Sweden edition

Baby girl died of massive overdose

Published: 12 Aug 09 13:32 CET | Double click on a word to get a translation
Online: http://www.thelocal.se/21266/20090812/

The baby which died in an alleged mercy killing at Astrid Lindgren's Children's Hospital in Stockholm was given a massive overdose of pain killers, a new report by the National Board of Health and Welfare (Socialstyrelsen) has concluded.

Welfare board to investigate baby's death (7 Mar 09)
Court orders doc held over baby's death (6 Mar 09)

Suspicions against the paediatrician who is currently under investigation on suspicion of manslaughter have thus been strengthened.

According to medical journal Dagens Medicin, the welfare board has established that the baby, who had sustained serious brain damage in a prior hospital visit, was administered the anaesthetic Pentothal before she died on September 20th 2008.

The board's scientific advisory committee are in agreement that the newborn baby girl was given a very high dose of Pentothal, which is a barbiturate general anaesthetic.

The committee at the same time rejects criticism directed at the Swedish National Board of Forensic Medicine (Rättsmedecinalverket - RMV) and find it unlikely that any fault lies there.

The welfare board is expected to issue a final report on the incident in the middle of September.

The doctor was remanded into custody on March 6th after having been arrested at her place of work on suspicion of manslaughter.

The doctor was released from custody after a successful appeal from her lawyer, Björn Hurtig, and denies any wrongdoing.

The chief prosecutor Peter Claeson told the news agency TT recently that a decision on whether to press charges in the case will be made at the end of August at the earliest.

Manslaughter carries a penalty of between six and ten years in prison in Sweden.

TT/The Local (news@thelocal.se/08 656 6518)

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The comments below have not been moderated in advance and are not produced by The Local unless clearly stated. Readers are responsible for the content of their own comments. Comments that breach our terms and conditions will be removed.

17:36 August 12, 2009 by workforthesoup

Terrible if true! Gross negligence! Very depressing.

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17:53 August 12, 2009 by Puffin

What do you mean? I don't fully understand why they are even prosecuting this

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19:56 August 12, 2009 by AR Studio

I agree, also I don't like the writing:

massive overdose: why massive? massive is a undefinable word. Overdose would suffice, lethal amount would be exceptable. Why mention it in the title if you mention later that is was an apparent mercy killing, but then stress the point that there was wrong doing in administering the "massive" overdose and not the actual act of "mercy killing". If it was a mercy killing than how do you suggest one perform it, and also why not give us a little more information regards the environment of the apparent mercy killing...

It appears very confusing language designed to dramatize.

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20:03 August 12, 2009 by Puffin

The language of this article is very emotive - but makes little mention of the context.

The baby recieved the "overdose" in conjuction with being removed from a respirator to be allowed to die that day as she had no chance of survival with devstatting brain damage.

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20:15 August 12, 2009 by AR Studio

So someone gave the baby a lethal amount of painkillers, before they knew the baby was going to be taken off the respirator. Is this what they are trying to insinuate? Even more confused...

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20:29 August 12, 2009 by Puffin

No

People taken off respirators are given painkillers/sedatives to ease the stress of dying by suffocation - the baby girl was due to be given this

The allegation is that instead of waiting for nature to take its course - the doctor gave an overdose of sedative so that the baby died a little before she would have done by natural causes - to the prosecutors are calling this slight hastening of death as a mercy killing

It's a very strange case

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20:44 August 12, 2009 by tapaninyc

Ar Studio, the 'massive overdose' is consistent with the reporting in all Swedish media. I have not seen the report but it is fair to presume that this is the language on the report.

I find the commentators much more confused than the article. 'Why would you prosecute?' Because when someone is administered a deadly dose of sedatives there should be a process to make sure that it is legal.

In Sweden the consensus is that whatever a MD does must be right, the people have a blind trust on the presumed medical ethics. My experience is that of all the countries where I have lived, Sweden is the only one where I would not trust a MD. I have learned it the hard way.

I was pleasantly surprised to find that a MD in Sweden can be prosecuted, now remains to be seen if ever a Swedish MD can actually be sentenced.

Here is the most appalling example of the things a Swedish doctor DOES get away with http://sismicro.wordpress.com/2009/06/16/a-swedish-rapist-doc-goes-free/

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21:31 August 12, 2009 by peropaco

Guys, dont be so hard of the editorial staff of the local. Is like asking a blind person why they are not able to see.

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00:03 August 13, 2009 by NJGirl

Is "mercy killing" legal in Sweden?

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#10

03:39 August 13, 2009 by tapaninyc

No, Euthanasia is not legal in Sweden, even as some of the comments on this board give the impression that it is.

A common Swedish problem is that presumed consensus is above the law, and medical professionals are often both judge and executor of that consensus. If a MD does something, s/he must have a good reason which is not to be questioned

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#11

04:24 August 13, 2009 by Hedley

I really do not know what happened. "Massive dose" looks like "an overwhelming high dosage" I really do not know how. However, as a MD I should know how much is high or what painkiller was used (being a pediatrician he should know that). I think it is right to be prosecuted for an involuntary homicide that should have a lower penalty (it happens in my country, Panama I think it must be the same in Sweden) that the voluntary one!

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#12

05:01 August 13, 2009 by Marley420

I remember when this story first broke and Kalla Faktum did a piece on this.

In this case, I do think the Doctor is innocent. However, I also believe, that the cause of the infants brain damage has been overlook.

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#13

09:28 August 13, 2009 by Puffin

According to the articles in the Swedish press - the 2 expert doctors investingation the case for Socialstyrelsen are not fully in agreement at the moment:

- the statement about a "massive dose" is the statement of just one doctor

- the other doctor is still wanting more information - for example he doesn't understand why only 3ml of blood was analysed - the whole "massive overdose" theory is based on this very tiny sample

This appears to be going to end up in court as a battle of the experts - some of the experts that the defence has hired say that the results are unreliable because:

- they are not based on research relating to babies but adults

- they do not take account of the fact that the baby had liver failure at the time of death which may lead to a different pattern of metabolisation of medication

- they have not taken the extent of the catestrphic brain damage into account.

One thing that this focussing on the final hours when she was taken off life support is doing is that it has totally obscured the details around who REALLY killed this baby - the staff at the other hospital that administered the incorrect dosage of drugs that cause the devasting brain damage which put the baby on life support in the first place

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#14

20:40 August 13, 2009 by tapaninyc

Hedley, that is exactly what the court is going to have to determine. Was there an intent to kill (in which case involuntary manslaughter is not an option), or was it a matter of relieving the pain of a terminally ill patient (in which case an accidental ODing may or may not have taken place.)

I think people are absolutely ridiculous coming up with sentiments about quilt and innocence based on reporting on various tabloids and chitchatting around the watercoolers.

Also, our criminal justice system requires that the issues of initial cause of brain injury and the OD of sedatives must be kept separate

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#15

21:44 August 13, 2009 by NJGirl

I understand a decision to take the baby off the respirator if indeed the baby was so brain injured that could not survive without the ventilatory support. Giving this baby high dose of barbiturates to "ease off" death is considered eutanasia and since apparently it is illegal in Sweden, the doctor in question should have criminal charges brought against him/her.

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#16

11:18 August 14, 2009 by lensart

Hmm... This is another example of dogma.

The act of turning off a respirator upon which the patient depends to sustain life is not murder, but injecting them with drugs is? Why would the second action be any different from the first?

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#17

02:34 August 15, 2009 by tapaninyc

The first is to cease prolonging life by artificial means, the second is actively taking a life that that otherwise would go on.

Is dogma another one buzzword ppl are using w/o understanding what it means? I have been seeing it a lot lately in strangest of contexts.

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