Hospital staff’s attempts to dress Vincent Zammit, who was wearing just a nappy, were repeatedly resisted with aggression so he was wrapped in a blanket and taken home in an ambulance, according to Mater Dei.

There was no evidence of any acute psychiatric conditions

The hospital denied “allegations” by the family that the 76-year-old patient was treated in an undignified manner and its report into Tuesday’s incident concludes there were “no shortcomings” on its part in Mr Zammit’s care.

“All necessary standard procedures were followed in the handling of this patient; indeed extraordinary measures were taken,” Mater Dei’s report, seen by The Sunday Times, says.

The report – the first time the hospital’s version of events has emerged – was passed on to Health Minister Joe Cassar on Friday night. It will now be handed over to the independent board of inquiry appointed by the ministry for further investigation.

The story came to light on Wednesday when Mr Zammit’s wife, Madelene, and son admitted in court to resisting police and arguing with the ambulance crew over how he was released from Mater Dei.

The family later told The Times they were angry at the way Mr Zammit was sent home in such an undignified way and criticised the hospital for forcing them into a helpless situation where they had to wait for him to die as he was not eating or drinking.

Mr Zammit’s wife said she was at a loss on how to help her husband of 53 years as he refused to accept any treatment and then suffered aggressive bouts when his blood sugar levels fluctuated. This was why she wanted him to remain in hospital where he could receive proper care.

In the past 10 months, Mr Zammit was admitted to Mater Dei on four occasions, and last Monday his wife said she dropped him off at the hospital’s Emergency Department in a taxi.

Hospital notes, according to the report, repeatedly state that Mr Zammit was admitted “unaccompanied” and that his condition had deteriorated due to the possibility of a malignant lung lesion.

Mr Zammit was reviewed by a number of doctors, but, as had happened in previous admissions, he “repeatedly refused investigations including basic tests” even though he was made aware of his potentially life-threatening condition.

“Various nurses, doctors, physiotherapists and social workers, as well as the hospital chaplain tried to convince the patient otherwise... Based on his refusals to receive care he was discharged,” the report says.

Mr Zammit’s family were informed he was going to be discharged and they agreed to take him back; however, they were unable to pick him up so hospital transportation was organised.

As the staff got him ready to leave, Mr Zammit refused to cooperate with the nurse to put on his pyjamas. She contacted her superior who also tried to convince him to cooperate. Instead, Mr Zammit lashed out at the nurse’s face.

The report says witnesses can attest that Mr Zammit was “physically aggressive” to staff who tried to dress him and calm him down.

A hospital incident report – an internal procedure carried out when medical staff cannot carry out their work properly – was also filed on Tuesday saying Mr Zammit was obstructive and aggressive.

“Hospital management took the immediate action of providing transportation and of sending a care worker to accompany Mr Zammit to ensure the discharge... occurs with safety and dignity to the patient,” the report says.

It adds: “The fact he was accompanied by a care worker, which is not standard procedure, was an extra measure taken by Mater Dei to ensure the safety and dignity of the patient’s transfer to his home, given his behaviour.”

When the ambulance reached his home, Mr Zammit’s wife denied she was informed about his discharge but the hospital insists it has proof showing otherwise.

The report is clear on Mr Zammit’s mental clarity. “There is no evidence of underlying acute psychiatric conditions... In all his admissions, he was seen by different professionals and at no point was psychiatric illness evident.” It was at this point that Mater Dei called the police to intervene. Consequently, Ms Zammit and her son had an argument with the police that landed them in court.

“Given the specific circumstances where the patient was totally uncooperative and there was, in actual fact, very poor family support, there were no shortcomings in the care of this patient,” the report concludes.