Appeals Court confirms acquittals of five doctors accused of negligently causing two-year-old girl’s death

The Court of Criminal Appeal has confirmed the dismissing of involuntary homicide charges filed against five doctors over the death of a two-year-old girl who succumbed to pneumococcal meningitis which had been misdiagnosed as gastroenteritis, while at Mater Dei Hospital in February 2011.

Seven doctors had originally been acquitted by the Court of Magistrates, but the Attorney General had subsequently filed appeals against six of them, arguing that the court of first instance had not taken into consideration the conclusions of court-appointed expert Mario Scerri, who had concluded that the doctors had been negligent and that this had led to the death of their patient, who could have been saved by antibiotics.

Madam Justice Edwina Grima, presiding the Court of Criminal Appeal upheld the First Court’s decision, saying she found no reason to vary it.

The judge noted that from the witness stand forensic medicine expert Professor Anthony Busuttil had concluded that the patient’s symptoms had not been typical of meningitis.

“Physical signs of meningitis - or more accurately of meningism - irritation of the brain coverings… were indeed looked for in this instance by the doctors on the ward and not found,” he told the court. “Firstly, a subject suffering from pneumococcal meningitis will feel unwell. So, there will be fever, perhaps vomiting and diarrhoea,” the professor had said, explaining that these symptoms were non-specific. Citing a scientific paper on the subject, he said pneumococcal meningitis can be difficult to recognise in its early stages because the skin rash that is normally a tell-tale sign of meningitis tends to be absent.

There was nothing in the girl’s symptoms that would have caused the doctors treating her to suspect meningitis, he said, adding that blood tests and stool cultures - which would still not have identified the illness - are usually only carried out if the symptoms are seen to persist for more than three to five days.

While recognising the fact that the doctors had made an incorrect diagnosis, the judge said that this did not mean that the doctors had not maintained the standard of care expected of them, which would have translated into criminal responsibility.

The judge also observed that from a general perspective, the prosecution had failed to prove guilt to the level required in criminal proceedings. It had not been shown that the accused had failed to properly complete an exam nor had they failed to provide the appropriate care based on the symptoms and clinical history of the patient.

It is not the case that the child was ever neglected by any of her doctors, the judge said.

Clinical exams had been carried out regularly, blood tests had been taken and she had been kept under watch.

The court said that that each of the defendants had taken every reasonable action that could be expected from them in the circumstances, acquitting them of all charges.