Two nurses have been sentenced to five years' jail for their roles in negligently preparing and administering a “deadly mixture” of a Measles, Mumps and Rubella (M.M.R.) vaccine and expired anaesthetic that caused the death of two infants in Savai’i last July. 

Acting Chief Justice of the Supreme Court Vui Clarence Nelson sentenced the nurses, Luse Emo Tauvale and Leutogi Te’o, to five years in prison for negligence causing manslaughter over the death of two one-year-olds: a boy, Lannah Samuelu, of Sasina and a girl, Lameko Siu, of Safotu Savai’i.

“Children are of the vulnerable groups in any society; it is therefore incumbent that society takes particular care when it comes to [their] treatment, health and well being," Justice Vui said in his sentencing remarks. 

“In this case the defendants completely and utterly failed."

Luse was sentenced to five years' jail for two counts of negligence causing manslaughter for her role in preparing the fatal mixture contained in the M.M.R. vaccine which was then administered to the infants.

According to police facts tendered in court, standard procedures for preparing vaccines were not followed at the Tuasivi Hospital on the morning of the incident, including a requirement that registered nurses thoroughly check the labels on the components used to mix vaccines. 

Luse mixed the M.M.R. vaccine powder with an expired anaesthetic, the Court was told.

“Unfortunately Luse, without checking the vial, mixed the powder of vaccine with what she thought was a proper [substance for dilution]," the facts state. 

"It was not."

Justice Vui found that the vial containing anaesthetic was clearly labelled but not checked. 

“That action would have avoided the tragic events that were then followed," he said. 

"[Luse] breached protocols and became grossly negligent in the discharge of her duties.”

The fatal vaccination was performed by a trainee nurse under Luse's supervision with the syringe and ampule  discarded in a rubbish bin.

But the baby's mother, soon after leaving the clinic with her infant daughter, began to notice rapid changes to her baby while waiting for a bus home. 

“Her baby’s body felt cold; her eyes could not open properly and her legs were [spasming] out; she rushed back to the Hospital for assistance and the nurses, including the defendants, tried to revive the baby but the young baby stood no chance," Justice Vui said. 

"She passed away."

Justice Vui said, at this point, applicable nursing protocols required that further vaccinations at the Hospital should have stopped following the death of a previously healthy baby. 

“It appears from the material the defendants did not recognise the possibility the problem was the vaccine," he said. 

The defendants told the Probation Office they concluded the baby was allergic to the vaccine.

"They concluded without any evidence to support their theory; a conclusion plucked out of thin air," the Acting Chief Justice said. 

The second defendant, Leutogi, concluded that the child must have been suffering from a prior illness. 

Justice Vui characterised this as a “clearly callous observation unsupported by evidence".

"If the child was sick, they should have not immunised the baby," he said.

Justice Vui said the doctor on duty at Tuasivi Hospital gave no instructions to the nurses after they reported the incident.

“Tuasivi hospital must also share the blame of what occurred,” said Justice Vui.

For Leutogi, the Acting Chief Justice said her crime related to negligence in her duties as a Nurse Manager and her role in persuading the mother of the second baby, the boy, to have the vaccine after she objected to having her child vaccinated. 

“And so Luse told her if that was case, she would need to sign a refusal to consent form; at this point Leutogi then convinced the mother to have her child vaccinated," he said. 

Police said Leutogi was warned by the other nurses not to but used the same mixture that had been administered to the first child earlier that morning and the nurse proceeded to personally administer the vaccine to the baby. 

In a mirror of the first case earlier that morning the baby’s condition rapidly deteriorated.

“Efforts to save this young baby stood no chance," Justice Vui said. 

“It took the death of the second child before the defendants to finally realise the problem laid not on the children but the supposedly safe vaccine."

Luse retraced her steps to the rubbish bin and retrieved the anaesthetic and syringes, where she noticed that the wrong bottle had been used to mix the vaccine and that it was expired. 

"Fear for consequences for her [led her to conceal] the vial and rest of the vaccine in a plastic bag and put it in her pocket; [she] said nothing to anyone about what she had discovered," Justice Vui said. 

“And she took the materials home. She kept this information until two weeks later when she disclosed the police investigators what had occurred.

“The post mortem conducted confirms the cause of death is the result of the children being injected lethal cocktail mixed by Luse with expired anaesthetic."

In addition to two counts of negligence causing manslaughter Luse was sentenced to an additional six months' jail for conspiring to defeat the course of justice by attempting to conceal the circumstances of the infants' death.. 

“You did not intend for this to happen, you [have been] a registered nurse for many years," Justice Vui said in handing down Luse's sentence. 

"I have no doubt the knowledge that your actions led to the death of two young children, is something you will carry to your grave; as will the parents."

The co-accused Leutogi pleaded guilty to one charge of negligence causing the manslaughter of the one-year-old boy from Sasina.

Justice Vui said that, given the gravity of the offence, the Court considered imposing a sentence of between 8-to-10 years' jail.

“For you, Luse, you face the more grievous charges, and I will use the lower end of eight years to start your sentencing," he said. 

But Justice Vui said the Court deducted six months from Luse's sentence for her good character and expression of remorse and further discounted her sentence by two-and-a-half years for her guilty plea.

Combining the negligence causing manslaughter and defeating the course of justice charge led to her receiving a total sentence of five-and-a-half years' in prison. 

The Acting Chief Justice noted the pair did not conduct a traditional apology to the victims; however  he noted their employers at the National Health Service conducted the ifgoa (reconciliation) and provided assistance to the dead infants' families. 

“It may be an ifgoa by the people that you work for, but that is no substitute for an ifoga from you personally,” said the Acting Chief Justice. 

For Leutogi, the Acting Chief Justice said her crime related to negligence in her managerial duties. 

“If anything you are the more senior for the two of you; you should have exercised greater care; the death of the second baby did not need to occur," the Judge said. 

"You’ve ignored the procedures and actively persuaded the second mother to have her baby immunised. 

“And, according to the Police summary of facts, you ignored the advice and warning from some of your colleagues. 

“There is however [in my view] no sufficient reason to treat you any differently; I consider your criminal culpability as on par with the co-defendant in this matter."

Leutogi was sentenced to five years in jail. 

A future coronial inquest will further examine the causes and circumstances of the infants' deaths, the Court was told.