The Judgment dated March 4, 2025, brings an end to an extensive investigation phase that began in 2014. The case commenced with the indictment of several doctors who attended to the patient during multiple hospital visits and concluded with the opening of oral proceedings against four of them.
The Criminal Court No. 15 of Madrid has concluded a lengthy judicial process involving an alleged offense of reckless homicide, resulting in the acquittal of four doctors for the care provided to a patient in 2014. The patient had suffered a fall down the stairs of her residence and sought medical assistance on several occasions at different hospitals in Madrid. Despite receiving various treatments, she passed away almost a month and a half later due to global respiratory failure that progressed to septic shock and multiple organ failure.
The Public Prosecutor, the sole prosecuting party, argued that the failure to conduct pertinent tests and provide appropriate follow-up care led to the patient’s death. The prosecution sought a sentence of twenty months' imprisonment for each of the four defendants, accompanied by special disqualification from passive suffrage during the period of the sentence and disqualification from practicing medicine for four years. The charges were framed as an offense of reckless homicide under Articles 142.1 and 3 of the Spanish Criminal Code.
The defense for the four accused doctors argued that there was a complete lack of causal connection between the medical care provided and the patient's death, asserting a clear rupture of the causal link. Specifically, the defense of the emergency physician who initially attended the patient emphasized that her clinical presentation at the time only included generic, mild back pain and severe wrist pain. The accused doctor performed the appropriate neurological examination, conducted radiological tests, and prioritized immediate treatment for the evident and urgent wrist fractures. Following standard protocols for elderly patients after a fall, the patient was referred to the Internal Medicine department, where a CT scan showed no abnormalities. She was then discharged with follow-up appointments in the Traumatology outpatient clinic.
The Public Prosecutor contended that the pathology leading to the patient's death was already present during this initial emergency consultation and that the failure to perform adequate diagnostic tests deprived the patient of the chance to survive.
The presiding judge, after analyzing the proven facts and evaluating the evidence, concluded that "it has not been proven that the patient initially presented with traumatic subarachnoid hemorrhage, bilateral Colles fractures, closed chest trauma, global respiratory failure, or traumatic injuries at various vertebral levels."
The defense provided expert reports from specialist medical experts demonstrating that these conditions were not present during the initial assessment and that it was impossible to foresee their development. They emphasized that medical negligence assessments must not be conducted retrospectively.
The judge ultimately concluded that there was insufficient evidence to establish, beyond a reasonable doubt, that the patient's death was due to medical malpractice by the defendants. The judgment cited the Supreme Court, noting: "The demand for criminal liability from medical professionals is particularly challenging because medicine is inherently inexact, with unpredictable factors that generate serious doubts about the causative factors of harm. The freedom of the physician, which should never result in recklessness, and the scientific relativity of medical practice are elements characterizing their work."
The judgment further elaborated that professional medical negligence arises when a medical act demonstrates clear carelessness, neglect, or omission of the required standard of care, considering circumstances such as time, place, and the nature of the injury. This negligence contradicts the qualifications that grant the professional their technical competence.
The judgment also highlighted that every individual has the right to have their case resolved within a reasonable time, as established in the Convention for the Protection of Human Rights and Fundamental Freedoms. The eleven-year duration of this case resulted in unjustified delays that inflicted significant harm on the accused, who endured the so-called "bench penalty" for an extended period without any moral compensation. The protracted process, characterized by unexplained delays and unnecessary procedural steps, has left a lasting impact on the acquitted professionals, who will find it difficult to forget the uncertainty and distress endured over the years.
The case concludes with the acquittal of the four doctors, recognizing that the prolonged investigation and legal proceedings have caused irreparable damage. The judgment serves as a reminder of the importance of safeguarding the right to a timely and fair judicial process.
