Arnold P.'s three lawyers, all renowned defense lawyers, brush all questions aside. Before the trial opened on Thursday, all of them and their client remain tight-lipped about the upcoming trial, refusing to comment on any of the charges.
Arnold P., 53, is the central figure in what promises to be a months-long trial. The former director and chief physician at a clinic in Wegberg, in the northwestern German state of North Rhine-Westphalia, stands accused of killing seven of his patients. On Thursday, he will appear in the criminal chamber of the regional court in Mönchengladbach. Seven other doctors will join him in the dock for what is is one of the biggest hospital scandals in the history of the Federal Republic of Germany.
The 382-page indictment accuses Arnold P. of committing 69 cases of serious medical malpractice, 60 of which caused serious bodily harm -- including three that resulted in deaths. The former doctor is also being charged with murder by negligence in four separate cases. His patients ranged between the ages of 50 and 92. In four cases, the victims' relatives will appear in court as joint plaintiffs.
On Jan. 1, 2006, Arnold P. bought the small St. Antonius clinic -- situated a few kilometers from Mönchengladbach -- from the city of Wegberg for just €26,000 ($38,300). The clinic, with only 100 beds and a dozen doctors, had been teetering on the brink of insolvency. P. had been working there since July 2005.
Public prosecutors say that after taking over P. decided it was necessary to cut costs. As clinic owner, he reportedly slashed spending on blood supplies, expensive medications and disinfecting agents. According to investigators, patients' wounds were no longer sanitized with sterile solutions, but with freshly squeezed lemon juice.
Suffering Real Torture
P. is also accused of having performed unnecessary surgery in a number of cases, including removing parts of intestines, gall bladers and pleura from anaesthetized patients -- purely out of greed.
In one case, prosecutors allege that a 60-year old woman came to the clinic to have a polyp removed. After the first operation she suffered from a sepsis related collapse. During a second operation, part of her appendix and a stoma were removed. According to medical evidence, she then had to undergo unnecessary chemotherapy which -- in combination with the unneccesary removal of part of her intestines -- led to her death.
"She suffered terrible agony this year and died far too young," her lawyer Hiltrud Hören from Mönchengladbach told SPIEGEL ONLINE. She will be representing the family of the deceased throughout the trial.
Karlheinz Rabe, also a lawyer from Mönchengladbach, is a joint plaintiff in the case. The relatives of his clients were admitted to the hospital with gastrointestinal problems, stomach cramps and rapid heartbeat or chest pains. They were all dead within a few weeks. One patient checked into the clinic on April 24, 2006 and died less than two weeks later.
Patients That Could have Been Saved
Investigators have also found evidence in the case they claim shows that the accused also claimed to have professional competence and expert knowledge in areas he did not. In seven cases, this led him to make errors that resulted in the patient's death. Under appropriate care, the patients could likely have been saved.
P.'s case is further hindered by many experts who have confirmed that the death rate in the 53-year-old's clinic was "extremely suspicious." He is also accused of continuing to practice medicine after his medical license was revoked.
Prosecutors are charging him with battery leading to death in three separate cased, grievous bodily harm in one case, aggravated battery in 24 cases, simple battery in 31 cases, battery by negligence in five cases and murder by negligence in four cases. In addition, he is being charged with denial of necessary medical assistance in one case.
The co-defendants, who worked alongside P., stand accused of being involved in their boss' deeds. Proceedings against two further doctors were dropped after they paid fines. "As far as I know this is the largest criminal procedure which has ever taken place against doctors," Rabe told SPIGEL ONLINE.
Arnold P. Believes He is Victim of Conspiracy
The investigations began when somebody registered an anonymous official complaint about Arnold P. in December 2006. Prosecutors soon confiscated patient records and searched P.'s house.
Chief Justice Lothar Beckers and his four fellow justices are preparing themselves for a long and complicated trial. The prosecutors alone have called upon 106 witnesses and six medical expert witnesses. According to the court, the defendants have announced that they will be presenting counter-expertise. Frankfurt-based lawyer Egon Geis, who in the past defended Helg Sgarbi -- accused of blackmailing and defrauding BMW heiress Susanne Klatten -- intends to work with well-known Berlin-based medical attorney Rolf-Werner Bock to rebut the charges.
For his part, Arnold P., who was jailed for half a year in 2008, sees himself as the victim of a conspiracy. He apparently still drives to his private clinic every day, where he is still described as the head physician.