Defence and prosecution counsel summed up their cases before jurors in the ongoing manslaughter trial of surgeon Dr. Paul Taiganides Friday.

Taiganides, 62, is accused of causing the death of gunshot victim Travis Alexander Ebanks in 2024 though gross negligence by mistakenly inserting a breathing tube in his oesophagus (food pipe) rather than his trachea (windpipe).

Prosecutor Richard Matthews, KC, told the jury that the trauma surgeon’s failure to recognise that the tube was erroneously placed was a “truly exceptionally bad” breach that had deprived Ebanks of oxygen and caused his death within minutes.

Ebanks, 29, was shot in West Bay in the early hours of on 21 Jan. 2024, and was taken by ambulance to the Anthony S. Eden Hospital in George Town, where he was later pronounced dead, after being treated in the Accident and Emergency trauma room.

In his closing address to the jury, Matthews referred to vital evidence of a chest X-ray which showed the tube in the oesophagus and a distended, gas-filled stomach, which would have been caused by air, through the tube, being pumped into Ebanks’ stomach instead of into his lungs.

Despite this, a 5.36am clinical note by Taiganides stated that the x-ray showed “proper placement” of the endotracheal tube, which the defence later said referred only to the correct depth of the tube. Matthews argued that was not a “natural reading” of the clinical note, and that it conflicted with objective findings.

Witnesses, including emergency clinician Dr. Patrice Angus, had described Ebanks as being alive and communicative when he arrived at the hospital. Matthews said the defendant’s claims that Ebanks was already dead, brain dead, or beyond saving were not contemporaneously recorded and served to minimise the significance of the misplaced tube.

Experts for the Crown had told jurors during the three-week-long trial that the wrong placement of a breathing tube into the oesophagus is a “non-survivable” event without prompt correction. They had noted that capnography – in which a patient’s ventilation status is monitored in real time – is the gold standard for confirmation of respiration.

Matthews also referred jurors back to testimony early in the trial by a police constable who was present in the trauma room while Ebanks was being treated. He said the officer testified that he had heard Taiganides’ colleague Dr. Sean Teeling “saying words to the effect that the tube had gone behind where it should have gone”.

In his summation of the evidence, defence counsel Ben Tonner, KC, asked the jury of four women and three men to place themselves in Taiganides’ shoes during the chaotic emergency, dealing with a patient who had been shot twice and was in profound shock, with heavy blood loss, organ distress and dangerously low oxygen saturation.

He said nurse notes and clinician testimony described a semi‑conscious, combative patient with a “sucking chest wound”.

Tonner said key resources were absent when Taiganides arrived in the trauma room – there was no anaesthetist present, no blood supply immediately available, and no X‑ray machine, characterising the scene as “worst‑case scenario”.

The court had heard that the surgeon assisted with chest drains at the site of a bullet wound on the right side of the chest. He had also intubated the patient, a task that would usually be done by an anaesthetist. Tonner told jurors that the surgeon’s “brave” decision to step up and intubate Ebanks himself when the anaesthetist was not available had ultimately landed him in court, a situation his client could never had imagined himself in at the time he was dealing with the wounded man.

Central to the case is whether the tube was initially placed in the trachea or the oesophagus. The defence cited direct visualisation, capnography, chest rise, and a temporary rise in oxygen saturation to 90% as evidence that checks had been carried out to indicate correct placement of the breathing tube.

The defence maintained that standard checks were performed, oxygen saturation rose, and colleagues corroborated correct placement of the breathing tube. Tonner told jurors that any failure to spot problems on the small, transient X-ray image occurred as the patient deteriorated into cardiac arrest.

Tonner also urged jurors to question the testimony provided by the police constable regarding overhearing that the tube had been placed incorrectly, citing unreliable accounts, timeline errors, and claims that a vital-signs monitor was blank, despite photos showing readings. He told jurors that the police constable had also stated that Taiganides had tried to hide his identity and his name badge from the officer – an allegation, Tonner said, was contradicted by CCTV.

Tonner also argued that the case falls far short of gross negligence, stressing that Taiganides was acting under extreme pressures without full resources, and that error does not equal crime.

Forensic pathologist Dr. Natasha Richards, in her evidence, had attributed Ebanks’ loss of consciousness in the trauma room to hypoxia‑related brain injury, meaning the brain fatally swelled as a result of a lack of oxygen.

Tonner noted that defence expert witness Dr. Fred Simon, who, like prosecution experts had carried out a desktop analysis of the emergency room treatment Ebanks had received, had supported Richards’ description of brain swelling and herniation, and had noted that no one survives brain herniation. Tonner pointed out that Richards’ original post-mortem report had indicated Ebanks would have died regardless of any intubation error, but in a revised report said tube misplacement contributed to his death.

In closing, Tonner said the Crown’s burden requires jurors to be sure Ebanks’ life would have been “significantly prolonged” with correct intubation – a threshold, he said, experts could not meet.

He argued that if the jury could not be sure the tube was mispositioned at insertion, or if it may have been correctly placed and later dislodged when medical staff rolled Ebanks over to place the X-ray machine below him, they must acquit.

The trial is scheduled to resume on Monday, 28 Sept., when Justice Cheryll Richards is expected to give the jury further directions.