Retired Andorra Doctor on Trial for Negligent Care Causing Elderly Woman's Rib Fractures

A retired doctor overseeing medical care at Salita care home in Escaldes-Engordany faces trial at Andorra's Tribunal de Corts for minor bodily harm due to serious professional negligence. The proceedings, which began eight years after the events, centre on an 81-year-old woman who suffered multiple falls during a 15-day stay under the government’s Respir programme starting 2 May 2018, culminating in six fractured ribs and a pleural effusion discovered after her discharge.

The patient’s three children described her as unusually drowsy, disoriented and in pain during her stay, attributing the incidents to neglect and inappropriate medication that deviated from her prescribed regimen. They noted she had no history of falls at home and supplied all necessary drugs and documentation upon admission, including bed rails following a previous mishap. One daughter expressed disbelief at the oversight, insisting the family never refused a proposed hospital transfer. A son called the episode “terrible,” particularly for their late father.

The 68-year-old doctor, retired for three years, testified that he examined her on 10 May—eight days after admission—following her first fall from bed. He detected right-side pain near the shoulder blade, diagnosed a possible rib contusion or strain, and prescribed rest and painkillers without imaging tests or hospital referral. After further falls, he discussed transfer with a daughter but said the family opted to wait as pain appeared managed. He maintained incidents were routed through nursing and physiotherapy first, with only escalated cases reaching him, and rejected overmedication claims.

Former director Ernest Sáiz testified that Respir admissions did not follow standard circuits but new residents warranted a doctor visit within about 24 hours, though timelines varied. He confirmed a falls log existed, family complaints triggered a Health Ministry inspection leading to organisational changes and nursing coordinator replacement, and a 24-hour review protocol for at-risk patients was not followed.

Nurses from 2018 described night shifts with one nurse and an aide handling around 80 residents across floors, rendering comprehensive checks challenging. Incidents were logged in clinical records, and protocols later strengthened after inspection. The doctor described the family as “difficult,” a characterisation disputed by Sáiz and staff.

Prosecutors and family seek four months’ conditional prison and four years’ professional disqualification, to be substituted given his retirement. Civil liability started at €6,000 but private prosecution eyes €20,000-€25,000 for family impact; CASS claims €3,519.25 for pre-hospital costs. Defence seeks acquittal. Conviction would engage Salita’s liability, potentially exceeding prior €30,000 estimates.

The family later had their mother, now severely cognitively impaired and unable to testify, declared incapacitated to prevent repeats; her condition irreversibly worsened post-falls. Salita faced further complaints years later, including four under review by Social Affairs in March 2023, one police-reported over a restraint-related fall. Trial, now in its third day, scrutinises the doctor’s conduct amid exposed care protocol flaws.