Doctor cleared of manslaughter

A doctor has been cleared of involuntarily causing a patient`s death by failing to give her immediate assistance as he waited for her medical file to be recovered.

The Magistrate`s Court ruled it had not been proven that the patient`s death was the direct result of the doctor`s actions or lack of actions.

The 31-year-old Mosta doctor had been charged with causing the death of an elderly woman when, as a registered doctor, he failed to give her immediate assistance at St Luke`s Hospital on August 11, 1999.

He had also been charged with failing to see or pursue the woman`s medical file in order to determine whether she required medical or surgical intervention and of failing to send the woman to the Intensive Therapy Unit (ITU) as a result of which she was kept in casualty and was not tended to in the best of ways.

The names of the Mosta doctor and the woman cannot be published by court order.

Magistrate Miriam Hayman heard how on August 11, 1999 help was needed in casualty and the Mosta doctor, a senior head officer, was called to assist.

When he arrived in casualty the unconscious woman was being brought back from a CT scan. She had already been examined by another doctor. The woman remained unconscious throughout her stay in hospital.

When the CT scan was completed and the woman was taken back to casualty, her medical file containing the results of the scan could not be found in casualty.

The scan`s results were verbally communicated to the doctor by a colleague who had examined the woman previously.

Magistrate Hayman heard the Mosta doctor explain that he had asked nurses for the file about three times. He said he would have liked to see the written scan results because there had been occasions in the past when the written results did not match what he had been told.

The woman was placed in the Mosta doctor`s care and he decided it would be best to place her in cubicle seven, pending the CT scan`s results. Cubicle seven, he said, was a priority area reserved for patients who needed constant observation due to their acute conditions.

Before leaving casualty, the Mosta doctor made sure the woman did not need assistance to breathe and that she was breathing properly. He also made sure she was being supplied with intravenous fluids.

He instructed the doctor who had examined her previously to give a proper handover of the woman`s conditions to the next doctor on shift.

The Mosta doctor also said he was not aware that the woman had been removed form cubicle seven and assigned to a ward.

Defence lawyers produced several doctors who testified that the Mosta doctor had acted responsibly and given the woman the best possible assistance by keeping her in cubicle seven. They said the woman was not eligible for intensive care because she was breathing without the need of artificial help.

After hearing all the evidence produced in court, the magistrate ruled it had been established that, in the absence of her medical file, the woman had been given the best possible assistance.

But there remained the central question: whose responsibility was it to find the medical file, within the hospital`s hierarchy? She said that, although she did not intend to trivialise the importance of what had happened in hospital, it was a responsibility shared by different people along the way. It was by no means the responsibility of just one person.

She ruled that it was difficult to comprehend how the doctor, although busy, could have got distracted to the point of not realising that the woman had been moved from cubicle seven.

Although what took place in casualty could not be described as professional behaviour the magistrate said it did not amount to involuntary homicide. It had not been proven that the woman`s death was the direct result of the doctor`s actions or lack of actions, neither had the cause of the woman`s death been established.

Magistrate Hayman also ruled that although it had been proven that the Mosta doctor had waited for the woman`s CT scan results to be recovered before deciding to assign her to the appropriate ward, it did not mean that he failed to give her immediate assistance.

Police Inspector Sylvana Agius prosecuted.

Dr Michael Sciriha and Dr John Attard Montalto appeared for the doctor.