Mount Carmel man­age­ment ac­quit­ted of charges of neg­li­gently al­low­ing pa­tient to com­mit sui­cide

Malta Independent - - NEWS - He­lena Grech

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

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