The Assistance publique-Hopitaux de Paris (AP-HP) will be tried before the criminal court for involuntary manslaughter, following the death in 2018 of a 55-year-old patient, admitted to the emergency room and left for several hours without "anyone caring".
In his referral order to the criminal court, issued on Wednesday and consulted by AFP, the investigating judge states that "the AP-HP committed an error with a clear link" to the death of Micheline Myrtil.
This patient, born in Martinique in 1963, suffering from headaches and calf pain, was taken to the Lariboisiere emergency room by the firefighters on December 17, 2018 at the end of the afternoon, then received and directed to a waiting room.
Called around midnight under a false identity ("Myatil" instead of "Myrtil"), the patient never answered and was then considered to have left. She was in reality on a stretcher, "unattended" between 1:00 and 6:00 in the morning, the time at which she was found dead, without having seen a doctor.
An initial autopsy report established that the patient died of "acute respiratory failure secondary to pulmonary edema."
– Called “out and about” –
According to the investigating judge, the "gross negligence obviously lies in the fact of having taken medical care of Mrs Myrtil in the emergency department at around 7:00 p.m. and not having been concerned with the development of her condition for more than five hours."
"Before," he continued, "calling her in vain to the general public under a false identity on two occasions, without further seeking to locate her when she was necessarily on her stretcher in the corner of the short circuit where he had been positioned, with her bracelet on her wrist, and leaving her there all night, without anyone worrying about it."
According to him, "the serious negligence excluded any possibility of survival" for Mrs Myrtil, putting forward "the lethal nature of an invasive meningococcal infection in the absence of medical care."
Although the Paris prosecutor's office had initially requested a trial for involuntary manslaughter at the end of 2022, it finally requested a dismissal on July 3, considering that "the causal link between possible deficiencies in hospital care" and "the death had not been established."
– Lack of staff –
During the investigation, the AP-HP defense argued that the protocol at the time "was in accordance with professional recommendations" and that the situation that day was "exceptional, both in the number of people admitted to the emergency room and in the fact that a doctor had been exceptionally absent due to sick leave occurring at the last minute."
Neither the AP-HP nor one of its lawyers, Mario Stasi, wished to comment.
According to an expert report issued in December 2023, the patient's placement "in a 'short circuit' zone did not seem recommended given her initial condition" but "had been validated by the referring physician due to a lack of space".
After the death, Lariboisiere announced increased patient screening measures in emergency rooms. The regional health agency (ARS) also issued various recommendations, including an increase in staffing.
During the investigation, the hospital's practitioners collectively blamed a lack of staff and resources, which has been denounced for a long time.
During the hearing, the emergency doctor who should have treated Mrs Myrtil on the night of her death pointed out an emergency system overwhelmed by the influx of patients and insufficient resources and premises complicating care.
"I didn't even know this patient existed until I heard she died," he tragically admitted.
The five main AP-HP unions (CGT, SUD, FO, CFDT, CFTC) deplored "that it took this tragedy for management to finally commit to the responses to be provided to the crisis situations suffered and denounced."
The case of Micheline Myrtil had more widely fueled the chronic and still current debate on the crisis in the hospital world, even before the earthquake of the health crisis linked to the Covid-19 epidemic.
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