Polish Paramedics Jailed for Murdering Patients Ed Holt The Lancet One of the longest, most macabre cases in Polish legal history came to a close last month. Two Polish paramedics who murdered patients and then sold their victims to local undertakers were finally sentenced to prison 5 years after local media discovered the scandal. Ed Holt reports. Last month, a court in Poland sentenced Andrzej Nowocien to spend the rest of his life in prison, and Karol Banas to 25 years in jail, for murdering patients while they worked at Lodz Hospital's emergency ward between 2000 and 2001. Two other men were also jailed. Janusz Kuklinski was sentenced to 6 years for knowingly failing to protect the lives of ten patients, and Pawel Wasilewski was given a 5-year sentence after being convicted of the same charge. All four have also been charged with taking money from undertakers in exchange for information about new deaths. Prosecutors are still trying to establish the roles played by dozens of other doctors and paramedics in what the judge at the trial, Jaroslaw Papis, called an "organised crime network" and a form of "uncontrolled madness". Only a handful of victims have been identified but there are thought to have been many more. After his arrest, Nowocien, for example, boasted to his prison cell mates that he should be given a medal by the national health system in view of the number of old people he had taken off its hands. The case was one of the longest in Polish legal history and began in early 2002 when local media first uncovered the scandal. Arrests soon followed but the large numbers of witnesses and the scale of the investigation meant that it was not until the beginning of this year that sentencing was reached. The court had earlier heard how allegedly more than 40 paramedics, doctors, nurses, and undertakers had conspired to ship seriously ill elderly patients straight to funeral parlours rather than hospitals, as a way to make quick cash in a grisly scheme that investigators have said could have been going on for almost 20 years. The group in Lodz, central Poland, which reportedly got larger every year as more medical staff were roped in, cashed in on the fact that many families, in the face of death, are often incapable of making decisions about practicalities such as choosing the funeral home. Instead doctors and other medical staff working at Lodz Hospital's emergency ward would recommend to the victims' relatives a certain home with which under-the-table deals had already been arranged. Undertakers would pay up to GB£300 pounds for notification of a new corpse, nicknamed a "skin". And when they wanted to speed up the deaths the paramedics would inject them with a drug to kill them. At the trial, the court heard how ambulance drivers, with the full knowledge and co-operation of some doctors, would inject ill patients with large doses of the muscle relaxant pancuronium to kill them and would wander around outside the emergency department smoking or stop off to buy hamburgers as patients lay dying inside ambulances. During the trial Nowocien, who was later described by the judge as "an agent of darkness", said: "On one occasion we were to transport a severely ill patient from Lodz to a nearby hospital in Glowno. The driver was going off duty in half an hour so we went to the emergency department and while I waited for the new driver to get ready for his shift I smoked some cigarettes. All this time the woman was lying for half an hour in a locked ambulance. When we finally set off we figured there was little sense in travelling all the way to Glowno because the patient was about to die any minute anyway. So we headed straight for the undertakers instead, knowing the problem would solve itself on the way. We passed on the woman's corpse direct to the funeral home." The Health Ministry has not commented directly on the sentence but state officials have suggested low pay for government-employed medical workers could have been the motivation for the macabre scheme. Corruption in the Polish health sector is perceived to be rife and surveys by groups such as the international corruption watchdog Transparency International repeatedly highlight high levels of perceived corruption in local health care. Anecdotal evidence from ordinary Poles has also suggested that many have either given, or been in, a situation where they have felt expected to give a bribe of some sort to a doctor or medical health worker in return for good treatment. Wages for medical staff in Poland can be as low as GB£300 pounds per month-a wage locals say is barely enough to provide for one person, let alone someone with a family.