A hyperbaric medicine specialist appears set to face criminal charges in Malta in connection with the death of UK-based Polish scuba diver Krzysztof Białecki in July.
The conclusions of a magisterial inquiry into the fatality have been reported by the Times of Malta, which says that the consultant could face a prison sentence of up to four years and a fine of around £10,000 if found guilty of involuntary manslaughter.
Białecki, 48, was one of two members of the Polish dive club Diving Explorers who died on 6 July. He had gone to help Dominik Dubaj, who had got into difficulties while they were diving the 65m-deep Le Polynesien wreck. Dubaj went into an uncontrolled ascent and both men ended up making rapid ascents and missed safety stops, as reported on Divernet.
Dubaj was declared dead on arrival at Mater Dei Hospital near Valletta, diagnosed as having suffered a cerebral artery gas embolism and pulmonary barotrauma as a result of the ascent.
Bialecki, reported to have been conscious and alert, had initially appeared to be making progress under treatment for decompression illness (DCI) in the hyperbaric chamber, but he later went into cardiac arrest and died at 7.10 that evening.
Inquiry findings
The judicial inquiry, led by magistrate Joe Mifsud, concluded that on the dive itself there had been no negligence on the part of organiser Diveshack Scuba School, a PADI 5* IDC and Tec Rec dive-centre in Sliema, or the other five divers in the club group, who were deemed to have taken all appropriate measures in the emergency.
However, a series of critical errors was found to have occurred at the hospital. The as-yet unnamed diving and hyperbaric medicine consultant had left the premises for a “prolonged period” in the afternoon, leaving Bialecki in the care of a junior said to be “still undergoing training and thus ill-equipped to handle complications and make key treatment decisions”.
The trainee had been instructed to maintain phone contact with the consultant and to avoid making independent major decisions.
At 6.20pm Bialecki had removed his oxygen mask and complained of increased abdominal pain and shortness of breath. The trainee had informed the consultant by phone and asked to call an anaesthetist in preparation for CPR, but the request was turned down. Białecki had suffered a cardiac arrest at 6.31pm, at which point the CPR team was alerted.
The consultant had arrived back only at 6.42pm, but Bialecki’s condition was already said to be critical by then and he died 38 minutes later.
The inquiry found that the consultant had admitted being unaware of the maximum depth at which the divers had been operating, assuming it to be no more than 50m, which could have led to errors in the treatment prescribed.
The consultant was said to have also misdiagnosed Białecki’s condition over the phone, suspecting oxygen toxicity rather than DCI.
During the initial treatment in the chamber, low-pressure valves had not been opening properly, causing Białecki to have trouble breathing. After the problem had been resolved no compensation was made for that compromised phase of treatment, resulting in a greater nitrogen load in his blood and exacerbating his condition.
The consultant had advised injecting Bialecki with the sedative Ativan, even though it came only in tablet form, and though Bialecki had been given two 1mg Ativan pills at 5.10pm the consultant had believed that none had been administered.
Critical moments
The consultant had been suspended pending the outcome of the magisterial inquiry, which concluded that his absence during critical moments and reliance on a trainee had contributed to Białecki’s death, while the diver’s treatment had been mismanaged to the point of negligence.
Bialecki’s death was said to be the first involving a fully conscious diver to have occurred at the hyperbaric unit in almost 40 years.
According to the newspaper the consultant is aged 43, holds diving-medicine degrees from South Africa and the UK and acts as a diving incident expert witness.
RISE IN DEMAND: An increase in diver treatments at the Mater Dei hyperbaric unit, as well as Malta’s other unit at Gozo General Hospital, has been reported by the Times of Malta. Mater Dei had treated 57 divers so far this year, it stated last week, already surpassing its annual average of 50. Gozo averages 30 divers a year.
Dr Stephen Muscat, former head consultant at Mater Dei, noted that “Malta is fast becoming a mecca for technical diving”, and that this was a factor in making divers more prone to accidents.
Also on Divernet: POT CONSULTANT SUSPENDED AFTER DIVER’S DEATH IN MALTA, MALTA FATALITIES WERE FROM UK’S BIGGEST POLISH DIVE-CLUB, BRITISH DIVE-PRO CAME TO THE RESCUE IN MALTA, DIVER DIES, 17 RESCUED AT WINDY MALTA SHORE-DIVE SITE
