Sunday, January 30, 2011

170. Havana Psychiatric Hospital Trial Concludes

Josè A. de la Osa, Granma International, January 24, 2011

From January 17-22, individuals implicated in the events which took place in January 2010 at Havana's Psychiatric Hospital were tried in the Second Criminal Courtroom of the Provincial People's Court within this city, for the crimes of negligence of minors, persons with disabilities, and misappropriation.
During oral arguments in the public trial, the prosecutor proposed sentences of six to 14 years' imprisonment for the hospital's director, deputy directors for Psychiatry, Clinical Surgery, Nursing and Administration, and the head dietician.
For the remaining defendants, who worked in administration and were charged with misappropriation of funds, sentences ranging from 10 to 12 years were solicited.
The court examined 70 witnesses and experts from the Medical Law Institute and the Central Criminology Laboratory, and a number of documents. For over 12 hours every day, the evidence was discussed and contrasted during court sessions.
During one of the sessions, a special report was presented on the results of an investigation undertaken by a national commission created by the Ministry of Public Health to study and determine the causes and conditions which led to the deaths which occurred at the hospital.
The commission was composed of 35 highly qualified scientific investigators who, as a whole, represented an important group of professionals from 14 specialties, including clinicians, intensive care specialists, integrated care family doctors, pathologists, heath administrators, epidemiologists, dieticians, anthropologists, biochemists, geriatricians, psychiatrists, pharmacists, logistics specialists and others.
The prosecutor maintained in his accusation that the hospital administration, despite having the experience, knowledge and resources available on-site, did not adopt necessary measures to protect patients, individually or collectively, from the impact of the January 9, 2010 cold front which produced very low temperatures, such as increasing the assignment of clothing, sheets and blankets to patients; preventing the entrance of cold air into wards with structural problems by covering windows and doors, or moving patients to rooms in better condition.
At the same time, the prosecutor insisted to the judges that those responsible for the lack of protection failed to reorganize or reinforce the human resources within the hospital in order to provide the protection needed by high risk patients, such as special medical or nursing services.
The prosecution alleged that those implicated knew that an increase in deaths due to respiratory illnesses had been observed during the winter period, this demonstrating the lack of commitment on the administration's part in the face of this situation, which led to insufficient attention to patients.
The prosecutor presented evidence of the failure, on the days when the events occurred, to implement procedures established in General Hospital Rules related to the organization, completion, management and integration of assistance. Among those which stand out were: the failure to provide adequate staff coverage on weekends: the designation as head of weekend staff of individuals who were not part of the administrative council and who did not have the authority to make decisions; and the failure to guarantee that staff and administrators were fulfilling their responsibilities and functions.
The prosecution explained that the aforementioned failures, allowed, tolerated and committed by the hospital administration, contributed to the events which took place.
He maintained that the hospital received a food allotment based on its 2,458 beds, of which only 1,484 were occupied on average, which guaranteed a diet including all basic nutritional components for patients, making it difficult to justify the situation encountered during the clinical evaluation which revealed signs of malnutrition, with a high number of patients diagnosed as anemic and lacking essential vitamins.
The prosecutor told the court that the failure on the part of some of the defendants to comply with internal control regulations and procedures, as well as regulations established by the Ministry of Public Health, led to misappropriation of resources intended for the nutrition of patients and of other products such as clothing and linens provided for patient use.
Given the facts presented, the prosecution concluded that the hospital administration did not act as the situation required; appropriate decisions were not made by those in authority. They failed their patients, failing to fulfill the responsibility conferred on them by the state.
Since these events came to light, sparing no technical or human effort, a difficult and painful investigation was undertaken in search of the truth, which touches every Cuban profoundly, unearthing such behavior in the heart of a sector which is the pride and strong point of Cuba and of many countries of the world, where, every day, health workers offer an unequivocal example of humanism, commitment and solidarity with the most needy.
Miguel Angel Valdés Mier, president of the Cuban Society of Psychiatrists, Ph. D. in Medical Sciences, who participated in the trial as an expert witness during one of the court sessions, affirmed that as a result of these painful events, he has felt " intense pain" over the deaths, which were used as a pretext to slander "one of the most noble conquests of the Revolution."
The team of lawyers who assumed the defense of the accused, publicly indicated that during the trial they were fully guaranteed the ability to perform their duties and in their closing statements expressed arguments supporting the defendants, such as considerations of a technical nature concerning the charges filed against the defendants.
The president of the Court declared the public, oral trial concluded for consideration of sentencing.

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