering our legitimate questions. The longer Mater Dei makes us wait, the more they confirm our suspicions,” she said.

The hospital said its communication with the family has been restricted following legal advice due to ongoing proceedings.

An ‘absolute disregard for ethics’- Megally's wife, Margarita

“The hospital will be in a position to share further comments once this case is concluded,” the spokesperson said.

Megally’s other daughter, Anastasia, said her father lived a life conscientiously serving others and striving to improve obstetric care, foetal medicine and obstetrics equipment in Malta.

“He was the most courageous and resilient man you could ever meet. He was outspoken, generous, compassionate and friendly, and worked tirelessly with a smile on his face while fighting a debilitating disease that severely limited his mobility,” she said.

“He always put everyone’s needs before his own. Even when he was in excruciating pain in emergency last May, he was still answering his patients’ questions on the phone.

“We are proud of the example he has set and the high standard of care he delivered. We want to be able to celebrate his life the way he truly deserves.”

Lawyers Tonio Azzopardi and Ryan Falzon are assisting the family.