Karin Grech Hospital death was 'like something out of a Charles Dickens novel', lawyer says

An elderly patient at Karin Grech Hospital died face down on the floor, hugging a toilet after choking on food he was not supposed to eat, a court heard as the case against three nurses accused of negligence continued.

The grim description was given by lawyer Stefano Filletti, who is appearing for the deceased's widow.

“It was like something out of a Charles Dickens novel,” Filletti submitted in court. “This was a terrible, tragic death. It could have been avoided. We’re not after a pound of flesh but someone has to answer for this.”

Chief nurse Maria Bondin, 61, from Paola, nursing aide Carol Bonnici, 59, from Siggiewi and nurse David Sant, 34, from Gharghur, were charged with involuntary homicide following the death of the 64-year-old man in March 2012.

The victim suffered from dementia and had to be supervised while eating, the court had been told. He had been recovering at the rehabilitation hospital when he choked on a piece of chicken and was discovered face down on the bathroom floor after going missing from his ward.

The victim who had difficulty chewing was placed on a soft diet. He had been served a chicken meal shortly before he met his fate, at a time when hospital regulations labeled chicken as ‘soft food’.

Yet, the meat should not have been served to that particular patient without having been properly mashed and thickened to the consistency specified by the man’s speech language pathologist.

“The food was heated and served. No one checked what had ended up on his plate… The thickening process was a medical process not a catering task. Someone was to do it and keep an eye on him,” Filletti argued, stressing that the fault lay not on the hospital system but on the staff who had been negligent in their duties.

Filletti pointed his finger at the accused. “The system, even if rudimentary, was functioning. It was the fault of those handling it.” The lawyer’s arguments were supported by the testimony of police Superintendent Jeffrey Azzopardi, who explained that the staff had been on full complement on the day of the incident.

In addition, the feeding instructions had been clearly fixed to the patient’s bed, the prosecuting officer argued. “Those were orders, so the negligence was absolute.”

The defence lawyers however stressed that it had been the system that had failed rather than the accused. As proof of this, they pointed to the fact that after the tragic death, hospital rules had been changed.

“We don’t know who made the rules or who changed them,” argued defence lawyer Stephen Tonna Lowell, assisting the nursing aide.

“The six-month magisterial inquiry had been inconclusive. No fingers had been pointed at anyone. The police had been asked to continue to investigate,” Tonna Lowell continued, noting that the inquiry had been instituted only after the widow had voiced her concerns regarding the death of her husband with a private lawyer.

The charges had been pressed against the three members of staff on the grounds that no one had checked the food nor supervised the patient, the lawyer went on.

An internal inquiry in 2012 had also proved inconclusive, Tonna Lowell said, adding that several questions had been left unanswered, such as why chicken had been classified as ‘soft food’ at the time. After the incident, it was re-classified as part of the ‘regular’ diet, the court was told.

The patient had not been placed ‘under constant watch’ nor was he to be fed by carers but was only to be supervised while eating, the lawyer went on, further questioning how the chicken could have been mashed when there had been no liquidiser in the ward, the only cutlery being the plastic ones provided by the caterer.

As for his client, “What is she doing here today?” the lawyer repeatedly asked, pointing out that the nursing aide had been allocated patients in two rooms when she noted that the victim had gone missing.

“She was either expected to have X-ray eyes or powers attributed to Padre Pio,” concluded Tonna Lowell with a hint of sarcasm, while questioning how the aide could have been watching over the sleeping patient, when a tray of food had allegedly been placed before him, while she had been in another room.

Lawyer Michael Sciriha, assisting the chief nurse, also questioned how charges could be filed against his client when she had not been responsible for supervising or feeding patients.

The third co-accused, the staff nurse who had given ‘a hand over’ before the incident occurred, had informed the other nurse that the patients were ‘OK’, before taking his break, defence lawyer Joseph Grech said.

In fact, the food could not have been checked earlier on since it had been delivered in a sealed warmer that unlocked automatically by means of a timer and the food served immediately while still warm, Grech argued.

“Something went wrong with the hospital management at the time. Things have now changed after that tragic incident,” concluded the defence.

Magistrate Donatella Frendo Dimech adjourned the case to March for judgment.