By Niall McCracken
A CONTROVERSIAL hospital death case that sparked a lengthy court battle has been reopened following a decision by the Attorney General to order an inquest.
A post-mortem examination found liver cancer caused the death of 66-year-old Brian Magill in December 1999, however his wife Bernie claimed the cause was a perforated bile duct that led to blood poisoning.
In 2010 a High Court ruling cleared three Belfast hospitals and senior medical professionals of any negligence surrounding the death of the retired bank manager from Belfast. A coroner subsequently decided not to hold an inquest as a result of what he described as “the thorough judgment”.
But now The Detail can reveal that Attorney General John Larkin QC has reviewed the case at the request of Bernie Magill and concluded that “inconsistencies in Mr Magill’s care have not been resolved".
In a letter to Mrs Magill, Mr Larkin wrote: “My view is that various public safety issues surrounding the medical and nursing care of Mr Magill have been highlighted and a coroner’s court would be the best forum in which this ought to be considered.”
While the prior civil legal action dealt with allegations levelled against medical staff and cleared them of improper care or negligence, Mr Larkin said there was still an opportunity for lessons to be learned of “a public safety perspective for the future”.
Speaking to The Detail Mr Magill’s wife Bernie said: “I would like to thank the Attorney General and I’m deeply grateful. I hope the inquest can be held speedily and all parties concerned can achieve closure.”
Mr Larkin is the chief legal adviser to the Northern Ireland Executive.
He has ordered inquests into a series of controversial hospital deaths and is currently seeking greater powers to investigate such cases.“PUBLIC SAFETY ISSUES”
In December 1999 Brian Magill died in Belfast City Hospital. He had been transferred there from the Royal Victoria Hospital after first being admitted to the Ulster Independent Clinic.
A post-mortem report attributed his death to liver cancer. But his widow Bernie Magill believed her husband died of blood poisoning, claiming a bile duct was perforated.
In September 2010 Mrs Magill lost a medical negligence case she took against the doctors who treated her husband in the weeks before his death.
The ruling cleared all hospitals and their staff.
Before her civil case Mrs Magill had campaigned for an inquest into her husband’s death.
An inquest is designed to be an accessible and transparent way of discovering how a death has occurred.
However following her lengthy civil action the coroner decided not to hold an inquest following “the thorough judgment” arising out of the legal action.
However in a letter to Mrs Magill dated November 2014, the Attorney General said that it was advisable that a fresh inquest should now be held into the death of her late husband.
Making reference to the previous decision not to hold an inquest because of the outcome of Mrs Magill’s legal action, Mr Larkin wrote: “The focus of a civil action will generally be on what happened in the past rather than also incorporating learning points from a public safety perspective for the future.
“My view is that various public safety issues surrounding the medical and nursing care of Mr Magill have been highlighted and a coroner’s court would be the best forum in which this ought to be considered.”
The Attorney General said he had based his decision on submissions made to his office by Mrs Magill which included the previous high court judgment, expert reports, witness evidence, police interviews as well as medical notes from the Royal Victoria Hospital and Belfast City Hospital.
In the letter Mr Larkin said the inquest should examine a number of issues surrounding the care of Mr Magill.
He said: “Despite the high court civil action, I feel that these inconsistencies in Mr Magill’s care have not been resolved and, overall, I feel that inquest is advisable.”
We contacted the Coroners Service about the case but a spokesperson said it “had nothing to add at this stage”.“WHAT OF THOSE WHO DIE ALONE?”
The handling of controversial hospital deaths is now being discussed at Stormont.
Doctors here have a statutory duty to report any sudden or unexplained deaths to the coroner.
The Attorney General can also direct the coroner to hold an inquest into deaths that may not have been initially reported where he considers it “advisable to do so”. This includes deaths that occur in a hospital setting.
Mr Larkin is currently arguing, however, that he needs greater powers to access confidential hospital records.
As previously reported by The Detail, the Attorney General wrote to the Assembly’s Justice Committee in March 2014 alerting members to a weakness in legislation that meant his office had no power to secure access to health trusts’ confidential documents.
The Attorney General can direct the coroner to hold an inquest into deaths where he “considers it advisable to do so”, but he stated that he lacked the necessary powers to “obtain papers or information that may be relevant to the exercise of that power”.
As a result he asked the committee to arm him with new powers to compel health trusts to disclose documents on controversial hospital deaths.
The Attorney General is currently seeking this power through an amendment to the Justice Bill which would give his office access to confidential health documents, such as Serious Adverse Incident reports.
Last year Health and Social Care Board officials told the Justice Committee that it was unable to support the Attorney General’s proposal as the power was “neither necessary nor desirable”.
In relation to the specific issue of the Attorney General obtaining access to Serious Adverse Incident Reports (SAls), the board stressed that the purpose of SAl investigations was to learn from mistakes.
However giving evidence during the latest Justice Committee meeting on Wednesday (4th February), Mr Larkin highlighted the fact that at the moment the typical type of hospital death brought to the attention of his office was of patients who had a wide family circle or friends raising concerns on their behalf.
The Attorney General raised the issue of people who “die alone, are friendless and without blood relatives.”
He said: “Right now the person who lives alone, dies alone in circumstances that if they were known would objectively attract our concern, there is no safeguard with respect to such a person now.
“At least the amendment would provide some measure of additional protection over and above what exists at present.”
Mr Larkin added: “This is really about a second set of eyes. And obviously with the best will in the world and health care systems working as best as they possibly can, errors are made and cases, including significant cases, slip between cracks.
“This is a provision which is designed to ensure, as far as possible, that there is a protection against that.”
John Larkin’s latest evidence came after the former Chief Medical Officer of England, Professor Sir Liam Donaldson published a review into Northern Ireland’s health service.
Among the findings was a conclusion that there was “substantial room for improvement” to the system of how hospital deaths are reported to the coroner here.
In his response to the report the Health Minister said his department was in the process of introducing a regional morbidity and mortality review system that would act as a safeguard for reporting appropriate deaths to the coroner.
The Detail has previously investigated how controversial hospitals deaths are being reported to the coroner. Please click here for further reports.