Lemon juice case: BGH overrides chief physician judgment

Lemon juice case: BGH overrides chief physician judgment

Lemon juice against wound infection

The BGH overturned a judgment against a chief doctor who treated an 80-year-old patient with commercially available lemon juice to heal wounds. The patient died two weeks later of complications from a wound healing disorder.

The Federal Court of Justice (BGH) today overturned a judgment against the then chief doctor of the Sankt Antonius Klinik. The doctor had previously been convicted by the regional court for treating a wound in an 80-year-old patient with a non-sterile lemon juice and not informing the patient of this in advance of the first procedure. The woman died two weeks after the lemon juice therapy.

The BGH rejected a judgment in the so-called "lemon juice case" today. The former chief physician of the St. Antonius Clinic in Wegberg, North Rhine-Westphalia, had treated an 80-year-old patient with a surgical wound with a non-sterile lemon juice. About two weeks after the treatment, the patient died of an infection in the surgical wound. Now the trial against the doctor has to be reopened, as the top judges of the Federal Court of Justice ruled today in Karlsruhe. At the defendant's request, the judges thus overturned the judgment of the Mönchengladbach District Court. However, the state judges had not considered it proven that the older woman had died as a result of the treatment. In January 2010, the judges nevertheless sentenced the former chief physician to probation for one year and three months for bodily harm resulting in death. Whether the doctor can now expect a milder verdict in the revision is unclear, but is very likely due to the verdict of the BGH.

Patient treated with lemon juice In the specific case, an older woman was operated on the intestine. The patient's wound had become inflamed after the procedure. The doctor then treated the surgical wound on the 80-year-old patient with a lemon juice that had not been sterilized before. After two weeks, the woman died of a wound infection. At that time, the state judges could not determine whether the use of lemon juice was responsible for the patient's death. However, the accused doctor should have informed the deceased about the possible use of lemon juice before the first operation, according to the state judge at the time. Because of the wound healing disorder, there was a second medical intervention. However, the BGH judges disagreed with this legal opinion. Accordingly, the doctor was not obliged to inform the patient in advance that lemon juice would also be used in the event of complications from a wound healing disorder.

If there is a risk of further illnesses or physical damage during the intervention, the treating physician, according to the judges, only has to inform the patient in exceptional cases about further dangers and methods of possible follow-up treatment before the first operation. However, this is only the case if there is a massive risk in the aftercare, such as the loss of an organ. In the case being negotiated, however, there was no such circumstance, the judges said. The federal judges further emphasized that the risk of treatment with non-sterile lemon juice was "only a certain additional bacterial load". In this case, it is not comparable to the risk to the future lifestyle of a patient who is at risk of losing the organ through the aftercare.

According to the judicial findings to date, the former chief physician was only guilty of informing the patient about the use of lemon juice in the run-up to the second operation. The BGH judges believe that this intervention is an “untested outsider method”. Accordingly, there is only dangerous bodily harm. According to all information, the physician could not be accused of causing bodily harm resulting in death, since neither the use of the lemon juice insert nor the second operation are possible causes of death. Now the regional court in Mönchengladbach has to hear the case again. There, the judges should check whether a conviction "on another factual basis" is considered. The facts available so far are not sufficient to convince the medical practitioner of fatal injury.

Lemon juice for wound healing? During the trial before the regional court, the doctor testified that he used a commercially available lemon for the treatment and had touched it with his bare hands. The lemon was cut in half with a knife. Then he filled the lemon with a syringe. The accused then soaked the juice with a strip and then placed it on the patient's wound. An expert at the time had stated in the process that no clinical data or empirical values ​​were available to date that indicate that lemon juice is used for wound healing. Such a method is rather unusual and has not been researched. The BGH ruling has the file number AZ: 3 StR 239/10. (sb)

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