Terrible silent story: in hospital, they tied the old man to a bed, injected him with strong drugs without permission, and found him dead

Unfortunately, the life of a 76-year-old seriously ill patient was immediately extinguished; all that was left was for the doctors to declare his death.

These reasons for the terrible history of Ukmergė only four years ago became apparent only when the judges were examining a damage case brought to the hospital: the Lithuanian Court of Appeal confirmed the decision of the Vilnius Regional Court to award 6 thousand euros to property non-real estate and more like a thousand euros for material damage.

According to the court, Ukmergė Hospital did not prove that the actions of its staff in caring for a patient with a serious condition met the highest standards of professionalism and diligence. On the contrary, they were not even adequate and legitimate.

According to the case data, it was established that in 2016. In July, an elderly woman was taken to the Ukmerg hospital hospital by ambulance from her home. The doctors who examined him diagnosed a cerebral infarction and later organic symptomatic mental and behavioral disorders due to brain damage. The patient was admitted to the Department of Neurology.

But here the old woman’s condition did not improve, on the contrary, she became more and more aggressive, it was not possible to talk to her.

“Relying on the qualifications of the hospital’s medical staff, I had reason to believe that the hospital was the safest place for patients with a mental condition like my mother’s, because medical professionals could and should know what care a person needs. it is not oriented in time, time and space. ” the daughter who took the case to the medical institution then referred the matter to court.

According to her, the hospital staff cared for her mother with little care, attention and diligence: “They did not do everything possible to care for a mother with obvious mental disorders and therefore unable to understand and control the meaning of her actions. so he couldn’t hurt himself. “

It was found that on the night the patient was restless, two nurses tied the woman’s hands to the bed with cloth bandages made by themselves. When he was soon able to free himself, the nurses tied not only his grandmother’s hands but also her legs. And then one of the nurses injected the patient with a solution of Diazepam, which can cause psychomotor restlessness, increased insomnia, agitation, irritability, aggression, nightmares, hallucinations, etc.

In injecting these strong medications, the nurse did not have the permission of the doctor on duty that night; the doctor only told her orally during the day when the nurse asked her what to do if her grandmother was restless at night.

“The doctor said to give her the medication as prescribed, but the patient was not examined by the doctor because they did not leave her for follow-up,” the nurse will explain later.

The patient, tied to the bed, stayed in the room, and according to the nurses she calmed down, and later, after about half an hour, a loud noise was suddenly heard: when the nurses ran into the room where the grandmother was , saw an open window and looked at the patient. The woman who jumped from the third floor was killed instantly.

The incident was the subject of a pre-trial investigation by the police, but was later rescinded by the prosecution because it did not establish that a crime had been committed.

The Commission for Determining the Damages Caused to the Health of Patients and the State Service for Accreditation of Health Care Activities stated that no harm was caused to the health of the patient during the provision of health care services to the Ukmergė Hospital. It is true that the Accreditation Service, which carried out the investigation, observed that the hospital still made mistakes: at the discretion of the GP, the nurse injected more diazepam solution to the patient, since the patient could only be given one ampoule per day .

Although no objective data on side effects and drug overdoses were officially received, the Lithuanian Court of Appeal found that “the provision of medical services to the patient violated the requirements of the legal acts and internal documents of the institution.”

“Professional liability is characterized by the fact that professional actions are evaluated by applying stricter standards of diligence, care, attention, caution, professional liability can be caused by any fault, even the slightest, that is, any negligence, negligence, insufficient performance of professional duty, “the court emphasized. . “Such action by a medical institution in which a nurse self-injects a higher dose of a prescribed drug without a physician’s permission is inconsistent with the standard of a diligent, caring, supportive, and prudent professional and shows a lack of competence for part of the staff “.

According to the court, caution and a lower dose of diazepam is recommended for elderly patients, as there is a risk of respiratory arrest and paradoxical reactions can occur.

“A situation where a nurse, rather than a doctor, decides to inject an extra dose of medication, as well as when nurses are unaware of such risks (the nurse said during the pre-trial investigation that a psychiatrist explained only after of a tragic event that a higher dose of diazepam could cause side effect), confirms the conclusion of the court on the illegality of the actions of the accused “, – noted in the court decision that has entered into force since its publication.

Furthermore, according to the panel of judges, the fact that during the pre-trial investigation a direct causal relationship was not established between the death of the patient and the use of a dose higher than that prescribed by the doctor does not in itself mean that that factor had no effect on the consequences.

“In this case, the damage to the patient’s life was caused, illegal actions were established, so that, unlike the application of criminal responsibility, the establishment of an indirect causal link is a sufficient condition for the civil liability of the charged as a result of these actions, “the court said.

The court hearing the civil case also drew attention to the misconduct of the Ukmergė nurses when they restrained a seriously ill patient to bed with ligaments of self-made material and then did not pay enough attention to her care.

According to the judges, the decision to tie the patient was made by the nurses without consulting the doctor on duty and the physical restraints used did not meet the standard of reasonableness and care.

“The medical staff did not stop wearing the bandages, even when it became clear that they were not enough to physically restrain the patient and be able to dispose of them,” the court said. – It should also be mentioned that the ligaments fixed for the patients were simply sewn from a stronger material, which was confirmed by the nurse. Thus, the hospital did not use medical means of physical restraint, but simply material ligaments that, according to the file, did not protect the patient from self-harm. In the event that the hospital does not have medical restrictions that can ensure patient safety, the standard of care and professionalism would be to refer the patient to another medical facility that has such medical facilities. “

The court, which ruled against Ukmergė Hospital, also noted that after the tragic death of the patient, a draft description of critically ill patients in hospital wards was prepared at the hospital, according to which patients with this condition were They are classified as seriously ill and should be monitored.

Ukmergė Hospital, which was prosecuted, disagreed with the claim of the deceased patient’s daughter and emphasized that the Patient Health Injury Commission and the State Accreditation Service for Health Care Activities had not found guilty. actions and inadequate provision of health services by hospital staff.

“Treatment, nursing, staff performance, and installation of hospital facilities did not lead to increased consequences, and the pre-trial investigation was terminated without any signs of crime or culpable actions by the hospital staff. “said the court in his defense.

According to the representatives of the medical institutions, the three competent authorities did not find that the hospital staff acted with negligence and that the measures they had taken were inappropriate in the situation.