The Ombudsman slammed the Health Division and hospital staff for their “wrong, uncaring and insensitive attitude” in withholding medical information from the parents of a 16-month-old baby boy who died unexpectedly of pneumonia nearly two years ago.
The authorities wrongly refused to produce the baby’s medical records or any information, basing their arguments on an ongoing magisterial inquiry, saying the case was sub judice, Ombudsman Joseph Said Pullicino said in a report.
But he pointed out that a magisterial inquiry should not exclude or “replace” an internal inquiry into an issue. Also, the Health Division should not use sub judice as a “pretext” to withhold information from friends and relatives, he said.
The baby was found dead in his cot in December 2008 by his father just three days after his parents, who are not named in Dr Said Pullicino’s report, took him to the Accident and Emergency Department suffering from croup.
The baby was rushed to Mater Dei Hospital in an ambulance but medical staff failed to resuscitate him. One day later, the autopsy established pneumonia as the cause of the death.
But the couple refused to accept this “vague” explanation, especially because their son was healthy three days earlier and demanded an explanation from the hospital management.
However, the management refused to give any explanation or hand over the medical records, saying the case was sub judice because there was a magisterial inquiry.
The inquiry, concluded in August 2009, established there was no mismanagement by medical staff. But the parents were not satisfied with the outcome and felt the inquiry had “incorrect information”. Instead, they turned to the Ombudsman.
His investigations revealed that hospital staff and the “top rungs” of the Health Division kept “aloof” from the situation because the issue was being investigated by the courts. Only the Paediatrics Department chairman approached the parents soon after their son died to explain what happened, Dr Said Pullicino said.
Even though the parents had every right to request a copy of their son’s medical files, he noted they were only given a copy after his office intervened. “This attitude and failure to provide any support to the parents on grounds of an ongoing magisterial inquiry was wrong, uncaring and insensitive,” he said.
Dr Said Pullicino, a former Chief Justice, pointed out that the sub judice element only bound the people involved in the inquiry.
“The condition regarding confidentiality arising from the sub judice status of matters covered by a magisterial inquiry binds only the magistrate and court staff and experts taking part in the inquiry and no other person is bound by any such condition unless expressly enjoined by the magistrate not to communicate any specific type of information,” he said.
Also, hospital staff were afraid of giving any information in case it could be used against them in a civil court case opened by the parents.
This, together with their “mistaken” breach of the court’s orders gave rise to a situation where the parents faced an “impenetrable wall”, Dr Said Pullicino said.
“Hospital management does not have a right to withhold any such information on the pretext that a magisterial or other inquiry is in progress or that its disclosure could embarrass or prejudice the hospital administration or the health professionals who are involved,” he said.
Also, he was “deeply appalled” that the parents did not receive any form of bereavement counselling for several months “at a time of deep pain caused by their child’s death”.
Dr Said Pullicino said his office could not investigate the magisterial report and said the parents could seek legal advice on how best to move forward if they wanted to take it up further.
He stressed he did not want to cast any shadow on the quality of the treatment and pointed out there was no evidence of any lack of reasonable medical and nursing care. However, there clearly was “a glaring failure in communication” between the hospital management and the child’s parents to ensure pain relief intervention.
The Ombudsman recommended that hospital authorities open an internal inquiry in these circumstances unless specifically prohibited by an inquiring magistrate and to also draw up a protocol to guide staff on how to tackle painful situations.
There had to be an urgent protocol with clear written instructions on how to deal with requests for the medical records of patients.
Finally, Dr Said Pullicino said voluntary organisations focused on palliative care should be roped in to assist professional support structures in difficult moments.
The Health Ministry said it was deeply saddened by the untimely death of the young child and welcomed the report. It would be taking his observations very seriously, it said.