Two carers convicted of negligently causing the death of a 101-year-old at St. Vincent de Paule

Two carers at the St. Vincent de Paule Residence for the elderly were handed suspended sentences after they were convicted of negligently causing the death of a 101-year-old woman, who slipped out of a hoist that was being operated incorrectly.

A doctor who had been charged together with the carers was acquitted.

During hearings, it had emerged that the three doctors who serviced the facility’s 1,300 patients, across its 35 wards, worked under immense pressure and would have to rely on the information provided to them by the nurses.

The three defendants: two carers and a doctor, none of whom are named in the judgement, were charged with negligently causing the death of the elderly patient, whose name was also withheld, on 31 August 2019 at Rużar Briffa Ward 3. 

Inspector Paul Camilleri had filed the charges after a  magisterial inquiry recommended that they be prosecuted for causing the elderly woman’s death.

The woman, who had suffered a broken shoulder as a result of the fall, died of a heart attack approximately 12 hours later. The investigation began after her niece went to the police to report that the woman had died in suspicious circumstances.

In her judgement, the court presided by Magistrate Monica Vella said it had “no doubt that the cause of the victim’s death was the fall… The court also believes that the heart attack, together with the victim’s very advanced age, had been triggered by the injuries she suffered as a result of the fall and the pain caused by the resulting fractures.”

The court had been told how the elderly woman was being carried by means of a hoist when she fell to the ground.

A court-appointed expert had examined the lifting apparatus used and found it to be working correctly with no defects. But the court also observed, during a site visit, that the staff at SVPR would move it under load by pushing the hoist from the boom. “This is not in keeping with the instructions on the manual, which explicitly states that the operator must only push the hoist from the push handle. When the inspection took place, this handle was missing.”

Had the patient been strapped in correctly it would have been “nearly impossible” for her to fall except if the patient made a forceful forward movement, concluded the expert.

Although the two care workers had claimed that they had both been working on transferring the patient, the court, after examining the evidence and injuries suffered by the victim, ruled that it was more likely that one of them had been operating the hoist alone and that the patient had slipped off the sling when it swung around, falling to the floor.

“This when [the other carer] who was supposed to have been with her was either not there when she was supposed to be there, or had been there but not close to the lifter and was therefore unable to intervene in the few seconds from when the victim started to slide off the hammock. The carers would undoubtedly have known that a patient who suffers a fall must not be moved before being examined by a doctor. But instead of following protocol, they had decided to lift her back onto her bed, without even asking for assistance,” the court said.

The court noted that calling for help was as simple as pressing a button that every patient had on their bedside.

This might have been an attempt by the carers to cover up the incident, but they were unable to do so because the patient had suffered visible injuries and was complaining of pain, requiring them to call for a nurse.

Ruling that there was a direct causal link between the carers’ actions and the fatal incident, the court found them guilty of involuntary homicide.

Not so the doctor on duty, however. Besides explaining the immense workload, the doctor who had been charged with the same offences as the carers, had told the court that he had taken the decision not to have the elderly patient transported to Mater Dei hospital because of the strain it would have caused her, not least because of the 10 to 12 hour waiting time at the emergency department, but also because she did not have any head injuries.

The doctor was summoned, and he booked her for an X-ray for the next day, but a few hours later the woman died of a heart attack, leading to a magisterial inquiry being opened.

After hearing the testimonies of several staff members at the St Vincent de Paule Residence, including the accused, Magistrate Vella said that she has no doubt that the fall had led to the victim’s death.

The court concluded that in this case there had also been negligence on the part of the physiotherapist, who had not taken into consideration the particular needs of the patient when deciding which type of sling should be used.

The Magistrate ordered that a copy of the judgement be communicated to the Police Commissioner, primarily because other people should have been arraigned, including the physiotherapist, but also in order for him, in his role as Principal Immigration Officer, to decide on whether the two foreign carers should continue to work in Malta, in view of their failure to discharge their duties according to the law.

Finally, Magistrate Vella also ordered her decision be brought to the attention of the management at the St Vincent de Paule Residence, in order for them to investigate the use of the various lifters, hoists, hammocks and slings involved.