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Two paramedics have been found guilty of failing to take “reasonable care” of a 39-year-old patient who died while they were attending to him.
John Sutherland (60) and Tom Le Sauteur (36) both denied the charge of breaching health and safety rules in the moments before the death of Frazer Irvine in March 2022.
Jurats found the pair guilty in the Royal Court yesterday following an eight-day trial.
The gallery was packed for the verdict, which left paramedics attending to support their colleagues in tears.
Sutherland and Le Sauteur were sent to a flat in Trinity on the evening of 18 March 2022 after Mr Irvine called 999 following a suspected overdose.
The two paramedics said that when they arrived the patient was sitting upright and appeared alert but was surrounded by empty beer cans.
They claimed that Mr Irvine then became aggressive, and the medics called police back-up.
After officers arrived, the patient began vomiting repeatedly and, despite help from the paramedics and police, he died.
A report showed that Mr Irvine had suffered cardiac and respiratory arrest, and that alcohol and a prescription drug were found in his system.
Criticisms levelled at the ambulance crew included that they did not assess the man’s degree of consciousness properly, that there had been unnecessary delays in the man’s care, and that they had not put him in the right position.
Advocate Frances Littler, defending Mr Le Sauteur, said there had been no “unthinking” or “uncaring” action on the paramedics’ part.
One of the main criticisms of the paramedics’ actions was the decision to not bring medical equipment into the flat with them at first.
But the advocate argued that the pair were right not to bring equipment with them, as they were not sure they were going to the right property and the patient had been uncooperative on the phone.
Mr Irvine had sworn at them and said he didn’t need their care, she said, and the paramedics “backed off”.
“They said they were there to help him. They explained what observations they wanted to make and why.”
The patient then entered a cycle of being “violent and aggressive” and then calming down, she said.
The court heard earlier in the trial that the Mr Irvine went outside, onto a balcony, where he lay down.
When the patient appeared to later lose some consciousness, the paramedics had explained that they were hesitant to rouse him as he had been aggressive earlier, and this would put him and them in danger.
They also said they had not done certain tests – like a finger prick or a blood pressure check – as these would be painful and could make the patient aggressive again.
Advocate Littler repeated Mr Le Sauteur’s words: “There was no unthinking action, no uncaring action in this case.”
There were also concerns that there were delays to treating the Mr Irvine.
But Advocate Ian Jones, defending Mr Sutherland, told the court the delays were “not unreasonable”.
A first, three-minute delay happened when police back-up arrived, when all of those attending formulated a plan together.
Another delay had occurred when the paramedics and police officers went to put on PPE, as is the service’s policy when they might come into contact with bodily fluids.
Advocate Jones added: “This happened quickly, extremely quickly.”
Another “unacceptable” delay occurred when Sutherland and one of the police officers returned inside the flat to gather evidence on possible drug use before trying to take the patient to the ambulance.
During his evidence, Sutherland admitted he would change this if he could go back and would not leave the patient.
In his closing speech yesterday, Crown Advocate Luke Sette, prosecuting, pointed to the evidence of two expert witnesses, who had told the court that “no attempt was made to clear his airways”.
He said: “Both experts agreed that Mr Sutherland and Mr Le Sauteur both failed to meet the standard required.”
Crown Advocate Sette said that it might have been obvious even to a layperson that his breathing was impaired, and that “getting them into the recovery position was important, that keeping obstructions away from their mouth was important, that keeping their hand away from their nose was important”.
“All of this to ensure that the airway was clear,” the advocate said.
One of the police officers who came as back-up spotted changes in the patient’s colour and breathing despite having less training, he argued.
“These are not technical failings: they are fundamental,” he said.
Delivering the verdict, Commissioner Sir John Saunders said both Jurats had found the case “difficult and sad”, and commended the “important” work done by the island’s paramedics and technicians.
“The Jurats have taken into account the conditions they were working in and the inexperience of the two police officers in dealing with a cardiac arrest.
“At the very least, the two defendants should have cleared the airways and ensured that at no stage his hand was obstructing the airway.
“Le Sauteur shouldn’t have need to be prompted to clear the airways by PC Wilton. He should have reacted more quickly to changes in colour and breathing, even if he could not see it.
“These changes were time critical and they demand an immediate response. They did not get it.”
They also felt the delays were unreasonable.
Sir John was sitting with Jurats Jane Ronge and Michael Entwistle.
Following the conclusion of the case, Chief Ambulance Officer Peter Gavey said: “I would like to publicly apologise to Mr Irvine’s family for what happened while he was in our care. I can only imagine how painful this has been for them.
“We have never forgotten that a man died during this incident and Frazer Irvine and his family have always been at the forefront of our minds during this case.
“Cases of this kind are extremely rare, and the public can be reassured that the States of Jersey Ambulance Service is committed to upholding the highest standards of care and patient safety.
“The service remains committed to supporting all its dedicated staff and will continue to provide specific support to any staff affected by the outcome of this prosecution.”
Sutherland and Le Sauteur have been suspended from service since 23 March 2022 and will continue to be suspended while internal investigations start following the conclusion of the trial.
Pictured top: Paramedics Tom Le Sauteur and John Sutherland outside the court. (Dave Ferguson)
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