Advert

Evidence about surgical complications dominates Hugo Chetcuti murder case hearing

Relatives were kept away from the suspect, who had also been brought to Mater Dei

Bojan Cmelik was charged with the murder. Photo: Matthew Mirabelli

Bojan Cmelik was charged with the murder. Photo: Matthew Mirabelli

The compilation of evidence against Bojan Cmelik over the murder of Hugo Chetcuti continued today. Doctors who saw to Mr Chetcuti at Mater Dei Hospital gave their testimony, along with police officers who were present at the hospital or participated in the search for the suspect on the night of the attack. 

What we learned:

  • Mr Chetcuti arrived in hospital after the stabbing at imminent risk of dying, and was rushed into surgery within 21 minutes.
  • Surgeons sealed multiple perforations in his bowels and Mr Chetcuti was “completely stable” around an hour after the operation, and was awake and talking the following morning. Surgeons were confident “all would be well”.
  • Three days later, he was showing multiple organ failure and was rushed into surgery again, where a new perforation was discovered. This could have been a “very late complication of the stab wound” and may have been hidden in the first surgery, or may have grown larger after the surgery.
  • Mr Chetcuti was suffering infection from a type of pneumonia bacteria. The mortality rate for this infection is around 50 per cent, but Mr Chetcuti was weaker because of massive blood loss. He died six days after the stabbing.
  • Police officers at Mater Dei hospital had to separate Mr Chetcuti’s relatives from the alleged murderer, who had been brought in for medical checks while the victim was in surgery.
  • The suspect was apprehended after a search and chase of around an hour, and aggressively resisted police officers once he was apprehended.

Earlier:

1.02pm: The sitting has been adjourned until September 26.

12.50pm: Mr Cmelik has been seated at the dock, following the proceedings - which are being held in English - attentively, with a security officer seated at either side of him while another two keep watch, while police officers continue to describe the night of the incident. The sitting is drawing to a close.

12.40pm: The officer says the suspect was meandering among the parked cars. Police called out for him to stop and he heard a taser being fired. The suspect put up,a struggle, hitting out with hands and feet. The witness says he grabbed the suspect by the neck and tried to pull him down, but given his size and strength, it took some time to bring him down. "He was aggressive all along and refused to obey our commands," the officer said. The suspect was later certified as having suffered a slight injury to his nose. An hour had passed between the initial call and the arrest.

12.35pm: At this point, we are mostly hearing from different officers on the alleged attack and the chase that followed. Joseph Ellul, stationed at RIU, recounts how he spent around an hour roaming the Sliema seafront before venturing to the residential area. The suspect was spotted in a side street towards the end of Rudolph Street, his shirt drenched in sweat.

12.30pm: Next to take the stand is police officer Ian Borg from the St Julian’s police station, who was on duty the night of the alleged attack. He testifies that he received a call regarding a stabbing and went to the site near Hugo's boutique hotel in Paceville, where he was given a description of the suspect's clothes and a particular hat. Driving in the direction of Sliema, he spotted a man wearing similar clothes running on the rocky beach. Fellow officers chased the suspect on foot while he drove on. His colleagues then returned and informed him they had lost the suspect near Surfside, until another call informed them he had been caught elsewhere in Sliema. When they arrived, his colleague identified the suspect as the same he had chased along the beach. He was handcuffed and led back to the station. 

12.25pm: PS St John is now back to talking about his experience at the hospital, with Mr Chetcuti in surgery and the suspect on his way for medical checks. He says that once the suspect arrived, there was some commotion among the victim's relatives, but the suspect was protected and kept away. Police remained at Mater Dei until everything was over to ensure the situation remained under control. The witness identifies the suspect in the courtroom.
There was some commotion among the victim's relatives, but the suspect was protected and kept away

12.20pm: Police testify that Isaac Chetcuti told them he had followed the alleged attacker up to a spot close to Mercury House, but couldn't keep up, and lost track of him. He then returned to his brother, who was being taken to hospital by taxi. 

12.15pm: PS St John is now recounting the moment of the attack, as related to him by the victim's brother Isaac Chetcuti shortly after it happened. The victim had stepped outside for a cigarette, accompanied by his brother and his personal security, a man known as il-Gypsy. His sister, Sharon, approached and said she wanted to go visit her husband at nearby outlet some 50m away. Mr Chetcuti asked his security to go with her. Shortly after, Isaac saw a person approaching from the left - "a tall, well-built man" - wearing a yellow straw hat. He called Mr Chetcuti by name, and Mr Chetcuti turned and opened his arms wide. The stranger embraced him and Isaac told police he saw his right hand move quickly two or three times back and forth. Then suddenly the man made off, taking steps three at a time, and disappeared, while the victim fell, clutching his stomach and yelling: “Catch him! Catch him!”

12.10pm: Officers found Isaac Chetcuti, victim’s brother, at the hospital and accompanied him to a quiet room to discuss what had happened. He told police the stabbing took place at around 10.30pm, during an event organised for the opening of a new outlet on St Rita Steps in Paceville. It was not an official event, police were told, but a food-tasting to which close relatives, friends and managers were invited. Nevertheless, the doors were kept open and some casual clients were allowed entry, mingling with the other guests.

12.05pm: The police officers arrived at Mater Dei at around 11.15pm, when Mr Chetcuti was already in surgery. The corridor outside ITU was full of the victim's relatives and friends, while district police were expected to arrive soon to bring the suspect, who had since been arrested, for medical checks. The officers took precautions to make sure that suspect would be kept isolated from the victim's relatives and called for more assistance via RIU.

12pm: Next up is PS Andrew St John, who was on duty at CID on the night of the alleged murder. He was contacted by his Inspector over a stabbing in Paceville, and was informed the victim was Hugo Chetcuti and the suspect was on the run. He was then told the victim had been taken to hospital and headed straight there. 

Photo: Matthew MirabelliPhoto: Matthew Mirabelli

11.55am: Forensic expert Marisa Cassar was meant to testify next, but it appears her testimony will be heard another day. A forensic lab officer, Inspector Casha, who was assigned to take photos of the accused in prison, has taken the stand instead. He is presenting his report and photos. 

11.45am: The surgeon is now being asked about his relationship with Mr Chetcuti, whom he earlier described as a friend. Mr Attard says he developed a friendship after a long time caring for him as a patient. He says Mr Chetcuti was always concerned about his health. He had no problems except for a condition in his large intestine - which was not touched in the stabbing - described as common at his age. 

11.40am: Over the next few days, doctors fought a long battle, catering for each step. Mr Chetcuti was suffering infection. As doctors worked to discover the cause, they found bacteria of a type of pneumonia, with a mortality rate of more than 50 per cent. The bacteria is "opportunistic", the surgeon, Mr Attard, says. "A normal person may fight this bacteria and get over it. But a patient who had lost three litres of blood was no longer a normal person."A normal person may fight this bacteria and get over it. But a patient who had lost three litres of blood is no longer a normal person

11.38am: The surgeon says he removed around a foot of intestines to rejoin healthy parts of the intestines together. Fluid had been leaking into a cavity causing infection. "The infection started when the knife penetrated the intestines," Mr Attard says. 

11.35am: The question right now is about a perforation - a puncture through a hollow wall - discoveredin the intestines after the first operation. Mr Attard, who carried out the second operation, says he explored the mesentery, a layer of blood vessels supplying the intestines, and found that the wound had been sutured in the first operation and was intact. But if the knife went through the mesentery, it could also puncture the intestines beneath. It could be, he says, that there hadn't been a full penetration, but that this later developed into a perforation. 

11.25am: Surgeons opened through the incision made in the first operation and found pus, a response to infection. They suspected there may have been another hole in the intestine: as the intestines are coiled over, the knife could have hit various parts, the surgeon explains. 

11.20am: The surgeon says he returned to the hospital on Sunday morning and found Mr Chetcuti back on a ventilator. He was concerned about the victim's abdomen, and called for a CT scan to check for pulmonary embolism, a blockage of the arteries. When the scan proved negative, he went straight to the operating theatre. 

11.15am: The morning after the stabbing, Saturday, Mr Attard says he found the victim in an induced coma, about to be woken up. Mr Chetcuti was stable and in good condition, and spoke to the surgeon when he woke. We were hopeful that barring complications all would be well," Mr Attard says. But by Sunday morning, there had been a dramatic change.We were hopeful that barring complications all would be well.

11.13am: Mr Attard, who has been a consultant surgeon since 1993, steps onto the stand. He says Mr Chetcuti was a "patient and friend", and he believes the family asked him to take the victim under his care. Dr Giglio, appearing in parte civile, informs the court that the heirs have exempted doctor from the obligation of professional secrecy, to give all evidence as necessary.

11.10am: Surgeon Mr Mostafa is still being questioned about the perforation found after his operation. The next consultant on call was a Mr Ellul, but for some reason, the victim did not remain under his care but was transferred to consultant surgeon Alex Attard. Mr Mostafa is asked whether this is normal procedure, but says he cannot explain it. Mr Attard will be next to testify.

Photo: Matthew MirabelliPhoto: Matthew Mirabelli

11.05am: Defence lawyer Ismael Psaila is now asking Mr Mostafa about the surgery he carried out: had the perforation been sutured, would the end result have been different? The surgeon says the leak was only discovered 30 hours after the first operation; the perforation was not leaking during the operation and he closed all perforations he could see. It might have been a micro-perforation which became necrotic, grew wider and wider and started to leak, he says. "It might have been a very late complication of the stab wound."

10.58am: The court is told that a second operation performed on July 8 had still found perforation: from the evidence of the forensic doctor it seems the wound had not been sutured in the first operation by Mr Mostafa, the night of the alleged attack. Mr Mostafa is asked about this: he did his best during the operation, he says, but that there may have been a microscopic perforation covered by fatty tissue, which couldn't have been seen by him or his assistants. Patient was completely stable an hour after operation

10.55am: The patient was sent to ITU and was "completely stable" after around an hour. The surgeon, Mr Mostafa, says he spoke to relatives and handed over to the next consultant at around 7.30am the following morning. He next saw Mr Chetcuti three days later, on July 10. He was in very poor condition and was showing multiple organ failure. 

10.50am: The court is given a detailed account of Mr Chetcuti's emergency surgery. Mr Mostafa, the surgeon, explains that he performed a large incision across the abdomen and drew out more than two litres of blood and clots. There were multiple perforations in the bowels, with the main injury in fatty tissues feeding the small bowel. Assisted by two trainee surgeons, Mr Mostafa stopped the internal bleeding and checked all internal organs. After suturing the bowel, they washed and checked the whole bowel three times over: in all, four perforations needed suturing. 

10.45am: The surgeon says that a few minutes before 11pm, he was doing the rounds when he was told of a stabbing case in casualty. He first saw Mr Chetcuti in the resuscitation room, in shock but still able to speak. After 10 minutes of being given fluids, Mr Chetcuti still had very low blood pressure. The surgeon says he spoke to relatives and took him to the operating theatre.  

10.40am: Next to the stand is Ayman Mostafa, a surgeon at Mater Dei. The magistrate warns him that in view of other evidence held by the court, he has the right not to answer questions. Mr Mostafa chooses to testify. 

10.35am: The emergency doctor is shown photos of the puncture wounds - two wounds of about 2cm each, which he states he recognises. Dr Mifsud says he led the resuscitation to make sure the victim got to the operating theatre alive. He had no further involvement after that. 

10.30am: Next witness is Dr Josef Mifsud from the Emergency Department at Mater Dei Hospital, and the senior on duty on the day of the murder. The doctor is asked about the urgency in transferring Mr Chetcuti to the operating theatre. He says the victim had a fast heart rate, low pressure and free fluid in the abdomen. Had they carried out a CT scan, he "would probably have died then", Dr Mifsud says. 

10.28am: Dr Joslin says he personally took photos on table to avoid loss of evidence for the forensic doctors. The photos are shown in court: two showing incised wounds, and two others of each wound. Dr Joslin wraps up his testimony: he accompanied Mr Chetcuti to the operating theatre and had no further involvement. Mr Chetcuti arrived at the operating theatre just 21 minutes after he was registered at the hospital

10.25am: An ultrasound scan revealed internal bleeding in the abdomen, and the victim's blood pressure was falling rapidly, so he had to be directed to the operating theatre, Dr Joslin says. He was showing signs of shock and sweating, and was classified as a Class 3, where Class 4 is the worst. Mr Chetcuti arrived at the operating theatre just 21 minutes after he was registered at the hospital, because of the gravity of the situation. 

10.20am: Dr Joslin testifies that on July 6 he was called out at 10.49pm for a stabbing in Paceville. On the way out in an emergency ambulance, he received another call telling him to head back to Mater Dei as Mr Chetcuti was being rushed there in another vehicle. When he arrived, he found the victim in resuscitation room with two stab wounds visible on the abdomen, and a medical team already at work. 

10.10am: Proceedings are about to begin. Mr Cmelik has just entered the courtroom accompanied by four armed security officers, wearing a white bullet proof vest under his dark jacket. First to testify today will be Jonathan Joslin, an emergency consultant at Mater Dei Hospital.

Read: Entrepreneur Hugo Chetcuti dead, six days after stabbing

Hugo Chetcuti died in July.Hugo Chetcuti died in July.

What happened so far?

In the last hearing on July 31, the magistrate ruled that there was sufficient evidence for Bojan Cmelik to face trial for the murder of the well-known entrepreneur. The court had heard how CCTV footage from nearby outlets captured the attack, and how the knife in the suspect's holster matches the two stab wounds inflicted on Mr Chetcuti. However, there were no fingerprints found on the holster and it turns out that there was DNA from a third person found on the blade.

Who is in court?

Inspector Nikolai Sant prosecuting, while lawyers Ismael Psaila and Marc Sant are defence counsel. Lawyer Joseph Giglio is appearing in parte civile

Advert
Advert
Advert