A surgeon has been exonerated and acquitted of the involuntary homicide of a patient on December 24 to 25, 2006.

The surgeon, *C, operated on the patient on September 7 that year together with another two surgeons, A and B.

The court said that the patient had been a very sick man with a serious heart condition. He suffered from uncontrolled diabetes and, as a result, from peripheral neuropathy. He also used to smoke around 30 cigarettes a day.

On September 7, 2006 he had a coronary artery bypass grafts operation, with a five per cent risk of death, which is considered high.

The operation was initiated by A, B harvested the veins and C carried out the operation.

B made a series of small incisions to take out a vein, lifted what he thought was a vein and said to C that the veins were not in a good condition.

C replied they had no choice but to work with what they had. The ‘vein’ was cut and clamped on one end.

C temporarily left the theatre and then returned to prepare the vein for the bypass.

At one point, A remarked that the vein on the operating table looked like an artery.

C went to verify and realised that A was right. He then tried to look for a vascular surgeon in hospital but there was no one and decided that it was too risky to wait for somebody to come from home.

So the three of them successfully replaced the artery artificially. But, on the following day, the leg was still cold. A second operation was carried out to extend the artery and this was also successful so much so that the patient even started to walk.

However, in the first week of December 2006, two of the patient’s toes turned blue and a decision was taken for the leg to be amputated.

On December 23, he was given the opportunity to spend Christmas at home but on Christmas Eve at 10pm, his son found him on the sofa in a pool a blood. He was rushed to hospital and he died at 3am on Christmas day.

The autopsy report said he died from massive blood loss following gastro-intestinal bleeding.

In her judgement, Magistrate Edwina Grima said she could not help but observe that although the experts in the magisterial inquiry reached their own conclusions after hearing the witnesses, it seemed that, at least two of them, did not know what the conclusions of the autopsy were and did not even ask what they were.

Moreover, C was not the person who did the mistake. His decisions were reasonable and taken in the best interest of the patient. He was never negligent careless or imprudent. He informed all the people concerned, including his superiors, about what had happened and there was no direct link between the man’s death and the medical mishap.

The magistrate said that the mistake could not be described as a gross, negligent one. The patient was thin, suffered from vascular diseases and diabetes. The artery that had been cut was positioned superficially in a situation described by experts as a rare complication which could happen and which was also reported in international medical literature.

But the accused in such unfortunate circumstances did all in his power to save a man.

Magistrate Grima said the prosecution did not manage to prove that the behaviour of the accused during the operation and after was not that expected of him.

The court, she said, believed he acted in the best interest of his patient so much so that he gave the patient the best possible and personal specialised care.

Quoting C, she said he explained his sentiments towards the patient in this way:

“It’s very sad that the patient died. People don’t realise, perhaps, that the surgeon is one of the people who suffer most when a patient dies.

“We want all our patients to live, not because of our reputation, but because we are trained to cure patients...

“When you have a patient... who is with you for three months and you are dealing with him day and night ... a surgeon not only loses a patient but loses a friend, and we go through bereavement as well…

Lawyers Giannella de Marco, Steve Tonna Lowell and George Hyzler appeared for the surgeon.

*The court banned publication of the names of the surgeons and the patient.