A magisterial inquiry was ordered earlier this year by the hospital authorities following an incident leading to the death of a patient.

However, the holding of the inquiry and its results were not made public by the health authorities and information only started coming out yesterday after questions raised by this newspaper.

In e-mail correspondence seen by The Sunday Times of Malta, Mater Dei Hospital’s Clinical Director Joseph Zarb Adami last month informed heads of department that following “an incident leading to the death of a patient” he found it necessary “to emphasise that several hours after patients return to ward and before the night steps in, all patients recovering from major surgery should be reassessed by the on-duty team to ensure that no major deterioration has taken place since the transfer from theatre.”

In his correspondence, Dr Zarb Adami also revealed that currently, high-risk patients requiring continuous monitoring after major surgery are not being given the adequate attention due to the shortage of nurses.

“Whilst I agree that high risk patients should be cohorted to High Dependency Units (HDUs), this at the moment is not happening due to shortage of nurses,” Dr Zarb Adami wrote.

When contacted, Dr Zarb Adami confirmed that an incident took place and revealed that the police were called in and a magisterial inquiry ordered.

“The inquiry concluded that the death was caused by natural causes and not through negligence,” he insisted.

Playing down the contents of his e-mail, as he said that “there are from one to two such accidents every week at Mater Dei,” Dr Zarb Adami said that “the incident was about claims made by a family member of the deceased patient that the death was caused by carelessness. This has not resulted,” he said.

We are not trying to hide anything

“Still, I felt that there was the need for further tightening (in the services provided) and that is why I wrote that e-mail,” adding that “we deal with these things all the time”.

Asked whether incidents at Mater Dei Hospital are common occurrences, he confirmed, but said that these do not always involve death.

“We are not trying to hide anything. Every time we have incidents or claims of negligence, we get in third parties (a magistrate) to conduct an inquiry. So far, nothing and no negligence have been ever found,” he insisted.

When this newspaper pointed out that what he was saying was even more worrying, Dr Zarb Adami said that it was the contrary.

“This shows how safe our patients are as nothing has ever been found,” he insisted.

Asked what he meant about patients needing increased monitoring after major surgery not being given the proper attention due to shortage of nurses, Dr Zarb Adami admitted that resources are limited.

Stating that demands for the setting up of High Dependency Units have been made for a long time by various hospital units, he said that the required resources (nurses) are not available.

He said that a HDU has already been opened for stroke patients and another one is to be opened shortly.

Mater Dei sources told this newspaper that there are no HDUs for patients requiring major surgery.

“It’s either the ITU – which has 19 beds – where you get one-on-one attention by a nurse or the general ward where a nurse has to look after 12 patients at a time,” the sources said. “There is no half-way ward as happens normally in other hospitals. This has been the situation for a long time and surgeons have been asking for HDUs since the hospital’s opening,” the sources said.

The Health Ministry has so far failed to explain why an inquiry on the death of a patient had not even been announced as normally happens.

Asked for a copy of the results of this inquiry, the ministry said: “Requests for magisterial inquiry reports should be directed to the Attorney General.”

“It is not standard practice for Mater Dei to issue press statements regarding magisterial inquiries,” the ministry said.

Only last year, the Health Ministry announced the holding of various inquiries including on the death of a patient at Mt Carmel and the use of outdated medicines at Mater Dei.

ivan.camilleri@timesofmalta.com