A horrific case of domestic neglect which led to the death of a woman has been decided by the courts.
Salvatore and his son Stanley Chircop of Birkirkara were charged with involuntarily, through negligence, causing the death of Serafina Chircop in 2014.
Serafina Chircop was taken to hospital by ambulance on June 7 2014, but died shortly after.
She was just 64 but looked twenty years older, witnesses said.
Inspector Luke Bonello had told the court that the police had been notified by hospital staff that a woman had been admitted in a state of appalling hygiene, covered in bedsores – one of which had exposed her hip bone – and was in danger of death. It emerged that the patient had suffered from advanced arthritis for 7 years and had ended up bedridden, but would refuse all medication besides painkillers. She did not want to be touched because she was in so much pain.
Salvatore Chircop would take care of the house and do what he could to feed his wife and hold her cigarettes as Serafina was a heavy smoker, he said. The court was told that the woman also had burns to her chest which had been caused when she was unable to swallow hot soup which her husband had been feeding her.
But it hadn’t always been this way. Before her health deteriorated, Serafina had been “the pillar of the house”, Salvatore had told police, taking all the decisions and wanting to have her way all the time.
A police sergeant testified to being despatched to Mater Dei hospital to deal with the report and finding the woman in the foetal position, covered in bed sores and filth. The situation spoke of “massive negligence on the part of her family members for not taking care of her,” she said, adding that a necklace she had been wearing was embedded in her skin, such was the level of grime. “Her hip bone was literally exposed because the skin had been eaten by worms. Although her eyes were open, she was not conscious, in the sense that she would be looking at you blankly.”
Despite medical staff’s efforts to resuscitate her, Serafina Chircop died in hospital.
The police sergeant had then gone to the home of the accused, she said, explaining that the residence had such an unbearable stench that she could only briefly look at the woman’s bedroom before having to go outside.
“Upstairs there was a filthy bed… grime that defies description. There was blood and some long-ago dried liquid on the bed, many flies circling a patch on the bed, not to mention the dogs who were allowed to lick these filthy sheets.”
A nurse who arrived in an ambulance told the magistrate that one of the woman’s eyes was stuck to the sheets and that no colour was seen in her iris, possibly as a result of this. She would only respond to painful stimuli, said the nurse. The woman was found lying on her side. When she was turned over, her lower side was found to be flat and stuck to the sheet. The nurse said it had been a niece who had called the ambulance.
The ER doctor who treated her testified that the “patient was evidently unable to take care of herself well and neither be cured.” There were many pressure sores on her body, he said. “When the patient… was washed and we moved her, a lot of insects emerged from underneath her and there was also evidence of many matchsticks underneath her.”
Serafina Chircop was also suffering from broken bones which had been left untreated.
This emerged as another doctor told the court that the woman had old fractures in both her femurs. There was also a new spiral fracture in her left femur, the doctor said.
From her medical file it emerged that the woman had suffered from rheumatoid arthritis and had refused two knee replacements. The doctor explained that in cases involving bedridden patients, it was important that they are placed under constant medical care and given assistance with basic hygiene.
The woman’s sister testified that Serafina Chircop was terrified of hospital. She would speak to her on the phone every day but would not visit her often because she had to take care of their mother. During those phonecalls Serafina would cry because she was in a lot of pain, explained the witness. The sister had called for the ambulance because she had seen her sister in so much pain, she claimed.
Under cross-examination, she had confirmed that the accused would regularly tell their mother that she needed to go to hospital but that she would always refuse.
Accused Stanley Chircop had taken the stand and testified that a lift had been installed at their home and that his father had bought a van to be able to transport the woman in her wheelchair. On one occaision, he said, he had found his mother in tears after a surgeon had told her that they were not going to operate on her and that she would be wheelchair-bound. From then on, she refused to go to hospital, he said.
Asked by the magistrate about the filthy condition his mother was in, he said they would try to turn her but as soon as they touched her she would scream and they didn’t want people outside to think they were harming her. “We couldn’t move her, she couldn’t move from the bed. She didn’t want to move from the bed…I don’t know exactly what was underneath her because I’m telling you, we’d go to turn her and she wouldn’t let us…we couldn’t do anything,” he said.
Under cross-examination, he said that the woman had been refusing to go to hospital for over a year.
But despite this, no carers were employed. Instead, said the accused, a niece of the woman would go once a week to wash her. But after Serafina started to give her trouble, the washing started to become superficial, he claimed. The court observed that this account did not tally with the abysmal state the woman was found in.
Co-accused Salvatore Chircop, the woman’s husband, also testified. He would give her medicines according to a timed list, he said, because she was unable to grip anything. He also said that she refused to go to hospital. Asked what stopped him asking for help, he said: “she did because I couldn’t do it and God forbid I do, because they’d come for nothing if she said ‘no, no’.” Chircop told the court that hehad called the ambulance.
Magistrate Donatella Frendo Dimech was outraged by the neglect. “It was only thanks to her sister and niece that Serafina was taken to hospital. Her husband and son, who used to live with her, took no initiative to have their mother treated and instead left her to rot and be taken over by muck, worms and insects.”
Noting contradictions in their testimony, the court pressed him on his statement that he was her “carer.” He would take her to the toilet in her wheelchair, he said, but hadn’t noticed the septic state of her sheets. They would change her sheets, although this happened more often when she was in better health, claimed the accused. Asked how often they were changed in her last month of life, he said “we couldn’t really…she didn’t want us to touch her. In the last bit.” The woman had given up on life, Salvatore said, and he felt that he shouldn’t defy her wishes.
He could not afford a carer, he said, but the court pointed out that there were state-funded options for care.
The magistrate ruled that from the evidence it was clear that Salvatore and Stanley Chircop had “abdicated from their duty to Serafina, abdicated from the duty of care that they placed themselves under when they decided to keep her at home without medical or professional care. They failed to predict the consequences of their inaction.”
Forensic and medical experts certified that the deceased woman’s emaciated state led them to believe that she had died of pneumonia caused by bedsores, malnutrition, lack of circulation and poor hygiene.
“Serafina Chircop was definitely neglected and was not receiving the help and attention that she needed,” noted one, observing that she had scalds all the way down her front caused by hot liquids and fractures compatible with a fall from her bed or rough handling.
The court observed that the scalds pointed to a woman who was unconscious, “and not the dictator described by her relatives, in a position to give instructions on her healthcare!”
The court, after providing a detailed analysis of jurisprudence and authoritative texts on the matter of duty of care, ruled that Salvatore and Stanley had chosen not to refer Serafina to hospital and had assumed a far greater duty of care by keeping her at home.
The court said that in this case the actions of neglect which led to Serafina’s death were “undoubtedly voluntary” as well as ”inexcusable and unjustifiable.”
Noting that the accused were not first time offenders and that the crimes were aggravated by the relationship between the accused and the deceased, the court opted not to impose a prison sentence, saying the facts of the case “militated towards the giving of a maximum suspended prison sentence.”
The pair were sentenced to 2 years imprisonment, suspended for 4 years and ordered to pay €732 in costs.
Back to: Malta Blog