The Health Department has said that a file documenting the internal inquiry into an incident where an elderly patient at Karin Grech Hospital choked to death has not been lost, contrary to what was said in court yesterday.

The incident had taken place in 2012 at the rehabilitation hospital.

The department said that the file is in a secure place and the department could exhibit in court if requested to.

The inquiry sought to verify whether the patient choked to death after being incorrectly given solid food. The revelation was made by former government chief medical officer Natasha Azzopardi Muscat during the compilation of evidence against chief nurse Maria Bondin, nurse David Sant and nursing aide Carol Bonnici, who have been charged with the involuntary homicide of John Darmanin. All three are pleading not guilty.

Mr Darmanin, a 64-year-old who suffered from dementia, was found dead in the hospital toilets on 7 March, 2012. He had choked on a piece of chicken, despite instructions that he could only be given liquids and soft foods.

His widow had filed a judicial protest, holding the hospital responsible for her husband’s death through negligence.

In court yesterday, Dr Azzopardi Muscat testified that she had instructed the board of inquiry appointed to investigate the incident to keep her informed of its findings. She said that some form of records should have been held at Karin Grech Hospital, but revealed that her initial searches failed to turn up anything.

Initially, Dr Azzopardi Muscat - who is presently serving in a consultancy role within the Directorate for Health Information and Research – had said that she had no recollection of an inquiry being held over this incident. However, the prosecution’s decision to exhibit an email exchange in which she had been involved jogged her memory.

She testified that as chief medical officer, she had presented a draft policy on how to deal with unexpected deaths, explaining that she had been dissatisfied with the lack of uniformity and consistency in the way inquiries were carried out across different state healthcare entities.

“But then the government changed and hospital management changed,” she observed, confirming that the draft policy had not been implemented at the time of her departure.

Magistrate Ian Farrugia ruled that the report on the internal inquiry is to be found and exhibited by the next sitting, ordering that a copy of this decree should also be sent to the permanent secretary within the Ministry of Health.