"We are not trying to say these nurses are monsters"

Thursday 26 September 2019

After its 16th day sitting in the Royal Court, the manslaughter trial of two mental health nurses has come to an end, with a verdict now expected later this week.

All three advocates involved in the case of Rory McDermott, 31, and Naomi Prestidge, 30, gave their closing speeches yesterday, to try and convince the Jurats of their case.

Mr McDermott and Ms Prestidge are jointly accused of causing the death of 22-year-old mental health patient Lauren Ellis through gross negligence. They failed to carry out checks every 15 minutes, over a period of one hour and 42 minutes, which they had been assigned to do, and during that time, Ms Ellis took her own life.

The two nurses have admitted they were sat in the nurses station on their phones at that time. Mr McDermott had left the ward to talk to a colleague, and Ms Prestidge had her feet on the desk. 

They also falsified records to hide the fact they had not done these checks.

Pictured: Lauren Ellis had been voluntarily admitted to the Crevichon Ward at the Oberlands after she had been self harming. 

Prosecutor, Crown Advocate Chris Dunford, argued that this absolutely amounted to gross negligence. 

But to have a Guilty verdict delivered, he has to have proved five things to the Jurats: 

1. Was there a duty of care?
2. Was there a breach of that duty of care?
3. Was there reasonable foresight of the risk of death?
4. Did the breach of duty make a substantial contribution to the death?
5. Did those actions amount to something more than a major error, something grossly negligent?

Advocate Dunford said the evidence did prove all these tests to the Jurats. "[The nurses] knew full well that Lauren was a risk to herself if they left her to her own devices," he said, "Lauren didn't die at home, or outside on her own. She was in a place that should have taken reasonable steps to protect her.

"She died in a specialist section of the hospital with people that should have used their specialist skills to prevent self harm."

Advocate Dunford added that they were not trying to call the two nurses monsters, but asked how they could have done their jobs any worse on this particular night?

Pictured: Both nurses have admitted failing to check on Lauren Ellis on the night she died. Neither work for HSC anymore.

Advocate Mark Dunster, representing Mr McDermott took issue with this statement in his closing speech however. He said proving the nurses were monsters was exactly what the prosecution had to do, particularly because of how high the burden of proof is in in a manslaughter case.

Both he and Ms Prestidge's Advocate, Claire Tee, referred to a litany of errors which took place in the admittance and care of Ms Ellis as to why she had died, echoing the evidence of some of the witnesses. They argued that while their clients did was professionally reprehensible, it was not even close to grossly negligent. 

Pictured: The Prosecution need to prove beyond reasonable doubt that the nurses knew of the severe risk Ms Ellis was at when they stopped doing the checks. 

A total lack of communication was one of the points both Advocate Dunster and Tee put emphasis on. Why were their clients not properly informed of the risk Ms Ellis posed to herself? Why had no one told them she had a bandage on her arm - the bandage she tied around her neck?

They also argued that even if their clients had done the observation checks, Ms Ellis still would been at major risk. An expert pathologist said it took seven minutes maximum to die of ligaturing, so in the 15 minute windows between checks - if they had been done - she would have had time to end her life. 

Advocate Tee said if Ms Ellis was put on 1-to-1 observation, it would have been clearer to the nurses that she was a higher risk, because 15 minute observation checks were the standard.

"[Ms Prestidge's] breach of duty was not as bad as to constitute gross negligence," Advocate Tee said, "instead it was a serious error of judgement as a result of lack of communication.

"As uncomfortable as it is, it must not be forgotten that the harm Lauren came to was done by herself." 

Pictured: Expert witnesses found Lauren's death to be down to a 'Swiss cheese'-like set of errors. They also said it was nature on the ward to not pay attention to 15 minute observation checks. 

Advocate Dunster made a further point for his client, because Mr McDermott was not even on the ward for much of the time Ms Ellis' checks were not being done. 

While the Prosecution argued there was no reason for him to be up on the high dependancy unit, the Court heard that he had asked to go up there as part of a break - he was feeling tired and burnt out.

Therefore, Advocate Dunster argued he simply didn't have the same duty of care to Ms Ellis when it was likely she died, so he could not be guilty. 

"When Lauren chose to apply the ligature to herself, Rory did not owe that direct duty of care because he was away physically," he said.

"The prosecution normally say they do not want to portray these nurses as monsters, but that is what they have to do. Have they shown that beyond reasonable doubt? Not in my submission." 

Judge Russell Finch will sum up the case on Friday, and a verdict will be delivered after that. 

Pictured top: The entrance to the Oberalnds Centre.