Mount Carmel management acquitted of charges of negligently allowing patient to commit suicide
The authorities and management at Mount Carmel Hospital were yesterday acquitted of being responsible for the death of a patient through negligence.
The patient committed suicide on 24 December 1989 by hanging herself with a belt in a bathroom she was allowed to enter alone while under the care of Mount Carmel staff.
Family of the woman argued that had the medical staff done their job to the best of their ability, they would not have given her the opportunity to commit suicide.
She was sent to Mount Carmel Hospital after she had tried to overdose on pills. This was obligatory and not voluntary. Family members who filed the complaint in court argued that had the Mount Carmel staff/management taken all of the necessary precautions, she would not have been able to commit suicide.
Mt Carmel management objected to this claim. The family came to Malta on holiday on 20 December. Four days later, the woman’s husband found she had overdosed on ‘Normison’ pills and immediately took her to St Luke’s Hospital.
While at St Luke’s and following the woman’s stomach being pumped, a decision had to be taken about where she would recover. The husband was concerned that his wife was a danger to others and herself.
The deceased was known to suffer from paranoid schizophrenia, and in January 1985 she had even killed another person and tried to kill someone else due to her paranoid delusions. She had also previously tried to take her own life prior to the visit to Malta.
This episode let to the deceased having spent one year in a mental health hospital under court order, which was extended to a second year, but she was allowed to go home from time to time.
Due to her history, the episode in Malta prompted the decision to be taken that she would recover through the assistance of psychiatric care at the relevant ward in St Luke’s Hospital. It transpired, however, that the psychiatric ward was full, so management decided to transfer the patient to Mount Carmel Hospital under a “compulsory hospitalisation” directive. This was signed by her husband as well as the doctor charged with her case.
The psychiatrist who evaluated the woman at Mount Carmel, Dr Joseph Spiteri, said that he did so in the presence of her husband and nurse Connie Magro. He said that the deceased appeared calm and had no symptoms of depression, “neither subjectively nor objectively,” the judgment reads.
Dr Spiteri said that she even told him “I have no suicidal wishes, I want to see my only child grow.”
She had no signs of delusions or hallucinations, and appeared to be aware of her problems, the courts heard. Following this examination, it was decided that she would be kept for observation by nurses together with other patients, and was given a dose of ‘Flaunxol.’
In her testimony, nurse Connie Magro explained that personal objects considered to be dangerous to the patient are removed, done so with respect and dignity to the patient and according to the severity of their case.
She said that patients are normally allowed to remain with their own clothing in order for them to retain their identity.
At that point in time, she said there were no written protocols of how such procedures should work, but traditional procedures were adopted based on best practice.
The patient had told nurse Magro that she overdosed on the pills because she was hearing Chinese voices in her head that were persecuting her, and that she was aware that this was a symptom of her illness. She told nurse Magro that at the time, while at Mount Carmel, she was no longer hearing voices.
Dr Spiteri had concluded that the patient could recover in the female general ward, with freedom of movement within that ward and that it was unwise of her to be prescribed ‘Flaunxol,’ so the injection was postponed.
Court experts concluded that following the statements made by the deceased during psychiatric evaluation, as well as the statement made by her husband, Mount Carmel management did not fail to carry out their duties. In its judgment, the court ruled that the tragic loss of Ms Van Den Hoek was not a result of negligence or incompetence, and therefore found neither the Director of Psychiatric Care at Mount Carmel, the Principal government doctor, the Parliamentary Secretary for Health, the Home Affairs and Social Development Minister or Joseph Spiteri of negligently allowing the death of the deceased.
Madam Justice Anna presided over the case. Felice