Medical negligence that shocked the Cypriot society - The greatest punishment

The "negligence" file opens with a look back at the cases that shocked the public

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The increased complaints of medical negligence in Cyprus lately are causing intense concern. SigmaLive attempts to open the "negligence" file by taking a look back at the cases that shocked the public. At the same time we talk to Michalis Vorkas who explains the legal framework of these cases.

The most recent incident of sudden death was the loss of 31-year-old Katerina Pekri, who passed away on Saturday, October 16, leaving two children.

Katerina Pekri, 31, was hospitalized at the General Hospital of Nicosia, where she was transferred due to complications she presented after a recent surgery in which she had undergone a private hospital.

In addition, two more sudden deaths of children leave questions about how the two children (one of them an infant) lost their lives in a very short time.

On October 8, a one-month-old baby breathed his last. The unfortunate baby was in the Limassol General Hospital for treatment, where the doctors who were watching him considered it necessary to transport him to Makareio Hospital.

The baby's family filed a complaint for medical negligence against the Limassol General Hospital with the police investigating a case of sudden / unnatural death.

A few days ago, another sudden death of a child had caused concern about how the child lost his life.

On September 29, a six-year-old boy died at a private hospital in Nicosia after surgery. The 6-year-old had a congenital heart problem.

At the same time, the incident with the infection of 8 patients who had undergone cataract surgery has returned to the forefront.

About a year ago, eight patients who underwent cataract surgery became infected with the powerful pseudomonas bacterium, causing some to lose their sight in one eye and two to lose their lives.

The first patient died a few days after surgery while the second patient died almost a year later.

Specifically, on Sunday 17/10, a second patient who had undergone cataract surgery died.

Speaking to SigmaLive, the 79-year-old's grandson said that her death was caused by multiorgan and heart failure. He further added that at the end of the month they are waiting for the conclusion of the investigation that had started for this case.

The babies who died from legionella

The death of three babies in 2009 by the Legionella bacterium shocked the whole of Cyprus.

Specifically, the legionella bacterium had developed from the double problem of water stagnation in the water pipes of the clinic and the non-disinfection of the water system on an annual basis.

It reached the newborns when the contaminated water of the clinic was placed in a nebuliser, ie a system of evaporation of water in the air, which was placed in the room where the babies were. As a result, the newborns inhaled the germ.

A total of 11 children were infected with the bacterium, three of whom died.

Three and a half years after the tragic event, Konstantinos Kastanos, then General Manager of the Hippocratic Hospital and the founders of the hospital, Odysseas Athanatos, Vassilios Makris and Christos Riris were sentenced to three months in prison with a suspension of three years and a fine of 8000 euros. accused and 1800 euros for each of the other three.

The legal aspect

Speaking to SigmaLive, lawyer Michalis Vorkas, who specializes in medical malpractice cases, referred to cases of medical negligence, when a case is considered medical negligence and what was the largest sentence imposed in Cyprus for medical negligence.

Initially asked when a case is considered medical negligence, he said that in Cyprus medical liability can take its form,

(1) Criminal liability

(2) Liability arising from a contractual obligation

(3) Liability, which may constitute assault or negligence

The patient seeking compensation for medical negligence must prove:

(i) The existence of a duty of care to the patient. To this end, the patient must prove the existence of a doctor-patient relationship. The doctor has a legal obligation to treat a patient in the hospital or clinic where he works, but he has no legal obligation to act as a lifeguard for a stranger who loses consciousness at a party or is injured in a car accident. Here the legal obligation is noted as opposed to the moral one

(ii) Negligence or omission on the part of the physician. The patient will have to prove that the doctor has breached his or her duty to be diligent by presenting evidence that the doctor's actions were inferior to what is considered satisfactory by the courts.

(iii) Causing damage. The patient must prove that due to the actions of the doctor his health has deteriorated or that he has suffered some other specific damage.

Asked how often medical malpractice cases are brought to court in Cyprus, he replied that, unfortunately, several lawsuits are filed in the Cypriot courts every year.

Asked later if medical malpractice cases due to the pandemic had increased recently, he replied:

"The pandemic has brought to the fore a new kind of medical negligence cases. "In particular, serious medical problems have arisen in a number of our fellow citizens who have received the coronavirus vaccines, which may be taken to court."

Referring to the highest compensation for medical negligence in Cyprus, he said:

"The largest amount awarded for such a decision as far as I know amounts to € 2,411,853 plus interest and court costs.

This amount included the minor's compensation for his pain and suffering, his future medicines, medical expenses and treatments, the expenses for his necessary assistants in the future, the loss of his income due to his inability to work as a and the costs already incurred before the trial.

The case concerned the negligence shown by the doctors and the nursing staff during premature birth, as a result of which the newborn was born with severe cerebral palsy, making him unable to walk, speak and see ".
The specific incident to which Mr. Vorkas refers is the case of Zoe Sultanian, who was born on July 16, 1999 in Makareio Hospital.

The history of the case

Anna Sultanian was taken to Makareio Hospital by Larnaca General Hospital where she was treated to give birth prematurely and although the doctors and nurses who saw her then told her that she still had time, while she was lying down she felt a water fly out of her body and had given birth.

He was a very small, immobile and battered child who did not even cry. When a nurse heard her mother she ran and saw Anna and little Zoe. As it was later heard in court, the nurse's reaction was to ask her why she did not call them. She was the one who had previously told her that she still had time until childbirth.

In court, the judge stated that the mother was left alone in a room without constant monitoring, as a result of which she gave birth alone. The newborn was not immediately subjected to the process of resuscitation and intubation and this omission further aggravated his condition and contributed to his cerebral palsy.

The cerebral palsy suffered by the plaintiff was the result of the actions and omissions of the doctors and the nursing staff of the two hospitals, namely the Larnaca General Hospital and the Makareio Hospital ".

It even turned out that there was a way for the child to be born and live a normal life.

Although she had to give birth in the presence of an obstetrician, not only was she not given this "convenience" but on the contrary she gave birth alone.

The shocking facts surrounding the case, however, did not end there. After the child was born and the nurses took it to take care of it, a woman who worked as a cleaner realized that they had left Anna Sultanian's placenta and there was a risk of losing her life and then she took it out herself!

This child lives from the day he was born with

· Cerebral palsy type quadriplegia

Cerebral hemorrhage, methaemorrhagic hydrocephalus and brain atrophy

· Serious problems with vision, hearing, while not even speaking

Treats seizures and convulsions

· Has motor disabilities, visual disturbances, mental retardation and speech retardation

Then, Mr. Vorkas, answering the question if there was a case of a doctor who was imprisoned for medical negligence, said that he is not aware of such an incident.

"Medical negligence can also take the form of criminal liability under certain conditions. The only decision on the matter is the Mavromatis v. Police (1996) 2 A.A.D. 69, 73. There, the charge is based on the fact that the accused 1, while he was the treating physician of a minor patient, gave instructions for administering 200 ml. manitol, while he should have known that the dose was excessive for the patient and further, while knowing the risks of the prescribed amount, failed to give the appropriate instructions for supervising the patient at the time of taking the drug. The Court of First Instance ruled that the accused, by his conduct, showed negligence, lack of attention and recklessness which falls within the definition of gross negligence and found him guilty for the following reasons:

The patient due to the young age had to:

a) take a different amount of mannitol from adult patients

b) to give clear recommendations for its monitoring during the administration of the drug

The Court of Appeal accepted the appeal against the conviction as it ruled that the Court of First Instance erred both in the legal aspect and in the conclusions on the facts in its decision. The Court of Appeals ruled that the criminal negligence required to prove responsibility is less than the culpable negligence required for the homicide offense, but greater than the degree required for the offense of driving without due diligence, negligence located on the same level as civil negligence.