Parents testify about their 7-year-old son's death

The mother of a seven-year-old boy who died of peritonitis within a week of being admitted to St Luke's Hospital and being operated for appendicitis yesterday told a court she had repeatedly insisted that her son's post-op symptoms could not be simply a side-effect to anaesthetic.

Josephine Massa said she had spoken to doctors and nurses between the Thursday, when her son was operated for appendicitis and the Monday, when a second urgent operation was carried out following the intervention of a foreign surgeon, but she was never told what was wrong with her son.

Medical staff had told her that the operation for appendicitis was successful but her son died in hospital within a week, Mrs Massa said.

She testified before Magistrate Consuelo Scerri Herrera in the compilation of evidence against a paediatric consultant charged with the manslaughter of her son Andrea at St Luke's Hospital between February 20-28, 2001.

The consultant, whose name cannot be published by court order, is also pleading not guilty to committing a crime he was duty bound to prevent.

Mrs Massa yesterday confirmed the evidence she had given at the inquiry into her son's death and explained that her son had first complained of a pain on his side on Tuesday, February 20, 2001. She called the family doctor and he told her the symptoms pointed to appendicitis.

Mrs Massa said she took her son to hospital and he was held for observation. There was no pain on Wednesday and it was thought he would be sent home the next day but he woke up in pain on Thursday and the paediatric consultant ordered an operation for that same day.

The operation lasted for about two and a half hours that afternoon and when it was over, she went home to get some rest because she had been at hospital since the child had been admitted on the Tuesday.

"When I eventually returned to hospital, my husband told me Andrea was throwing up and suffering from diarrhœa but that he had been told this was a side effect of the anæsthetic.

"I told Andrea to get out of bed and walk around a bit. But when he stood up I noticed that he had a swelling on his back so I called for the nurse," Mrs Massa said.

The nurse told her the paediatric consultant would visit her son the next morning and when he came round he asked her if the boy suffered from asthma and if he was allergic to penicillin.

"I told him that he was allergic to penicillin and he prescribed an antibiotic that was not penicillin-based but I never saw anyone give him the antibiotic.

"All I know is that he was being infused by drip but not if it contained some form of antibiotic," she said, and the boy kept throwing up and suffering from diarrhœa.

She explained that a nurse had brought a receptacle for her son's urine but it remained near his bed for three days and no one came to monitor it.

"On Friday night he was still in the same condition. He had by then developed a rash all over his body and white patches on his face. I called for the nurse but she did not want to come into the room because she was pregnant, and she sent in another nurse. She also sent for the doctor who, however, did not examine Andrea.

"On Saturday, his condition remained unchanged, and no doctors came to see him.

"The nurses came to administer suppositories and I repeatedly told them that his condition could not be the result of the anaesthetic but they never gave me an answer. All they told me was that the doctor would come but he never came," she said.

"On Sunday, the woman surgeon who had carried out the operation for appendicitis, came into his room and when I told her about the urine receptacle, she called the nurse outside the room and told her off.

"But she did not examine Andrea and she left before I had time to speak to her about his symptoms," Mrs Massa said.

On Monday morning, two medical students came to see her son. Later on a foreign surgeon told her and her husband that their son was in a bad state and had to be operated immediately.

After the second operation, on Monday, February 26, 2001, Andrea was admitted to intensive care. She was eventually informed that her son died and two autopsies were carried out to establish the cause of his death.

"I would love to know how he ended up the way he did. He was such an energetic boy. He was healthy and he had everything," she said.

Mrs Massa's husband Charles testified earlier, and confirmed the evidence he had given at the inquiry into his son's death.

Asked if he wanted to add anything, he said: "The consultant had prescribed antibiotics. This meant medical staff were aware that my son had an infection. So how could this have happened?

"My son spent four days with the same symptoms after his first operation. He had very high fever and diarrhœa and was vomiting every 10 minutes. The diarrhœa was so uncontrollable that we had to use nappies and change them constantly," he said.

"It had to be a foreign surgeon to finally tell me that my son was in a very bad condition and had to undergo an urgent second operation.

"How could the cause of my son's death have been established at the autopsy but remain undiscovered in the week he was in hospital?

"Andrea was full of energy and was only kept in hospital for observation because he was suffering from mild symptoms of appendicitis.

"After he was operated, everyone assured me that the operation had been successful. Yet he died in hospital after a week... An autopsy later revealed that he had died of peritonitis."

Mr Massa said he never saw antibiotics being administered to his son and as far as he knew, only one X-ray of his son was taken. He said he was not sure if it had been taken before or after the first operation.

He said he had looked at the insurance certificate and had learnt that the consultant had taken sick leave from February 26, 2001, but as far as he knew the consultant remained responsible for his son.

Under cross-examination, Mr Massa said that the consultant did not carry out any operation on his son. He said he never got to see his son's medical file although, as far as he could remember, medical records were kept at the bottom of his son's hospital bed.

The case continues.

Police Inspector Carlo Ellul is prosecuting.

Dr Michael Sciriha and Dr Hugh Peralta are appearing for the paediatric consultant, while Dr Giannella Caruana Curran is representing Mr and Mrs Massa.