A missing mental patient is declared dead by a judge

• Judgment: The greatest compensation in history for medical malpractice

Lorenzo Nieto Peralta has been missing since April 11, 2017, when in slippers, gown and pajamas he crossed the door of the Our Lady of Carmen Neuropsychiatric Center, in Zaragoza. No one stopped him . Nor did the security officer who, without leaving his post, warned the panel that a patient was coming out the door. It was five in the afternoon and three hours later they notified the family. The first search had not worked.

The psychiatric is on the outskirts of Zaragoza, near an industrial estate, in a slightly desolate environment. María Peña Andrés, Lorenzo's wife, remembers that it was relatives and neighbors who were looking for him during the three days following his escape. "Seeing the case of poor Blanca Fernández Ochoa I feel very discriminated against . In the disappearance of my husband, it took the Civil Guard 15 days to bring the dogs to track the area and that was after insisting a lot," she claims.

When he disappeared, Lorenzo was 58 years old. Peña Andrés and his son went to court to claim the performance of the psychiatric center and the psychiatrist. Now, the Court of First Instance number 14 of Zaragoza has proved them right, with a sentence that has surprised jurists and experts .

Step payment

The court ruling has condemned the neuropsychiatric center and the psychiatrist responsible for the patient to pay compensation of 170,000 euros to the family . The judge in the case has equated the condition of disappeared from Lorenzo to that of the deceased. The payment method is also a novelty in these cases. The condemned psychiatrist and center must pay the family, mother and son, 17,000 euros per year for 10 years . The law establishes that after that time without appearing, you can declare your death.

But what happens if Lorenzo is found before the age of ten? If it appears lifeless, the convicted party must pay the compensation only once. If, on the contrary, it appears alive at the same time, the right to compensation is suspended, but the amount charged is not returned. The judge understands that during that time the family has suffered moral damage that is entitled to compensation. Nor would a euro be returned if Lorenzo appears after ten years .

The judicial resolution has surprised as much or more than the disappearance without a trace of Lorenzo. How could anyone see a man dressed in clothes to be at home? How can the disappearance of a patient be equated with his death for the purpose of compensation?

Zaira Milan Pablo , a family lawyer, admits that there are no judicial precedents similar to this case, beyond a judgment of the Provincial Court of Alicante of 2008. In that resolution the escape of a psychiatric patient was also compensated. The conclusion of the courts is that the disappearance of the father is a tragedy for the family that "is actually of greater suffering than death itself because of the prolonged uncertainty ." The ruling occurred on September 26 and admits to the Provincial Court of Zaragoza.

Negligent Custody

Beyond the equivalence between disappearance and death, the judge admits that both the psychiatrist and the center failed to take care of the patient . Lorenzo entered the psychiatric hospital on March 31, 2017 on a voluntary basis. He had been diagnosed with persistent depressive anxiety syndrome since 1992. But he maintained a stable situation until 2004, controlled with treatment and psychotropic drugs. Since that year, an aggravation of his illness began "persistent generalized depression and accentuation of personality traits". Peña says that "one day he arrived from his vacations to his position as an official of the Ministry of Justice and did not remember anything. He had forgotten everything. He who had always been so responsible, and who was in charge of several people ... ". It started with intermittent income. The latter, motivated by his "autolytic ideation." That is, a clear risk of suicide.

In the psychiatric center did not improve, according to the sentence. Moreover, the psychiatrist who treated him, and who has been convicted, restricted the freedom that Lorenzo enjoyed within the center . It went from a free regime to one that they internally call "the bata regime." But that change of situation was only on paper. None of the controls that the patient had was modified and, more importantly, the judge was not informed that he was in involuntary detention. Here the failure centers its reproach to the performance of the doctor and the center.

The modification of the inmate's regime was made a day before it disappeared . The judge in the sentence insists that what is expected of the center was "not the cure of the psychiatric patient, but its stabilization and a legitimate expectation of patient safety, with an adequate assessment of both his clinical history and the cause of his admission ".

These expectations were not met. The psychiatric responsibility is in "the patent lack of personal and material means, to prevent the escape of patients [...] without special security measures, or surveillance cameras that recorded or were effectively controlled by someone with the ability to neutralize the enclosure doors. " Lorenzo is still looking for him .

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