When Gavin Jones took legal action over the circumstances of his mother’s death in Paphos General Hospital he was subjected to a litany of administrative abuse spanning more than six years. Below is his account of a long fight for justice
By Gavin Jones
MY CYPRIOT mother, the artist Thraki Rossidou Jones, died in July 2007 in Paphos General Hospital in tragic circumstances. Despite vociferous protests from my wife and myself, a nurse force-fed my mother, an unconscious nil-by-mouth stroke victim. Within minutes she was dead.
Clearly, my wife and I were determined to get a thorough investigation and demanded an inquest. The first inquest hearing began in May 2008 but, by then, our lawyers had not been sent the police file of witness statements and other relevant papers. At the first hearing, the judge directed the lawyer representing the Attorney General’s (AG’s) office to release the file to our lawyers but no explanation was given for the 10-month delay. The second hearing lasting only a few minutes took place on June 12. The AG’s lawyer said that the file would be sent over later in the day. It wasn’t. Hearing number three a week later produced the same result, the state’s lawyer stating that more time was required to locate the file.
Luckily, in the court cafeteria we casually told a policeman who was acquainted with our case that the file was ‘lost’. He then coolly announced that the file was not ‘lost’ at all. It was in the filing cabinet in his office! Our lawyer then advised the judge that the ‘lost’ file was no longer ‘lost’. Strike one.
Hearing number four took place in July. You guessed it. Our lawyers had still not received the file despite the court knowing it had been ‘found’. The AG’s lawyer confirmed that the state had the file and that our lawyer would have it that very day. Delaying tactics par excellence. The judge ordered its release but, as the summer recess was upon us, September would be the earliest that hearing number five could take place, which was purely procedural.
Hearing number six took place on October 10. However, neither the state’s pathologist nor the hospital’s cardiologist were there, both having informed the court that they were otherwise engaged in seminars. We were not advised beforehand and had naturally turned up. Yet again, another adjournment. It’s not difficult to realise why Cypriots are disaffected with their judiciary. Further arbitrary changes continued throughout the inquest procedure which racked up a grand total of fourteen hearings, the last being in March 2009.
We naturally thought that the marathon inquest fandango was now over. Not a bit of it. We then had to wait a further ten months for the verdict despite a stipulation in the Cypriot legal system that an inquest verdict should be delivered within six months of the completion of the case. From start to finish, the process had taken almost two years. At least we were relieved that the judge had stated that asphyxiation was the cause of my mother’s death: in medical parlance, an unnatural death which implies a non-accidental cause.
We then had to overcome the next hurdle. In order to launch a lawsuit against the state for medical negligence, I needed control over my mother’s affairs, something which I thought was a formality as I was an only child. Wrong. Our lawyers obtained the relevant file from Paphos District Court. The papers revealed that my mother’s lawyer had submitted an affidavit in which he’d removed me as an executor of her will by stating that I hadn’t been living in Cyprus, (as he well knew, my wife and I had been in Cyprus for some considerable time), that she’d died in England (she’d died in Paphos) and that she’d died in 1998 (she’d died in 2007). This affidavit with these false facts had been accepted and verified by the court, thus giving him control over her affairs and assets. Why did the court not check the death certificate which clearly states date and place of death? I was then forced to go to court to remove the false executor and reinstate me. Moreover, I filed a complaint to the Disciplinary Board of Advocates (DBOA) over the lawyer’s behaviour. A year later I received a letter from the DBOA which exonerated him, citing “common clerical errors” as an excuse and that there was no case to answer: apparently not even negligent let alone fraudulent!
Seeking justice rather than compensation, we launched a medical negligence lawsuit at the end of 2009 which reached court in February 2012. The appointed judge directed both sets of lawyers, ours and the state’s as represented by the Attorney General’s office, to try and settle out of court. This we agreed to and proposed a figure. We heard nothing more for eight months, only to return to court in October to discover that the AG wanted to take us on in court. A date in February 2013 was fixed for the process to begin but then the judge was transferred to another court and a lady judge took over. Three more court dates and two more judges came and went before finally in December it was honoured.
With me finally in the witness stand and preparing to be cross-examined by the AG’s lawyer, the judge asked me why I hadn’t agreed to settle out of court. Assuming that he was unaware of the background to the case, I explained in detail what had transpired and that I had agreed to his suggestion almost two years ago. Furthermore, I also pointed out that he was judge number four in this long-running saga and that the delays were not of our making.
He then warned me that despite the asphyxiation evidence and the fact that the cardiologist was at home instead of being on duty in the hospital building at the time of my mother’s death, I could be facing legal fees for the state of €20,000 with a similar amount for our own lawyers. As there are no juries in Cypriot courts, my fate was in the hands of this man who was spelling out in no uncertain terms which way the wind was blowing. Later, the judge again referred to his opening statement that I should settle. We left the court and our lawyer immediately advised us to settle. In such a prejudicial atmosphere, I reluctantly agreed. For me, it was a Pyrrhic victory with great emotional cost.
It’s hardly surprising that lawsuits involving medical negligence in Cyprus are far and few between. Proving one’s case is difficult at the best of times, despite overwhelming evidence in one’s favour. The maximum payout in Cyprus is €17,000 and is dependent upon the age of the victim and other factors bearing on loss.
My mother was 87 so in legal terms she was deemed to have almost negligible financial ‘value’, even though the evidence pointed to culpable homicide. Life, it seems, is cheap in Cyprus and the judiciary are demonstrably biased against plaintiffs.
To put this in a first-world context, in the UK the average settlement in a case where clinical negligence damages have been awarded was some £280,000 in 2009-10. The UK National Health Service has set aside £22.7bn for current and expected claims. In the USA, individual medical negligence claims often run to millions of dollars.
Our costs for the lawsuit were relatively light and the final damages settled were €3,000. Our lawsuit was never about compensation per se but about justice. However, separately the fourteen inquest hearings racked up more than €15,000 for legal fees and medical advice. These charges were not part of the lawsuit and were therefore not eligible to be reimbursed, of which we were unaware. In order to obtain the right inquest verdict to enable us to proceed to the lawsuit, unbeknown to us we had to bear those earlier separate costs ourselves: a cruel irony and hardly just.
Over the years, many Cypriots have described to me disturbing incidents which have taken place in their hospitals. Without exception, they decided to take the matter no further as they felt that they’d be wasting their time and money and that the system was weighted heavily against them.
This is not a uniquely Cypriot phenomenon. In his famous book on government, society and freedom entitled The Man versus The State, Herbert Spencer (1884) recognised the scope for abuse of citizens. However, in close-knit societies such as in Cyprus, there are also deep-rooted allegiances which bind families, friends and associates and these relationships tend to preclude any action being taken against one another which would upset the status quo. Backed by ministerial and judicial policy, hospitals, clinicians and administrators have come to believe that they are untouchable and unaccountable and any evidence of wrongdoing, even manslaughter, must be swept under the carpet, with any accusations denied and resisted.
There’s a serious downside to this state of affairs. This silence and acquiescence permeating health care in Cyprus stunts improvements in standards, keeps incompetents in post and more than likely condemns thousands to premature death. A former Ombudswoman’s report on public health cites poor quality of care, outright medical negligence, loss of medical files, and delay of emergency operations due to excessive red tape.
By agreeing to pay damages, however derisory, as a result of my mother’s death, the state has in effect admitted that problems exist in one of its key institutions. Will the new AG therefore investigate the hospital for force-feeding an unconscious stroke victim? Will he prosecute the hospital for ‘losing’ my mother’s medical notes? Will he ask why a doctor, who was supposed to be on duty in the hospital building during my mother’s trauma, was at home? I’ll let the reader guess what action he’s likely to take.
Gavin Jones’ e-book A Mental State ISBN 9781 78301 1353 expands upon much of this article’s contents. Available from www.amazon.com or www.amazon.co.uk using either a Kindle or free e-reader software.