Malia Li during her trial in the High Court at Auckland last year. The former healthcare worker was found guilty of the manslaughter of her husband Lanitola Epenisa. Photo / Michael Craig
The former healthcare worker found guilty of manslaughter after her husband was found with pressure sores and fused to a recliner chair in a room with maggots and mice, has failed in a bid to overturn her conviction.
Malia Li was convicted of manslaughter in July last year after failing to provide her husband Lanitola Epenisa with the necessaries of life following two strokes that left him immobile.
Epenisa died in October 2016 from the blood infection sepsis, after the two strokes in quick succession took away his ability to walk and speak coherently, and he developed pressure sores from being unable to move.
He was found dead by emergency staff in a squalid Māngere home, drenched in urine in a room with a maggot-ridden bag of soiled clothes and a nest of mice.
The pressure sores were deep enough to see Epenisa’s muscle and bone and were infected with faecal matter, a pathologist said.
Li, 54, was convicted of failing to provide her husband - deemed a vulnerable adult - with the appropriate medical care, hygiene, food and water between January and October 2016.
The Crown said her lack of care was “grossly negligent” and not a mild lapse or temporary moment of forgetfulness.
In September 2014, Epenisa suffered a stroke and was admitted to hospital.
Shortly after his discharge in late 2014 he suffered a second stroke and was readmitted to hospital. He was discharged for a second time in February 2015.
Epenisa’s health conditions included serious diabetes, high blood pressure and kidney failure. His condition deteriorated markedly after his second stroke, the Court of Appeal noted.
“He had to be assisted to get from the bedroom to the lounge; he had to be fed; he had to be toileted and cleaned; and he needed help to take his medications.
“Mr Epenisa was highly vulnerable. Mrs Li was Mr Epenisa’s primary caregiver throughout.”
In sentencing Li in December last year, Justice Edwin Wylie told the mother-of-two there was a “gross breach of trust” involved in her offending.
“Your neglect of your husband started well prior to his death.”
He sentenced Li to five years and seven months’ imprisonment.
Li appealed against her conviction on the ground that the jury’s verdict at trial was not reasonable in light of the evidence of plastic and reconstructive surgeon, Dr Bruce Peat, called by her defence.
Peat’s evidence was that the pressure sores around Epenisa’s buttocks became overwhelmingly infected in a short timeframe and rapidly caused his death.
In the circumstances, the defence submitted, there was nothing Li could do for her husband.
The evidence of forensic pathologist Dr Joanna Glengarry, who was called to Epenisa’s death, was that she found him in poor physical condition with relative emaciation.
His back, arms, legs and the side of his torso had multiple deep and extensive pressure ulcers. Large wounds were found on his buttocks.
The pathologist concluded that Epenisa had died from sepsis, due to the infected pressure wounds on his sacrum and buttocks.
In dismissing Li’s appeal Justices David Goddard, Timothy Brewer and Rebecca Edward considered the jury’s verdict was not unreasonable.
“Firstly, it was open to the jury to reach a guilty verdict, even if they accepted the evidence of Mr Peat that in this case the pressure sores could have appeared and caused Mr Epenisa’s death within a period as short as 10 hours.
“The Crown’s case was that Mrs Li failed to provide Mr Epenisa with necessaries and/or to take reasonable steps to protect him from injury over a period of some months, and that it was the failures over this longer timeframe that caused his death.
“Secondly, it was well open to the jury not to accept that the pressure sores had developed in as little as 10 hours in this case...
“It was open to the jury to conclude that on all the evidence they heard, they were satisfied beyond reasonable doubt that the pressure sores had developed over an appreciably longer period in the present case than Mr Peat’s minimum of 10 hours, and that Mrs Li was aware of those sores in time to take action before they became infected.”
These reasons, taken individually and together, confirm that the jury’s verdict was not unreasonable.